4 Things Functional Medicine Providers Should Stop Doing

Author: Jeffrey Wacks, MD

Functional medicine has made incredible strides in reshaping how healthcare is delivered. Its emphasis on root-cause resolution, personalized care, and patient empowerment sets it apart from conventional approaches. However, as the field grows, certain practices threaten to undermine its credibility and effectiveness. Here are four things functional medicine providers should stop doing to better serve their patients and the broader medical community.

1. Overemphasizing Diagnostic Testing and Treatment of Heavy Metal Toxicity

Heavy metal toxicity is a legitimate concern from a public health perspective. While a certain amount of heavy metals are found naturally in the soil and therefore the food supply, industrial processes and improper waste disposal can significantly increase the concentration of these metals in the environment. In this sense, heavy metals are one aspect of a legitimate public health problem: our environment and specifically our food supply is contaminated with too much toxic chemicals that create oxidative stress and inflammation, which damage our health in a variety of ways.

That being said, the science behind clinical assessment and potential intervention of heavy metal toxicity in individual patients is not currently at the level it needs to be for it to be included in routine Functional Medicine practice. We see many Functional Medicine providers rely heavily on provoked urine tests, which can produce misleadingly high results, suggesting toxicity where none exists. This approach can lead to unnecessary chelation therapies, which are not without risks, including nutrient depletion and kidney stress. Even if one does have elevated levels of heavy metals in the body, there is no evidence that routine heavy metal detoxification strategies significantly improve any markers of metabolic function or any other meaningful patient-oriented outcomes.

By shifting away from indiscriminate heavy metal testing and treatment, providers can focus their energy on addressing more common and impactful root causes of illness.

2. Promoting "Detoxes" Without Evidence

"Detox" programs have become a marketing buzzword, often promising unrealistic benefits. From juice cleanses to expensive supplement protocols, these interventions are frequently based on shaky science. The body already has sophisticated detoxification systems—the liver, kidneys, and lymphatic system—that work tirelessly to eliminate toxins. 

Instead, providers should be educating patients on supporting their natural detox pathways through nutritional optimization, regular physical activity, antioxidant support, and optimization of the gut-liver axis via evidence-based practices.

In our opinion, the Functional Medicine community should refrain from promoting extreme or overly restrictive "detox" programs that can do more harm than good, especially for vulnerable populations. By prioritizing sustainable lifestyle changes, functional medicine practitioners can empower patients to enhance their health without falling into pseudoscientific trends.

3. Ignoring Basic Nutrition in Favor of Niche Interventions

It can be tempting to focus on advanced protocols and cutting-edge supplements, but this often comes at the expense of foundational nutrition. Patients who consume highly processed diets or lack basic nutrients will not benefit from exotic treatments if their primary dietary patterns remain poor.

For example, consider a middle-aged patient who presents to a Functional Medicine provider with fatigue. Imagine that patient gets a large battery of testing, including advanced diagnostics such as organic acid testing, comprehensive stool analysis, food sensitivity testing, etc. But consider that in retrospect, if the provider had done a nutritional analysis at the first appointment, they would have discovered that the average caloric intake of the patient was 1000 kcal/day. If chronic caloric restriction is the root cause of the patients fatigue, then all the other diagnostics were unnecessary and made the case needlessly complex. 

In-depth nutrition analysis of caloric intake, macronutrient ratios, nutritional quality, etc. must be a foundational aspect of Functional Medicine practice. Providers that skip or de-emphasize this step actually discredit the mission: to identify and treat the root cause of chronic disease and symptomatology. 

4. Making Money on Supplements and Diagnostic Testing

We will get some pushback on this one, but in our opinion, it is at worst illegal and at best unethical to make a substantial profit on supplements and diagnostic testing. Providers should review with their legal counsel the relevance of Stark/Anti-kickback statues in this context. But irrespective of that, it is simply unethical to make money off diagnostics/interventions that a provider recommends because it presents a conflict of interest. When we recommend a supplement to a patient, we want everyone to be clear that we are recommending it because and only because we feel that it would benefit the health of the patient and that it has reasonable scientific evidence behind it.

That being said, we understand why providers do this. Making money on supplements and diagnostics might allow the practice to decrease the service price, which might attract more clients. We get it. However, it is our opinion that as a community we should stop doing this because it erodes the credibility and trust of the Functional Medicine movement and detracts from the mission. 

Conclusion

Functional medicine providers have the unique opportunity to transform healthcare, but this requires constant reflection and adherence to evidence-based practices. By steering clear of overdiagnosed conditions like heavy metal toxicity, abandoning unsupported "detox" protocols, focusing on nutritional foundations, and ensuring financial transparency, practitioners can elevate the standard of care. These shifts will not only improve patient outcomes but also solidify functional medicine's place as a respected and effective approach to health and healing.