Increased access to testing should not be confused with personalized testing.

More and more people are beginning to understand the importance of proactive wellness in an increasingly unhealthy world. At this point I wonder if we are even practicing preventative medicine. It feels more like we have to defend ourselves from the onslaught of all the ways our world makes us less healthy: declining nutrition in our food, climate change, compounding generational risk, exposure to toxins, the list goes on.

But the good news is, we have never been more empowered to understand our personal health. We are rapidly moving away from doctors holding all the power, telling you what labs you can and cannot get. Or what medications they’ll allow you to have. We are no longer confined to only receiving information on our bodies when we are sick enough to need help*.

*If you can afford it that is - the cost of functional medicine and enhancing wellness is another topic for its own post but is important to remember that in this country being well is an economic privilege, although it should be a human right.

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Generally, I think that is awesome! The gatekeepers can keep guarding their gate - we found ladders and dug tunnels to find other ways in. In defense of conventionally trained doctors - we aren’t taught health-care, we are taught sick-care. If I have a serious or acute illness please take me to my local university-based hospital and give me all the pharmaceutical interventions you can. MDs are amazing at what they do. But we have to stop expecting them to do what they aren’t properly trained to do - which is wellness.

This isn’t to say there aren’t incredible physicians out there who excel at promoting wellness, practicing health care and stay up to date on or are open to the functional medicine world. These unicorns exist but just like the mythical creatures, are pretty hard to find.

So yes, I am in favor of consulting Dr. Google who can find you a specialist, aka a reputable health tech company providing direct-to-consumer testing options for your health. Nevertheless, this doesn’t mean I recommend doing this without a guide.

In medical school I was taught the importance of patient autonomy and putting that importance above all. And I thought “That’s bullshit.” Please don’t stop reading, I promise I’m not a monster.

Imagine if you went to your car mechanic and they explained all the things that were wrong with your car in technical detail, and then explained to you all the highly detailed options you had for fixing your car. Oh also they wouldn’t be able to tell you the cost of any of the options provided either and how dare you even consider that when it comes to your car! Assuming you have minimal knowledge of how cars function (can’t imagine this substack is popular with the car enthusiasts), would you feel like you were the best person in that room to make a choice? No.

I want my car mechanic to learn about my priorities, my goals, my expectations for my cars, etc to help decide on the best course of action. But giving me all the information and then expecting me to make the decision of what to do is not reasonable. I don’t have the book knowledge nor the experiential knowledge to best make that decision.

This is my concern with the immense rise of direct-to-consumer health testing: knowing how to react to the enormous sea of health data everyone can now receive. There is a reason people get training in health fields - often for many many years. The human body is (probably) more complex than a car, with many different systems interacting. An out-of-range value on a test result may or may not need to be addressed. The importance of a test results may be highly dependent on numerous factors which may or may not be included in the test taken. And a the best course of action for a recommended next step may be dependent on other factors like age, health conditions, and personal goals. And often, it needs to be taken in the context of the rest of the results. Without this context, actions may be a waste of time and money, fail to progress wellness, and at worse, actually have negative impacts.

Access to testing should not be confused with personalized testing. I love seeing all the new testing available for understanding and optimizing wellness. But I highly encourage having a proper guide, or battle leader, to help you on this journey of defensive wellness.

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Some other options for finding practitioners most likely trained in some of these newer tests are training programs like the Institute for Functional Medicine or the School for Applied Functional Medicine. Testing companies may also have a practitioner network they can refer you to. And keep (nicely) pestering your conventional practitioners with your knowledge of these tests and what you think about them - the more they hear about something the more likely they are to look into it. I promise you 99% of them went into healthcare because they want to help people and because they love learning. They didn’t know that by the time they finished years of brutal, inhumane training that put them in a mountain of debt they’d be so jaded. If you approach them slowly, with a nice comforting tone of voice they usually response pretty well - add some treats and behind the ear scratches and you’ll have them listening to you in no time.