New IFM leaders discuss goals and future of functional medicine

Earlier this year, the Institute for Functional Medicine (IFM) announced it would be appointing a new chief executive officer (CEO), Amy Mack, and introducing a new role, naming Cary Sennett, MD, PhD, president of medical education and research. These strategic moves are an exciting change for functional medicine and were celebrated at the recent Annual International Conference in Hollywood, Florida.

We caught up with Mack and Sennett in a recent interview, discussing their goals for their new positions as well as where they think functional medicine is heading. This is an exciting time to be in functional medicine and integrative healthcare, and they share some of their insights into how practitioners can remain at the forefront of change.

Integrative Practitioner: Can you describe your roles for our audience?

Mack: I come with a background in non-profit and government management. I worked over 20 years in youth development and public service and really honed in on non-profit work in the last 15 years and had the eye on how [IFM] itself is growing from a culture, business, and revenue standpoint. I do have a background and degree in biology and have a fair bit of knowledge about what we’re doing at IFM, but one of the things that was really important when I was taking on the CEO role was to bring in the director of medical education and research to really continue to build upon that part of what IFM is doing.

Sennett: My job is to bolster the medical education and research [within IFM]. My primary responsibilities have to do with increasing our capacity to deliver educational programs so that we can build the functional medicine capacity that the public needs as the field continues to grow. I’d say that’s one of the highest priorities on the medical education side. On the research side, there’s a clear opportunity for us to strengthen the evidence that supports functional medicine—both tactics and the general strategy that are central to the field. My role as the leader for the research function is to really build out a collaborative research enterprise, as well as strengthen and build out new strategic relationships that will give us leverage. IFM is a smaller organization, and in order for us to be able to achieve our mission, we need to be working closely with others and working collaboratively with others. My role is, in part, to help build out those relationships.

Integrative Practitioner: What are your goals for your new role?

Mack: One of the big ones is really building a communication [strategy] for the organization—not simply being in retroactive mode where we’re responding to questions, but working with our team to build a communications plan for how we’re going to get the message out and build upon the relationships that we have about widespread adoption and the importance of widespread adoption in leading to systems change in healthcare and health policy. The big areas that are a part of that are building community and looking at not simply how we are providing education to our practitioners, but how we are helping our practitioners to be the voice for what it is that we are teaching and have them be a part of the movement to push functional medicine and widespread adoption forward.

The other area that we haven’t spent a lot of energy on, but we will be shifting focus toward, is how we can build upon the patient response, and really looking at patients as a driver for change in health policy and the role that functional medicine can play in that. We are a small organization, but we are quickly growing. In the last two years, we have more than doubled in size. My focus is on continuing to really build a culture that supports that kind of growth. Our growth is not stopping, and preparing the organizations both financially for that kind of growth as well as building the structure to support a staff that is under pressure to get this really important work done in healthcare, is another main focus.

Sennett: My first priority is to expand the evidence base that supports functional medicine, in particular the functional medicine clinical model. There is a lot of evidence, and I think people need to appreciate that we are starting from a really good place. We have a citations database which includes almost 7,000 publications that speak directly to the interventions that are taught in our curriculum. Part of my job is to disseminate the evidence that currently exists, to build out and generate evidence that support not so much the individual tactics but the way of thinking and approach to the patient that is the core of functional medicine and actually leads to better outcomes for patients.

Cost of care is such a problem right now and functional medicine offers a solution, especially for those with chronic conditions. On the medical education front, we have a robust set of educational programs, but most of them are onsite, which limits the ability to deliver. It’s not really a scalable solution. So, a lot of work is about transforming our training and making it more digital, more accessible virtually, as well as expanding our international footprint. The priorities on the education front include expanding the number of virtual or online programs and beginning to look at how we can expand our international portfolio.

Integrative Practitioner: You’ve just been officially introduced as the new leaders of IFM—what’s next for you both?

Mack: When I think about how we take the first bite at our really big initiatives is how we ensure that the staff is prepared for this level of work. Part of that is do we have the right team in place, do we have enough of that team in place, and how do we build upon and provide the training internally that we need. It’s interesting to be an organization that is focused on training externally, and sometimes that can lead to us losing focus about what we need to do internally. We really shifted on the operations team to ensure that we are both training at the right level, staffing at the right level, and resourcing at the right level. The projects we mentioned will drive the majority of our work over the next 12-24 months, continuing to build upon the already good evidence base, continuing to find the partners that can help us and leverage the best of them and allow them to leverage the best of us to be able to build that evidence base, really figuring out how we look at our curriculum and our training, and how do we transform that to be the most accessible to the biggest number of people externally. From my point of view, it’s continuing to build that foundation.

Integrative Practitioner: What are you most looking forward to doing or accomplishing in this role?

Sennett: We have almost a blank piece of paper in terms of building a research enterprise, and I see many opportunities for IFM to build out our research capability that is highly collaborative, working with strategic partners and academics, and working with providers. I am very excited because I have had conversation with folks outside of IFM, and what I sensed was a tremendous enthusiasm, tremendous interest in working together to do research, and I’m looking forward to building the in-house capacity that’s needed for us to be effective, high-value partners to those who are not part of IFM, strictly speaking.

The work on the educational side is also very exciting. I didn’t come to IFM with the experience in education and curriculum development that IFM has. I’m a general internist and an economist, and a lot of my work has been measuring and it’s taken me in to the world of evidence-based medicine and research. I’m excited about the research opportunities because it seems so clear to me on the education front. I am leaning heavily on a very talented staff with a lot of experience, so I’m looking forward to accomplishing this together and to some extent following their lead.

Integrative Practitioner: Where do you see the landscape of functional medicine heading in the next few years?

Mack: As an organization, we built a strategic plan two years ago. At the time, we identified ourselves as the center of the functional medicine ecosystem, and what we meant by that was that we weren’t the only ones pushing functional medicine and there were some interesting players in the industry in academics, payers, regulators, etc. that were also in the space of functional medicine. As we continue over the next several years, there are some interesting places for us to be developing more solid structure that continues to build upon the foundation of the functional medicine ecosystem.

As an organization, we have been fairly focused at the domestic level, with all the good reason. We should be thinking locally in terms of the United States and how we think about health policy. The reality is 20 percent of our participants come from international entities. In that space, there are opportunities for us to see a functional medicine ecosystem that will build itself quickly and will be able to see outcomes quickly. That’s the space that we are growing in interest.

The other space that I think is the most important if we think about widespread adoption and what that truly means is to focus on underserved communities. There is something about functional medicine and integrative medicine that can make it feel like it is medicine for the wealthy, but we have a real responsibility to change that and have it be functional medicine and good health medicine for all, regardless of your economic status. Coming from a background of youth development and serving underserved communities, and having the staff as well really interested in growing an emphasis around underserved communities, I think that’s a place we will really be growing. If you can take just one nugget and bring healthy eating and healthy lifestyle into underserved communities, and we start with one person and that quickly spreads to a family in a community, you can imagine what that can do not only for the long-term health of that community but it could actually quickly reduce healthcare costs in that community. It’s a unique microcosm to think about, but it’s actually a place where we could be putting emphasis.

It’s funny that we don’t talk about underserved communities in functional medicine, but it could be the quickest place to have impact almost overnight. It’s very akin to the mentoring space where I come from—if we established the mentoring relationship for one child, all of a sudden moms in that community wanted the same kind of relationship for their child because they could see the benefits. It’s the same kind of thing [with functional medicine], to get in there and establish healthy living in a community and help them understand that they didn’t have to be eating processed foods from the convenience store. We were really pushing for that, and we could achieve such change really quickly.

Integrative Practitioner: What do you think are some of the challenges integrative practitioners and functional medicine providers face, and what do you think they can do to stay ahead of these potential obstacles? 

Sennett: One of the real challenges here has to do with how functional medicine is paid for and how it’s not paid for. Insurance in general is not really generous in respect to coverage for functional medicine services, so it becomes healthcare for the 1 percent, which is a huge challenge and also a tremendous missed opportunity. Part of solving this challenge is demonstrating the value that functional medicine brings to healthcare delivery, which again gets us back in to research and demonstrating the outcomes associated with the delivery of medicine using the functional medicine model are as good as or better than the outcomes achieved by conventional medicine, and that those outcomes are achieved at a lower cost. We know that from the research that has been done that these are true, that focusing on lifestyle leads to material improvements in health, particularly in patients with chronic illness. What we need to is demonstrate that. So, that’s the challenge, and the opportunity.

Editor’s note: This interview was edited and condensed.