Closing the “endlessly revolving door?” Functional medicine and professional jurisdiction
Embargo Date
2027-09-11
OA Version
Citation
Abstract
Functional medicine lies at the intersection of basic science and medical practice. It promises to address enduring problems with the United States healthcare system, ranging from the marginalization of preventative care and public health to the unchecked growth of prices and costs. The field has positioned itself in opposition to biomedical reductionism and to the view that diseases have a single causal factor, instead promoting a theory of disease that incorporates multiple genetic, social, institutional, and environmental factors. Despite its promises, functional medicine physicians (FMPs) typically work in private, cash-based practices where they charge high fees for their services. This dissertation examines the epistemological tensions, clinical ambiguities, and professional divisions that arise when FMPs engage in practices that compete with their medical training. FMPs devise strategies to legitimate their expertise, to build trust with patients in a context of uncertainty and prohibitive out-of-pocket expenses, and to challenge the status hierarchies that govern the broader field of healthcare. As members of a powerful profession, FMPs are caught in a complex web of competing professional commitments that involve careful expansion, contestation, and maintenance of medical professional boundaries – and of medicine’s object of intervention.
Description
2024
License
Attribution-NonCommercial-NoDerivatives 4.0 International