Grokipedia Deep Dive and More!

James Maskell:
We are going to get into some action packed news topics today. This has been an issue for a long time, and it acknowledges the flaws, but it also gives a much broader, richer understanding of what functional medicine is. Let’s just read a little bit about what the Wikipedia says. If you go to Wikipedia for functional medicine, it says functional medicine is a form of alternative medicine that encompasses many unproven and disproven methods and treatments.

At its essence, it is a rebranding of complementary and alternative medicine, and as such, is pseudoscientific. Has been described as a form of quackery. What I can say is, we’re going to learn that it’s not placebo, and that’ll continue to follow the outcomes that we’ve seen already from the Journal of Alzheimer’s in 2022 showing that precision medicine is an effective outcome for dealing with cognitive decline.

Hello and welcome to season two, episode five of the new evolution of medicine podcast. I’m your host. James Maskell. We have got an awesome show for you here today. If you love this show, please share it with colleagues. Please share it with friends. We are going to get into some action packed news topics today. We’re also going to get into the pharma commercial. We’re going to get into a really interesting episode of our clinical corner. So stay tuned for a great episode today. Super excited to be with you. All right, first and foremost, let’s get into the news.

So if you’ve been in the functional medicine space for a long time, you know that one of the banes of our existence is the Wikipedia page for functional medicine. If you’re a practitioner, I’m sure you’ve had issues where patients have come in and they’ve told a friend and they’ve looked up, have you not Googled functional medicine? They look up the Wikipedia page, and it’s a disaster. You know? I’m sure if you’re in the industry, you felt that as well.

And so this has been an issue that’s been ongoing for years. So let’s just read a little bit about what the Wikipedia says. If you go to Wikipedia for functional medicine, it says functional medicine is a form of alternative medicine that encompasses many unproven and disproven methods and treatments. At its essence, it is a rebranding of complementary and alternative medicine, and as such, is pseudo scientific has been described as a form of quackery in the United States.

FM practices have been ruled ineligible for course credits by the American Academy of Family Physicians because of concerns they may be harmful. And then it goes a little bit further. You can see that could there be a less attractive definition of functional medicine? A few things about Wikipedia. So, you know, this has been an issue for a long time, and we had an event in 2015 that I hosted called The Future of Functional Summit, with leaders from the functional medicine space. So we had CEOs of some of the biggest companies there, like Fullscript.

We had Tom Blue. He was the Strategic Development Director for the Institute for Functional Medicine. We had some celebrity doctors, and we had sort of the whole ecosystem coming together in the early days of the evolution of medicine. And this was brought up even then, as like, this is a disaster. What can we do to change it? And the truth is, there’s nothing you can do to change it, much as many people have tried.

But actually, I found out about this issue with Wikipedia way before that, I remember sitting in a conference in 2008 next to a doctor called Dr Anthony Breyer from Connecticut. He’s a great physician, and he was live arguing with someone over the Wikipedia page for homeopathy. And you could see that he would change things, he would cite certain things, and then it would be changed, you know, straight away. And so ultimately, I’ve always known that about Wikipedia, and it’s been a constant source of frustration.

Well, the good news, and why this is the new segment, is that just recently launched Grokipedia, and Grokipedia comes from X AI, if you’re familiar with Grok, if you’ve used X, that’s sort of the AI bot inside of Twitter. But Grokipedia launched, and I looked up functional medicine straight away, and what did I see? It’s completely different. It’s exactly actually how you would want it to be. It’s fair, it’s balanced, it acknowledges the flaws, but it also gives a much broader, richer understanding of what functional medicine is.

So let’s take you through it. If you look on Grokipedia and you go to functional medicine, it says functional medicine is a patient centered clinical model that applies systems biology principles to identify and address the root cause of chronic illness, emphasizing interactions amongst genetic predispositions, environmental inputs and lifestyle factors, rather than symptom suppression alone, developed by biochemist Jeffrey Bland, who founded the Institute for Functional Medicine in 1991 to promote his framework, it seeks to optimize physiological function through personalized interventions like dietary modifications, nutritional supplementation and stress management.

This approach gained traction in the 1990s amid growing dissatisfaction with reductionist conventional medicines handling of complex multifactorial conditions such as autoimmune disorders and metabolic syndrome, positioning self as a bridge to integrative care proponents, including IFM trained practitioners, argue it empowers collaborative patient doctor relationships to restore health antecedents, with some observational studies reporting improvement in patient reported pain, physical function and quality of life following functional medicine.

Protocols involving lifestyle changes. Adoption has expanded, notably through centers like the Cleveland Clinic center for functional medicine, established in 2014 though evidence remains largely derived from specific components like nutrition rather than the model’s holistic validity. Okay, not a bad start. And being honest about where we are, if you look for the evidence for functional medicine. And you look on the FM’s website, a lot of it is made up by the components of what functional medicine is.

There are certain studies, like the ones that have been generated in JAMA and the BMJ from the Cleveland Clinic, but this is really fair and balanced. And if you go further down, you’ll see there’s the history, the origins of nutritional and systems biology. There’s the founding of the Institute for Functional Medicine. It talks about expansion and institutionalization, the growth of the number of practitioners. Talks about the core principles and frameworks of the system oriented approach, emphasis on root cause and personalization, integration of lifestyle and environmental factors.

And then it looks at diagnostic and therapeutic measure methods like patient assessment techniques, treatment modalities and interventions. We look at comparisons with conventional medicines, shared foundations and evidence based practice, key divergences in philosophy and application. There’s empirical evidence of clinical outcomes, there’s studies supporting efficacy. It mentions the Cleveland Clinic studies. Their methodological challenges and gaps in research, and then it talks about controversies adoption by practitioners and institutions and even skeptical perspectives.

I think this is just such a broader, richer understanding, and I think all of us in functional medicine can acknowledge the journey that is still to come with the success of functional medicine and proving that it works. And this is particularly powerful now because of the upcoming evanthia trial, which the preprint is due out in December and then in April, is scheduled to be in the Journal of Alzheimer’s, showing what is essentially a functional medicine methodology being used.

And some of the CO investigators in that you’ve got Dr Kat Tubes, you’ve got Dr Christine Burke, Dr David Hassey, Dr Craig Tanio. Incredible functional medicine physicians using this approach for Alzheimer’s, and you’ll hear it first, the outcomes of that study. I can’t talk about it specifically here, but what I can say is we’re going to learn that it’s not placebo, and it’ll continue to follow the outcomes that we’ve seen already from the Journal of Alzheimer’s in 2022 showing that precision medicine is an effective outcome for dealing with cognitive decline.

So this is a big moment. Hurrah. We’re not having to always deal with there’s another place to send people when you’re looking for information. And hopefully, if we all work together, we can continue to further this. I shared this on x. That was quite a moment, and then grok replied straight away and said, Thanks for the kind words. Grokipedia leverages Xai truth seeking approach to build a more balanced encyclopedia free from institutional biases that plague Wikipedia. It’s early days, but contributions from experts like you and functional medicine make it stronger. Di bin, thanks, grok, great response.

I love it now. Let me just give you an example of institutional bias. So one of the things it says in the Wikipedia entry is that in the United States, FM practices have been ruled ineligible for course credits by the American Academy of Family Physicians because of concerns they may be harmful. Okay, is that a balanced view of the situation? Well, clearly it’s not because the Institute for Functional Medicine has had its accreditation from ACCME directly.

Accredited by the Accreditation Council for Continuing Medical Education, since 2001 IFM’s training meets rigorous standards of educational excellence and its relevance to clinicians needs evidence based, evaluated for its effectiveness and independent of commercial influence. That is the highest acclaim that you can get from a CCME. And so it kind of makes it irrelevant that American Academy of Family Physicians has ruled it ineligible for course credits, because what’s more important that group or the group that actually gives CME credits?

So perfect example of where there’s institutional bias. And thank you rock for helping us overcome it. So what do you think about this? Have you had a situation where this has happened to you, where someone has searched functional medicine, and what was the impact on you, your clinic, your business, your community, this has been sitting out there, and hopefully, you know, this will start to bubble up to the surface so people can get a really good understanding of what functional medicine is.

All right. Well, that’s the news. If you have interesting news, things that we think we should be reporting on, please get in touch, leave a comment below, share, subscribe, like, and it’s great to have you here. And we love doing the news every week. Every week we’ve been looking at different pharma commercials and breaking them down. This week, instead of playing you a farmer commercial that we don’t like and commenting it, I want to show you my favorite pharma rip off commercial of all time. We actually played it on the functional forum a while ago. But check out this commercial. I love it.

Commercial:
Do you find yourself longing for the apocalypse? I did. I was looking for a reason to live. Hi. Are you feeling tired, irritable, stressed out? Well, you. You might consider nature from the people that brought you getting outside comes prescription strength. Nature, a non harmful medication shown to relieve the crippling symptoms of modern life.

Nature’s recommended for humans of all ages, and it’s great for pets too. Nature can reduce cynicism, meaninglessness, anal retentiveness and murderous rage. In clinical studies, nature is proven to decrease work induced catatonia, caution. Nature may cause you to slow down, quit your job or seriously consider what the you’re doing with your life.

If you are overly cynical, jaded or emotionally numb, you may need to increase your dose of nature. Do you have trouble being even mildly uncomfortable? Nature may not be right for you. Side effects may include spontaneous euphoria, taking yourself less seriously, and being in a good mood for no apparent reason. So ask your doctor if nature is right for you. Ask your doctor if nature is right for you.

James Maskell:
Have you ever prescribed nature? I think it’s a growing trend, and I think that, you know, you see it in lifestyle medicine. I think that all across the saludogenic ecosystem, there’s understanding that the nature is helpful, and that’s a prescription that I can get behind, and I’m sure you can get behind as well. So in that vein, it was reflected back to me about a year ago, when I had a friend came and stay at my house and really see my life and what it’s like, she said to me, you know, you are really living the new story. And what does she mean?

The news story refers to the work of Charles Eisenstein, who talks about the fact that we as humanity are in what he calls the space between stories. The old story of disconnection, extractive capitalism is coming to an end, but the new story is the story of interbeing. Inspired by that feedback from my friend, I’m going to start a new series on my Instagram, and I’d love for you to come and join the party and to be part of it.

It’s called Living the new story, and every so often on Instagram, I’m going to be sharing ways in which I’m living the new story, whether it be the work that I do here and why that’s important to me, the work that my wife does, the education project that I’m involved in, where we’ve essentially got alternatives to school. There’s 100 kids in that my kids are part of, whether we look at the way I’m involved with men’s work, or how that comes about, the food system that we engage in building community locally, I would love that this would kick off a new hashtag, hashtag, the news story.

And I would love it if you’d be willing to participate, share the ways that you live in the news story, and ultimately, over time, we can really co create what the new story is all around this concept of interbeing. How are we with each other? How do we participate with each other? So if that sounds interesting. You’d like to be part of it. Check out my instagram. You’ll see stories starting very soon on the new story, what it is, and different ways in which I feel like I’m living the new story.

And I hope that you’ll come along and join us. So I want to take it next to talk about the mission that we’re all on here. Ultimately, I’ve shared every episode that the mission that we’re on is to build a network of practices capable of reversing chronic illness, and we have a particular focus on cognitive decline, because I believe, for all the reasons that I’ve shared before, that cognitive decline will be the disease that will unlock the concept that a functional medicine approach, a root cause lifestyle approach, a precision medicine approach, is a much more appropriate intervention for a range of chronic illnesses, but particularly in that area.

So who are our supporters? I want to share with you our mission partners, because our mission partners are all here to actually support you in the journey to build your successful practice. So I’ve ventured true neuro before. If you go to goevomed.com/truneura. This is a data synthesis tool, a clinical implementation tool and mentorship to help you deal with the most complex cases, to organize the data and to be able to scale your practice, to be able to help the next practitioner that you hire do the medicine as well as you.

And that’s a key missing piece that has been missing in the evolution of medicine as we go from many, many micro practices to real capacity. And so check out goevomed.com/truneura and you can get a demo there. Fullscript has been a partner of ours right since the beginning. We’re super excited over 125,000 clinics.

So chances are, if you’re listening to this, you already have an account. But what you might not know is there’s a lot of tools inside Fullscript that even if you have an account you’re probably not using, and over the coming weeks and months, we’re going to share some of those amazing tools so that you can get the most out of the platform and really save yourself time, energy and effort dealing with the logistics of labs, of supplements, of delivering whole person health.

If you’re having any issues with the business side of your practice, I’d love to introduce you to freedom practice coaching. Again, they’ve been supporters since the very beginning. They have this scalability assessment. If you go to goevomed.com/fpc, you can pinpoint exactly where you are in your practice journey and what the next step is going to look like. And get the support for that if you take that. A quiz at goevomed.com/fpc you’ll be able to get a full report as to where your practice needs to go, and ultimately, even some free coaching time to start you on the journey in that direction.

And then finally, Big Boost Marketing. Uli was the COO of the evolution of medicine for a number of years, he’s been building websites and helping practitioners market their practice for the last decade, and if you have any needs to bring in new patients, to start doing paid marketing, he’s the man to bring you discovery calls at the most reasonable cost to really become the best known practitioner in your community. So go to goevomed.com/bigboostguide. Start with the guide. Read all about how to get your practice found on AI, on grok, and ultimately get yourself in a position to be truly successful wherever you are.

Now we’re going to get into clinical corner. We’re going to take a bit of a slightly different look this week, in clinical corner, a really cool tool that I found online. I’m always looking for interesting ways to try and understand sort of where clinics are in their journey. And I found this tool that I’m going to share with you all now, because I think this tool is really valuable.

Now if you’re listening, you’re not going to be able to see this, so I highly recommend that you either a watch this on YouTube, where you’ll be able to see this, or B, if you got this via email on our email list, or if you’re checking out goevomed.com/podcast. We’ll have it up there so you can see the visual. But what I want you to imagine, if you’re listening, is a five by five matrix. So ultimately, this is called the functional medicine Capability Maturity matrix.

It was created by a PhD in Hong Kong called Graham player. But I think as you see, as you go through this, you’ll see that he really understands the maturity of functional medicine practices, and there’s a lot of value in here for practitioners, right? So on the left hand side, on the x axis, there’s five layers of success. You have conventional, which would be conventional medicine. So right at the beginning of your functional medicine journey, you’ve got proficient and integrated, and you’ve got expert and teaching.

So by the time you’re at, let’s say level three, that’s probably like successful in that category, but you’ve still got some areas you know that you can get better at. And then across the top, you’ve got clinical mindset, patient engagement, assessment, capabilities, nutrition and lifestyle and treatment design. So what I’m going to go through is go through each one of the columns. You know what the matrix says for where you need to be to hit that level. All right. So let’s start with clinical mindset.

So first level, conventional disease centered, symptom management, single drug approach. So then aware and curious, systems thinking, exploring root causes and connections. Level three, trained and practicing functional view so the ATM framework, antecedas, triggers, mediators and pattern recognition, starting to look at patterns in chronic illness, proficient and integrated. N of one, precision, io, individuality, mastery.

And then level five, expert and teaching field innovator, advancing models and contributing to the literature. So think about where you are in that five point score in your clinical mindset, and where would you like to be, all right. Part two, patient engagement. So conventional is 15 minute visits, medication focused, minimal lifestyle the number two, aware and curious, extended history, including lifestyle factors.

So now you’re starting to understand where did this come from. Trained and practicing shared decisions, 30 to 60 minute visits with health coaching. I’m super proud that health coaching is now an integral part of functional medicine, because we kind of did that. You know, when we launched the functional forum back in 2014 my partner Gabe was probably the first functional medicine health coach, doing it since 2008 working in a functional medicine clinic and being the health coach.

And I’m so glad that today it’s just sort of a given that this is the best way to practice functional medicine. You see it there in part three, part four, therapeutic relationship, 60 to 90 minutes behavior change. Now I don’t really believe that having spending more time is definitely more valuable. I do think that successful practices will use other practitioners, like a dietitian, like a pharmacist, like a health coach, to extend the visit without necessarily extending the clinician time, but the focus is on the therapeutic relationship and then Part Five.

And this is the reason, when as soon as I saw this, I was like, This guy knows what he’s talking about is group and community Shared medical appointments and virtual care innovations. Now, as you know, I happen to write the book on group visits, the community cure. If you haven’t read it, if you go to thecommunitycure.com/audiobook, you can download the audio for free. But the reason why I wrote that is because I agree that the gold standard of patient engagement is the group visit. Why?

Because the patients will share more with a peer than they will with you. We’ve heard that time and time again, people are more engaged and can be motivated by other people in the group. It’s not just all on you and your staff. You will never be better supported via. Than with a group, a clinician and a team, and what is a powerful addition to the team, a group of peers going through the same thing as you, who could support you along the journey. So that is the patient engagement part of things.

All right, let’s get to assessment capabilities. So level one, standard labs, disease pattern, focused, isolated markers. Sound familiar, aware and curious. Lifestyle assessment, adding the bottom of the matrix, nutrition, sleep, stress, data into your assessment. Three, functional testing, organic acids, food sensitivity, some of the foundational functional medicine testing that most practitioners have gone through, advanced patterns.

Number four, genomics, microbiome toxins. Now I’ve shared this with a few other practitioners, and they feel maybe these things should be the other way around, but ultimately, you can have your own opinion about that. I do think that microbiome is becoming more and more central. I do think toxins are pretty central, but this is basically like adding to your assessment capabilities.

And if you look at the cognitive decline stuff, you see that there’s all of this information is needed to really understand what’s going on with cognitive decline. And so you know this is the highest level practitioners that are executing on this protocol, and then level five, pioneering assessment, custom algorithms, predictive panels.

So we were just at the PLMI conference, and one of the things that was being talked about was this, S I, I and S I R I, which are essentially combinations of other inflammatory biomarkers that are being put together in certain calculations to give you a more broad and rich understanding of where the inflammation is coming from or how bad the inflammation is. And I think this is a really exciting movement forward. Dr Bland was introducing it there.

We do have some really exciting news coming soon about new markers that give a more stable understanding of background, chronic inflammation. So stay tuned for that in a future episode. All right. Level four, the fourth column is nutrition and lifestyle level. One, generic advice, eat better, exercise more. We’ve all heard that. And I would say, you know, lifestyle medicine is slightly above that, where you understand there’s, you know, these six pillars of lifestyle medicine, and assessing in that way, then you have basic nutrition, food health connection.

So understanding the connection between food and health. Level three, personalized nutrition, elimination diets and supplements. Level four, therapeutic nutrition, food is medicine protocols. And then level five, program developer, evidence based protocols with outcomes. You’ll see there’s a trend in the fifth level expert and teaching of capturing the outcomes contributing to literature. This is the most advanced area, and this is where we need the most focus, because ultimately, this is what is going to take the model forward.

And so, you know, a lot of the tools that we’re recommending, like true neuro one of our mission partners, the whole point of that is that it’s a community of doctors tracking their outcomes together to move the field forward. This is level five. We’re trying to get you to level five. We’re trying to elevate the whole community so that we can have a bigger impact and affect the lives of more people in every community and all around the world.

Because right now, America is the furthest ahead in functional medicine, in any sort of integrative or alternative medicine, and so there is a reason for us in America to work together on this, because it’s going to affect the rest of the world. All right. The fifth column is treatment design. So level one, medication. First, single intervention model, treatment design. Second level, adjunctive therapies, basic supplements and lifestyle. Number three, multi component, nutrition, lifestyle, mind, body. So really looking at a biopsychosocial way of dealing with things.

Number four, sequence protocols, root cause, with promise, tracking, tracking your outcomes. And then level five, protocol, innovation, new approaches, publishers, cases. So you can see conventional, aware and curious, trained and practicing, proficient and integrated expert and teaching, there are five levels. I would challenge you, if you’re listening to this, to give yourself a score.

Which score Are you for each of these different areas, and what do you need to get to the next area? And my judgment is that one of our partners will help you get there. Well, that was clinical corner. I think this was a really interesting tool that I found. If you thought it was interesting, let me know. Give us a comment. Check it out on social media. We’ll be talking more about it as this comes out.

Ultimately, this is what the evolution of medicine podcast is about. It’s about inspiring you, keeping you up to date with what’s happening in the industry, and also sharing with you the tools that we think are valuable to help take the movement forward. This has been another episode, episode five of the evolution of medicine podcast. Thanks so much for tuning in. I’m your host, James Maskell, and we’ll see you next time you.

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