Doc Ditches Rx Pad to Push Functional Medicine Approach

The conference room at a Mustard Seed Market and Cafe in Solon is packed with people waiting for Dr. Dorothy Sprecher. Before she speaks, the functional medicine practitioner surveys the audience on hand for her lecture: "Are your hormones driving you crazy?"

In the first row, two women from Ashtabula County catch up on neighborhood gossip. A patient of Dr. Sprecher's calls out to her, "This is my sister. She came up from the south." Wooster, that is.

Before beginning, the Georgia native gets acquainted with her audience.

"Why are y'aII here tonight?" Dr. Sprecher asked. "What do you want to hear about tonight?"

People respond:
Insulin.
Thyroid hornone.
Cortisol.
Do hormones affect the digestive system?
Can we use diet to manage our hormones?

Welcome to functional medicine and Dr. Sprecher's private practice, The Center for Hope &Healing, established in 1997 in Geauga County's Russell Township. In a century-old building, the center's staff addresses countless patient health concerns. The practice has about 600 active patients, said business manager John Ferlito. Some travel from Canton, Elyrta,Columbus and Erie, Pa.

"I had tried what I thought was everything." said Brecksville resident Shawana Johnson, 48, regarding herunexplained moodiness, lethargy, hair loss and weight gain. "Normal practitioners don't specialize in thisarea. They don't have the expertise."

First-time patients meet with Dr. Sprecher for at least two hours.They complete a 20-page questionnaire about their medical history, lifestyle practices, diet and stressors. Testing also is done. Ultimately, a plan using diet, nutraceuticals including dietary supplements and medical foods, and lifestyle changes is implemented to reverse symptoms and restore balanced health.

Functional medicine has changed the lives of these patients and Dr. Sprecher herself.

In 1990, she treated patients and managed a group family medicine practice in nearby South Russell. WhIle successful according to conventional medicine norms, Dr. Sprecher was not satisfied. She said she entered the profession to heal pain and suffering.

"After three or four years, my compassionate heart and prescription pad weren't enough," she said. Also, she found herself on the receiving end of the prescription pad because she was disabled by chronic fatigue, stomach pain and fibromyalgia.

Eventually, through a nutraceutical representative, she discovered functional medicine and nutritional biochemist Jeffrey Bland, Ph.D., who co-founded The Institute for Functional Medicine in Gig Harbor, Wash., in 1993.The nonprofit institute offers intensive functional medicine training and provides continuing education classes. Dr. Sprecher restored her health, and studied under Dr. Bland.

She thinks the majority of health problems are reversible or preventable. She looks at causes behind symptoms, finding answers to why, for example, someone might over- or under-produce hormones.

"We ask, 'How did they (the patients) evolve to an unbalanced state?'" said Dr. David Jones, president of The Institute for Functional Medicine. "We look at genetics and environment. It's taking each patient and finding unique elements in their life that are not working."

Guiding this detective work is the principle that everyone has a unique biochemistry, disease is manifested individually, and accordingly, treatment is individualized. No convenient cures, no "magic bullets," Dr. Sprecher said. "When we look at antecedents and triggers for an illness, it's looking at the whole process," said Dr. Thomas Morledge, medical director for the Cleveland Clinic Willoughby Hills Family Health Center. He integrates functional and conventional medicine in his practice. The approach requires time and patient commitment. But it also requires progressive insurance coverage or money.

Office visits and traditional laboratory tests often receive insurance reimbursement, but unique tests, genetic workups, saliva testing to measure cortisol levels, intestinal permeability, and comprehensive digestive stool analysis - might not be covered.

Dr. Johnson, president and owner of Global Marketing Insights Inc. in Independence, a strategic planning firm, did the research, and was prepared for everything, including the testing. "Anything to feel better," she said.

Office visits were covered up to 80% under her insurance benefits. Testing that totaled around $1,500 identified low cortisol levels produced by the adrenal gland and insulin resistance, and was paid out-of-pocket. Following a regime, Dr. Johnson shed 15 pounds from her 5-foot frame. Her red hair is now shiny and full, and energywise, she feels like she did at age 18.

"They'd (insurers) rather take care of me if I was diabetic, than protect me from becoming a diabetic," said Dr. Johnson, who has an executive doctorate in management. "It's preventive medicine and the medical system is not geared toward that."

-Crain's Cleveland Business, December 11, 2005