In the very beginning of the rheumatoid arthritis saga in the summer of 2012, my partner and I were trying to figure out what to do. We were hedging our bets by kind of doing it all–seeing a rheumatologist AND a functional medicine MD, but I knew we were eventually going to come to a point where a choice had to be made. Namely, which path would we take. Aside from the obvious distinctions traditional medicine (pharmaceuticals) vs. functional medicine (whole body and supplements), the cost of each venture was nothing to discount.
On one hand, insurance will cover the great portion of my traditional MD (rheumatology) visits, the prescribed medications, and lab work. Their offices are generally set up to bill your insurance carrier and handle all of the paperwork.
On the other hand, insurance is typically not-so-willing to pay for functional medicine. The functional med offices will provide you with paperwork, but you must file it with your insurance carrier on your own. If you are disabled and on Medicare, submitting the claim generally results in denial. Functional Medicine is not yet accepted in the mainstream of healthcare. Most of the supplements are available on amazon.com and most vitamin stores, so they are not directly reimbursable. You may take them off of your taxes as an itemized tax deduction, however. Any lab work is generally covered by your insurance carrier in the same manner as always. The prescription-only items are, obviously, dealt with as any other Rx would be by your insurance carrier.
Functional medicine takes time. Realizing the full benefits of paleo also takes time. Our society of instant gratification and the quick fix does not lend itself to this type of medicine. We want to take the “purple pill” for our stomach and then eat the spicy food that usually gives us heartburn. We want the chip that’s cooked in oil that prevents the proper absorption of fat. Hey, it causes anal leakage, but it’s game night. Who does sports without chips and dip? In short, we want it all. This is also part of the consideration of which path to follow. People who go to functional medicine docs are typically desperate. We are the patients who are at the end of our proverbial rope, tired of taking drug after drug with no relief, and who traditional MDs don’t know what to do with. Some of us don’t care if we ever eat another cupcake. We just dream of a life without pain and to be able to function again. We’d do anything.
I have to admit that since the rheumatologist wanted to put me on methotrexate, and I was well aware of what that was and what the side effects were, I was already leaning away from traditional medicine. I wonder if the decision would have been so straightforward if he had wanted me to go on something I didn’t know and believe to be so noxious. Not that I would have blindly followed advice without researching what he prescribed, of course, but what if I found the recommendation to not be so abhorrent? I’d like to believe that all the information on paleo and leaky gut would have tipped the scales to functional medicine, but it is possible that It would have taken longer than it did, thereby, prolonging the pain and the saga.
We are very lucky to have the funds to follow whichever path we felt best. I do realize that this is not the case for everyone.
My doc continually asks if she’s giving me too many supplements and letting me know which ones are most important. They realize they are not YET mainstream and that insurance can be tricky. They’re human; they’ll work with you. Functional medicine takes a certain amount of out-of-pocket funds. This is true, but you’ve got to ask yourself how much your health is worth, as well.
I have a friend with RA who is taking the traditional medicine route. She says she can’t NOT eat pasta, and traditional medicine is just “easier” (no cleaning out a house of foodstuffs you can’t eat, no cooking all of the time, no changing the diet, no supplements etc.) and covered by insurance or cheaper. I am sorry to say that the list of pharmaceuticals she takes keeps expanding. Worse, she is still in pain. Her insurance is covering her rheumatology visits, drugs, and lab work, but she continues to worsen. Her job is suffering , and she wonders how long she can continue working and contributing to the household income.
It’s a very personal decision. It is not easy, and there is a lot to consider. I do not judge. It just saddens me to see the suffering.
PS Please keep in mind that I am speaking of my personal experience. YOUR insurance carrier and YOUR healthcare offices may behave in a different fashion.