02. Is This a Doctor's Office or a Beauty Salon?

The day of my first functional medicine appointment was one of those clear sunny fall days where it looked like the leaves had just been painted on the trees. After coffee with a friend, I rushed home to log on with plenty of time.

In the virtual waiting room, I marveled at what a victory this appointment was. It had been nearly impossible to find a functional provider who accepted insurance. Why?

Wouldn't insurance companies love this low-tech, minimally invasive approach? The endoscopies and CT scans I got through conventional doctors cost thousands, whereas functional doctors tend to just order detailed lab work. Instead of procedures, they focus on vitamins, sleep, exercise, and healthy food to prevent disease from happening in the first place. Treating the whole body as one interconnected system means fewer appointments with specialists.

When I looked into it, the explanation was that experiments have yet to prove that functional medicine is effective. In-depth blood tests for sex hormones, thyroid activity, or food antibodies are considered “investigative,” not “medically necessary.” Insurance apparently only covers diagnosed disease, which means there is no billing code for lifestyle counseling.

Finally a nurse practitioner in a white coat appeared. I was hoping to see a doctor—an upgrade in expertise I felt I needed because something was seriously wrong with me. She sat in front of a blank white wall and I had no sense of where she was—in Florida, New York, or an office a half hour away?

I told her my whole story—the stomach aches, the energy collapse, the rashes—and she listened to it all. She never disagreed with me, but she didn’t guess at any possible causes either, reassuring me at how they would run a comprehensive panel.

“Then we’ll meet again on…” She looked concerned as she checked her screen. “I guess October 4.” A whole month away. She mumbled something about the clinic being busy.

“You have to do our Gut Restore program,” she said at one point, a three-month program featuring a microbiome test, regular nutritionist appointments, and gut repair supplements. When she started repeating, “I really really really recommend Gut Restore,” I realized it cost money and she probably got a commission for selling it.

When I asked about the price, she told me a 'health coach' at the front desk would take care of me. Minutes later, I was in a video conference with Jasmine.

Wearing a headset in front of a reception desk, Jasmine smiled and said, So I see we have you down for Gut Restore. As she spoke, slivers of silver glitched around the outlines of her head revealing a break in what I had thought was a real office.

Gut Restore would cost over $800. The one thing I needed from them was not covered by insurance.

Today’s co-pay would be waived, she started saying, if I signed up for the Preferred membership at $99 per month. Members get 20% off IV therapy, massages, and body contouring, whatever that was. There were other membership levels with different time frames, discounts, and perks but it all started to run together into one big goop.

When the call was over, I sat there staring at the dark screen. The nurse was nice and had spent a full hour with me, but I came away feeling empty and a little sad. Was this a real doctor’s office or some kind of private equity-run wellness spa?

In the end, I decided to go ahead with their blood tests. What could it hurt?