C H I R O E CO . CO M F e B r u a r y 2 4 , 2 0 1 7 • C H I R O P R A C T I C E CO N O M I C S 41
WELLNESSAPPROACH
THE NUMBER OF INDIVIDUALS WHOSUFFER FROM COMPLEX CHRONICdiseases such as heart disease,
diabetes, cancer, and autoimmune
disorders is on the rise. The conven-
tional care provided by allopathic
medicine is oriented toward acute care
and the diagnosis of trauma or disease
of limited duration, such as a broken
limb or heart attack.
Medical physicians practicing in this
model typically prescribe drugs or
surgery with the goal of ameliorating
the immediate conditionand symptoms.
If, as a DC, you are frustrated by
watching your patients suffer from
chronic disease and be cycled through
the system of diagnosis and drugs
without improvement, Functional
Medicine (FM) can provide you with
powerful tools and strategies to help
your patients regain their health.
Why Functional Medicine?
The acute-care approach is ill-equipped
to handle the multifaceted issues that
accompany most chronic diseases. It’s
also a model that fails to address the
unique genetic background of each
individual. It also does not take into
account the impact of modern lifestyles
and environmental factors that can
lead to an increase in chronic diseases.
These factors include diet, exercise,
exposure to toxins, and stress. For
these reasons, most doctors are
unequipped to assess the underlying
causes of disease. They do not know
how to utilize diet, exercise, and
nutrition as preventive factors in
combating chronic disease.
From an allopathic perspective, FM
offers a novel approach and method-
ology to treating andpreventing chronic
diseases. From a chiropractic perspec-
tive, seeking to discover the underlying
cause of disease by examining how
structure impacts function is a foun-
dational principal for the profession.
By joining forces, either through
collaboration or in a more formal
integrative or multidisciplinary practice
setting, allopathic physicians and
chiropractors can help their patients
derive the greatest benefit from both
perspectives. Practitioners of FM
develop individualized treatment
programs that address the interaction
between the external environment and
the internal environment of the body,
The heart of the matter
What you need to know about Functional Medicine.
BY MARK SANNA, DC
A
D
O
BE
ST
O
C
K
http://www.chiroeco.com
42 C H I R O P R A C T I C E CO N O M I C S • F e B r u a r y 2 4 , 2 0 1 7 C H I R O E C O . CO M
WELLNESSAPPROACH
including the immune, endocrine, and
gastrointestinal systems.
How is Functional Medicine
different?
From an FM perspective, the primary
factors considered during a patient
assessment include foundational
lifestyle factors: nutrition, exercise,
sleep, stress level, interpersonal
relationships, andgenetics. These
primary factors are, in turn, influenced
by certain predisposing factors,
ongoing physiological processes, and
discrete events that result in an
imbalance in the body’s ability to
maintain .
How to do quick user assign in kanban in Odoo 17 ERP
C H I R O E CO . CO M F e B r u a r y 2 4 , 2 0 1 7 • C H I R .docx
1. C H I R O E CO . CO M F e B r u a r y 2 4 , 2 0 1 7 • C H I R O
P R A C T I C E CO N O M I C S 41
WELLNESSAPPROACH
THE NUMBER OF INDIVIDUALS WHOSUFFER FROM
COMPLEX CHRONICdiseases such as heart disease,
diabetes, cancer, and autoimmune
disorders is on the rise. The conven-
tional care provided by allopathic
medicine is oriented toward acute care
and the diagnosis of trauma or disease
of limited duration, such as a broken
limb or heart attack.
Medical physicians practicing in this
model typically prescribe drugs or
surgery with the goal of ameliorating
the immediate conditionand symptoms.
If, as a DC, you are frustrated by
watching your patients suffer from
chronic disease and be cycled through
the system of diagnosis and drugs
without improvement, Functional
Medicine (FM) can provide you with
powerful tools and strategies to help
your patients regain their health.
Why Functional Medicine?
The acute-care approach is ill-equipped
to handle the multifaceted issues that
2. accompany most chronic diseases. It’s
also a model that fails to address the
unique genetic background of each
individual. It also does not take into
account the impact of modern lifestyles
and environmental factors that can
lead to an increase in chronic diseases.
These factors include diet, exercise,
exposure to toxins, and stress. For
these reasons, most doctors are
unequipped to assess the underlying
causes of disease. They do not know
how to utilize diet, exercise, and
nutrition as preventive factors in
combating chronic disease.
From an allopathic perspective, FM
offers a novel approach and method-
ology to treating andpreventing chronic
diseases. From a chiropractic perspec-
tive, seeking to discover the underlying
cause of disease by examining how
structure impacts function is a foun-
dational principal for the profession.
By joining forces, either through
collaboration or in a more formal
integrative or multidisciplinary practice
setting, allopathic physicians and
chiropractors can help their patients
derive the greatest benefit from both
perspectives. Practitioners of FM
develop individualized treatment
programs that address the interaction
between the external environment and
3. the internal environment of the body,
The heart of the matter
What you need to know about Functional Medicine.
BY MARK SANNA, DC
A
D
O
BE
ST
O
C
K
http://www.chiroeco.com
42 C H I R O P R A C T I C E CO N O M I C S • F e B r u a r y
2 4 , 2 0 1 7 C H I R O E C O . CO M
WELLNESSAPPROACH
including the immune, endocrine, and
gastrointestinal systems.
How is Functional Medicine
different?
From an FM perspective, the primary
factors considered during a patient
assessment include foundational
lifestyle factors: nutrition, exercise,
sleep, stress level, interpersonal
4. relationships, andgenetics. These
primary factors are, in turn, influenced
by certain predisposing factors,
ongoing physiological processes, and
discrete events that result in an
imbalance in the body’s ability to
maintain homeostasis.
Conventional medicine focuses on
the constellation of symptoms the
patient presents with and the grouping
of these symptoms under the label of a
diagnosed disease. The diagnosis is then
accompanied by the prescription of a
drug (or group of drugs), and in some
cases therapy, in an attempt to mitigate
or ameliorate the patient’s symptoms.
Beyond this point, traditional
medicine finds itself at a loss. This
approach to the treatment of disease
neglects fundamental aspects of health
that are often the underlying cause of
the patient’s condition. It also groups
patients together who present with
similar signs and symptoms, and thus
neglects thedifferencesbetweenpatients
as well as the multiple potential causes
that a “disease” may have.
What are the hallmarks of a
Functional Medicine practice?
FM practitioners tend to spend
considerably more time with their
patients than conventional medical
5. doctors do. The level of evaluation
provided is more consistent with a
chiropractic intake examination and
history than that of a medical
examination.
Critical information is collected
about underlying factors that may be
contributing to the patient’s condition.
These include an analysis of the
patient’s lifestyle, daily living habits,
history of trauma and prior illnesses,
environmental exposures, and genetic
influences.
Patients are often asked to complete
extensive questionnaires that cover
topics not usually addressed in a tradi-
tional medical setting. These include
toxic exposures in the home and
workplace, a daily diet history, and a
specific history of the characteristics of
both the patient’s acute and chronic
symptoms. The responses provided by
the patient offer the clinician insights
into health-related information that
might not be easily gathered during a
typical patient history.
FM practitioners may also recom-
mend laboratory testing, including
routine tests, such as a complete blood
http://www.rayenceusa.com
http://www.chiroeco.com
6. C H I R O E CO . CO M F e B r u a r y 2 4 , 2 0 1 7 • C H I R O
P R A C T I C E CO N O M I C S 43
count (CBC), as well as less conven-
tional tests, such as stool, saliva,
hormone levels, and genetic testing.
These tests help determine which
biological processes may be functioning
at less than optimal levels. This infor-
mation is then compiled to develop a
comprehensive customized plan of care
to restore the patient to good health.
FM therapies may include
chiropractic adjustments, nutritional
supplements, nutraceuticals, botanical
medicines, bio-identical hormones,
detoxificationprograms, and therapeutic
diets. A regimen of care will also
typically include lifestyle counseling
relating to exercise and stress-
management techniques. The goal is to
empower the patient to be active in the
healing process and to improve their
own health to change the course of
their underlying dysfunction.
Functional Medicine
in clinical practice
Chiropractors have long known that
chronic disease is driven primarily by
factors related to lifestyle choices. New
approaches to prevention and health
management are required to turn back
the tide of chronic disease that is now
7. on course to outpace deaths from
infectious disease over the next decade.
This can be accomplished by inte-
grating what both chiropractic and
allopathic practitioners know about
how the human body functions. This
results in a level of care that is both
patient centered and science based, that
addresses the causes of chronic disease
rooted in lifestyle choices, environ-
mental exposures, and genetic
influences. This is precisely what FM
does and it is perfectly aligned to
address the health challenges
confronting the majority of our
population today.
FM integrates the art and science of
healthcare. There is extensive research
and science-based evidence that
supports the collaborative approach at
the foundation of FM. Research shows
outcomes are improved when an
effective therapeutic partnership exists
between doctor and patient.
This partnership engages the body,
mind, and spirit. It encourages deep
insight and a more comprehensive
answer to challenging and complex
health problems. One way to increase
your satisfaction in practice is by
providing your patients with answers
that are unavailable to them elsewhere.
8. FM may provide you with a source for
those answers.
MARK SANNA, DC, aCrB Level
II, FICC, is a member of the
Chiropractic Summit, the aCa
Governor’s advisory Cabinet, and
a board member of the
Foundation for Chiropractic Progress. He is
the president and CeO of Breakthrough
Coaching. He can be reached at 800-723-
8423 or through mybreakthrough.com.
http://www.speaktodrbruce.com
http://www.chiroeco.com
Copyright of Chiropractic Economics is the property of Doyle
Group and its content may not
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without the copyright holder's
express written permission. However, users may print,
download, or email articles for
individual use.
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Integrative Medicine • Vol. 16, No. 1 • February 201722
Bland—Creating Synthesis
9. Defining Function in the Functional Medicine Model
Jeffrey Bland, PhD, FACN, FACB, Associate Editor
CREATING SYNTHESIS
Jeffrey Bland, PhD, FACN, FACB, is the president and founder
of the Personalized Lifestyle Medicine Institute in Seattle,
Washington. He has been an internationally recognized
leader in nutrition medicine for more than 25 years.
Dr Bland is the cofounder of the Institute for Functional
Medicine (IFM) and is chairman emeritus of IFM’s Board of
Directors. He is the author of the 2014 book The Disease
Delusion: Conquering the Causes of Chronic Illness for a
Healthier, Longer, and Happier Life.
In 1991, the Institute for Functional Medicine was founded with
7 defining characteristics of functional medicine. These
included1:
1. Patient centered versus disease centered.
2. Systems biology approach: web-like
interconnections of physiological factors.
3. Dynamic balance of gene-environment
interactions.
4. Personalized based on biochemical individuality.
5. Promotion of organ reserve and sustained health
span.
6. Health as a positive vitality—not merely the
absence of disease.
7. Function versus pathology focused.
During the last 2 decades, interest in functional
10. medicine has grown dramatically. A recent Google search
of the various terms describing different medical concepts
produced the following data:
1. Functional medicine: 507 000 results.
2. Integrative medicine: 704 000 results.
3. Holistic medicine: 483 000 results.
4. Complementary and alternative medicine (CAM):
490 000 results.
Starting with publications in the mid-1980s, use of
the term functional in medicine referred to what had been
termed functional somatic syndromes.2 Functional somatic
syndromes are defined as related syndromes that are
characterized more by complex symptoms than by disease-
specific abnormalities or histopathology.3 Conditions that
fall under the functional somatic syndrome terminology
have included4:
1. Chronic fatigue syndrome.
2. Fibromyalgia.
3. Multiple chemical sensitivity syndrome.
4. Irritable bowel syndrome.
5. Premenstrual syndrome.
6. Polycystic ovary syndrome.
7. Chronic pelvic pain syndrome.
8. Nonulcer dyspepsia.
9. Chronic pain of unknown origin.
10. Depression.
11. Minimal cognitive impairment.
12. Interstitial cystitis/painful bladder syndrome.
13. Restless leg syndrome.
14. Autistic spectrum disorder.
15. Autoimmune syndrome.
11. In an article published in the Archives of General
Psychiatry in 1985, functional somatic syndromes were
suggested to be associated with hypochondriasis.5 In fact,
much of the literature that has been written on the topic of
functional somatic syndromes has historically been
associated with the field of psychiatry, as well as with the
representation that these syndromes can be “lumped”
together as issues derived from psychological factors. This
“lumping” assumption about the origin of these conditions
has resulted in treatment options that are primarily
behavioral and cognitive in nature.
In the functional medicine model, the word function is
aligned with the evolving understanding that disease is
an endpoint and function is a process. Function can
move both forward and backward. The vector of change
in function through time is, in part, determined by the
unique interaction of an individual’s genome with their
environment, diet, and lifestyle. The functional
medicine model for health care is concerned less with
what we call the dysfunction or disease, and more about
the dynamic processes that resulted in the person’s
dysfunction. The previous concept of functional somatic
syndromes as psychosomatic in origin has now been
replaced with a new concept of function that is rooted
in the emerging 21st-century understanding of systems
network-enabled biology.
Abstract
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Integrative Medicine • Vol. 16, No. 1 • February 2017
23Bland—Creating Synthesis
For the past 20 years, however, the assumption of
“lumping” all the functional somatic syndromes under the
mechanistic assumption of being psychosomatic and
related to hypochondriasis in origin has been challenged
by those who argue these syndromes should be split into
different subgroups based on their specific etiologies at
the cellular/tissue level. This has resulted in a very robust
debate between the “lumpers” and “splitters” as to how
best to approach the management of specific conditions
that fall under the term functional somatic syndromes.6,7
This debate and the resulting evolution of the medical
approach to these conditions started to shift in the early
1990s toward an understanding that each of these
conditions was unique in its origin. This shift in thinking
was driven by the advances made in molecular and cellular
understanding of the etiology of these syndromes and the
resultant change in the patient’s functional status. As such,
each patient needs to be addressed clinically by a
personalized treatment that was derived from an
understanding of the etiology of their functional
impairment.
This change in thinking was a result of new diagnostic
tools such as radioimmune assay, computer-assisted
tomography, nuclear magnetic resonance spectroscopy,
positron emission tomography, and single photon emission
computed tomography scans that allowed for functional
characteristics of specific tissues/organs to be evaluated in
real time. These new technologies supported the
development and growth of functional neurology,
13. functional immunology, functional cardiology, functional
oncology, functional radiology, and functional genomics.
All of these fields have seen their importance grow
exponentially since the early 1990s. From 1990 to 2016,
more than 31 000 papers were published in the National
Library of Medicine–cited medical literature discussing
aspects of functional neurology; 11 000 in functional
cardiology; 76 000 in functional immunology; 89 000 in
functional oncology; and 42 000 in functional radiology.
From a historical context, the definition of functional
somatic syndromes is changing in response to this new
definition of function at the organ system, organ, tissue,
cellular, and subcellular levels. This transition in the
definition of function is driven by the influence of the
introduction of newer assessment tools for evaluating
functional changes at different organizational levels. The
use of noninvasive testing methods and many new
biomarkers of physiological function have all combined to
provide a much greater understanding of the functional
status of the individual. A demonstration of the emerging
importance in the changing context in health care of the
definition of function was demonstrated in 1994 with the
approval by the US Congress of the Dietary Supplement
and Health Education Act, which was passed to regulate
claims for dietary supplement products. This act defined
allowable label claims for dietary supplements to be based
on structure-function criteria. Under this act,
structure/function claims may describe the role of a
nutrient or dietary ingredient intended to affect the
normal structure or function of the human body—for
example, “Calcium builds strong bones.” In addition, they
may characterize the means by which a nutrient or dietary
ingredient acts to maintain such structure or function—
for example, “Fiber maintains bowel regularity,” or
14. “Antioxidants maintain cell integrity.” The concept of
structure and function being related is a perspective that
can be applied at many levels from that of the whole
organism to that of the subcellular effect of a substance on
the function of specific molecular networks.
It was the recognition in 1991 that the definition of
functional in medicine was changing from a singular focus
on psychosomatic to an integrated focus including the
whole biological system that led to the founding of the
Institute for Functional Medicine. It was believed by the
founding members of the Institute for Functional Medicine
that the information that would emerge from completion of
the Human Genome Project would revolutionize medicine
by creating a framework for the understanding that the
origin of disease in the individual resulted from the
interaction of their unique genome/epigenome with their
environment, diet, and lifestyle. It was forecast that during
the next few decades this new genomic information coupled
with new technologies that allow for the evaluation of the
physiological, cognitive, emotional, and physical function
of the individual would redefine the use of the word
functional in medicine and open a new era of precision,
personalized, participatory, and eventually predictive health
care. It was the understanding of this revised definition of
function in medicine that resulted in the founding of the
Institute for Functional Medicine. The functional medicine
model was based on the recognition of the dynamic
interplay between the individual’s genetic template and his
or her environment that results in an outcome manifested
in their functional capabilities. It was believed that the
future of the medical diagnostics would not be based solely
on the diagnosis of disease, but rather in detecting early
changes in function that would allow successful intervention
with personalized therapies that used tools with more
favorable risk profiles than the therapeutics needed to treat
15. more advanced stages of disease.
The early 1990s were also the time when many of the
now common syndromes started to gain better
understanding and prominence in medicine. Syndromes
that grew to be seen as major medical issues during this
time included the following:
1. Metabolic syndrome and obesity-related health
issues.
2. Fibromyalgia syndrome.
3. Chronic fatigue syndrome.
4. Polycystic ovary syndrome.
5. Obstructive sleep apnea syndrome.
6. Irritable bowel syndrome.
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Integrative Medicine • Vol. 16, No. 1 • February 201724
Bland—Creating Synthesis
7. Esophageal reflux disorder syndrome.
8. Erectile dysfunction syndrome.
9. Attention deficit disorder syndrome.
10. Depression syndrome.
11. Chronic pain syndrome.
12. Cognitive dysfunction syndrome.
13. Autistic spectrum disorder syndrome.
Since the early 1990s, these syndromes have become
16. recognized as some of the most common disorders for
which people seek medical attention. We have witnessed a
transition in medicine from the singular focus on disease
to that of the age of the complex chronic syndrome. Many
of the most financially successful pharmaceuticals
approved during the past 20 years are for syndromes
rather than diseases including equine hormones for
menopausal syndrome, statins for elevated cholesterol
syndrome, sildenafil for erectile dysfunction syndrome,
pregabalin for fibromyalgia syndrome, and celecoxib for
arthralgia syndrome.
The emergence of the following triad has fueled the
interest in functional medicine that is rooted in this newer
definition of function: new diagnostic/prognostic tools
that allow assessment of function, genomic understanding
of individual differences in response to the environment
and lifestyle, and the increasing understanding of the
cellular etiology of complex chronic disease. Functional
genomics is the application of omics technologies to the
discovery of how biological systems are regulated. Since
2000, there have been more than 32 000 articles published
in the peer-reviewed medical literature on this topic. This
work has allowed for an understanding of what previously
were “lumped” under the term functional somatic
syndromes to now be “split” into conditions with different
origins that require precision, personalized care for their
successful management.
In 2013, an important study was published with the
title, “Functional Somatic Syndromes: One or Many? An
Answer by Cluster Analysis.”8 The conclusions from this
detailed analysis in 394 patients with functional somatic
syndrome symptoms, which were evaluated on the basis of
47 somatic symptoms, was that the clusters could not be
defined by increasing symptom scores alone. This argues
17. for the “splitters” claim that each of these conditions is
unique in its etiology and requires personalized
intervention.
In 2015, Williams and Moore9 from the Perelman
School of Medicine at the University of Pennsylvania
authored the paper “Lumping versus Splitting: The Need
for Biological Data Mining in Precision Medicine.”They
point out that the mining of data from the recent spectrum
of biological and biomedical research is revealing broad
implications for medicine as it moves toward a more
precision, personalized form of delivery. Until recently, it
was not possible to accurately quantitate changes in an
individual’s functional status before the onset of
recognizable disease. The ability we now have to detect
early changes in function is a disruptive influence on the
health care system that creates the context for delivering a
more precise form of personalized medicine. New
functional assessment tools are being developed in every
specialty area of medicine by using the new biomedical
information that is becoming available in this postgenomics
era. These tools will allow for the assessment of complex
chronic health problems that were in the past considered
as functional somatic syndromes to be understood at the
systems biology level. This approach will allow the patient
to be managed by application of the functional medicine
operating system at the systems biology level that treats
the cause and not just the symptoms of their condition and
moves closer to achieving a predictive medical care
system.
Schadt and Björkegren10 described the development
of a systems biology approach to health care as the
foundation of the new biology that will provide medical
solutions to complex health problems that have been
18. resistant to the 20th-century approach to disease treatment.
They pointed out that health and disease patterns are
governed by the complex network of interaction among
genes, environment, diet, lifestyle, and social environment.
Moreover, they argued that these interactions determine
both individual health and in the collective societal health.
All of this new biology and network-enabled wisdom
about health and disease is driven by a much more precise
understanding of function and what it means at every level
of organization.
In retrospect, it is remarkable how the concepts that
became the founding principles for the definition of
functional medicine and the Institute for Functional
Medicine in 1991 track with the development of
biomedicine during the past 25 years. In the past
2 decades, we have witnessed medicine responding to the
remarkable discoveries that have been made in
understanding of the effect that genes and environment
have on health and disease. The health care industry is
showing changes in response to the transformative effects
of this new biology that is focused more on defining
individual function/dysfunction and less on the lumping
of individuals into specific disease categories.
Functional medicine has evolved to be a clinical
operating system for the application of a patient-centered,
systems biology approach to health care. Its focus is on
understanding an individual’s physiological, cognitive,
emotional, and physical function, as well as on the design
and implementation of a therapeutic program that is
personalized to the functional needs of the patient. The
functional assessment can be applied at many
organizational levels derived from a systems network
biology perspective ranging from the patient’s social and
spiritual functions to organ system, organ, tissue, cellular,
19. or subcellular functional levels. Functional medicine
practitioners are trained to think in terms of function
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Integrative Medicine • Vol. 16, No. 1 • February 2017
25Bland—Creating Synthesis
derived from biological and social systems and network
biology. They become skilled in looking at the patient
simultaneously from the frame of reference of both a
telescope and microscope—the macroscopic and the
microscopic holograph.
In the functional medicine model, the word function
is aligned with the evolving understanding that disease is
an endpoint and function is a process. Function can move
both forward and backward. The vector of change in
function through time is, in part, determined by the
unique interaction of an individual’s genome with their
environment, diet, and lifestyle. The functional medicine
model for health care is concerned less with what we call
the dysfunction or disease, and more about the dynamic
processes that resulted in the person’s dysfunction. The
previous concept of functional somatic syndromes as
psychosomatic in origin has now been replaced with a
new concept of function that is rooted in the emerging
21st-century understanding of systems network-enabled
biology.
References
1. Jones DS, Quinn S. Textbook of Functional Medicine. Gig
20. Harbor, WA:
Institute for Functional Medicine; 2010.
2. Maue FR. Functional somatic disorders: Key diagnostic
features. Postgrad
Med. 1986;79(2):201-210.
3. Barsky AJ, Borus JF. Functional somatic syndromes. Ann
Intern Med.
1999;130(11):910-921.
4. Wessely S, Nimuan C, Sharpe M. Functional somatic
syndromes: One or
many? Lancet. 1999;354(9182):936-939.
5. Kellner R. Functional somatic syndromes and
hypochondriasis: A survey of
empirical studies. Arch Gen Psychiatry. 1985;42(8):821-833.
6. Miyaoka H, Miyachi H, Oishi S. Is “functional somatic
syndrome” clinically
useful? Nihon Rinsho. 2009;67(9):1726-1730.
7. White PD. Chronic fatigue syndrome: Is it one discrete
syndrome or many?
Implications for the “one versus many” functional somatic
syndromes
debate. J Psychosom Res. 2010;68(5):455-459.
8. Lacourt T, Houtveen J, van Doornen L. “Functional somatic
syndromes, one
or many?” An answer by cluster analysis. J Psychosom Res.
2013;74(1):6-11.
9. Williams SM, Moore JH. Lumping versus splitting: The need
21. for a biologic
data mining in precision medicine. BioData Min. 2015;8:16.
10. Schadt EE, Björkegren JL. NEW: Network-enabled wisdom
in biology,
medicine, and healthcare. Sci Transl Med. 2012;4(115):115rvl.
GROUNDBREAKERGROUNDBREAKER
AWARDSAWARDS
CONGRATULATIONS!
Dr. Steven Aung
University of Alberta, Edmonton, AB
Dr. Jozef Krop
EcoHealth and Wellness Inc., Mississauga, ON
Dr. Stephen Sagar
McMaster University, Hamilton, ON
Dr. Donald Warren
Naturally Well Naturopathic Clinic, Ottawa, ON
Dr. Joseph Wong
Toronto Pain & Stress Clinic, Toronto, ON
Groundbreaker Awards Gala Dinner
In celebration of the 10th anniversary of the Dr. Rogers Prize,
we are
excited to honour the pioneering spirit of the Groundbreaker
Award
recipients who paved the way for a new era in Canadian health
care.
Friday, February 24, 2017 | 6:00 -10:00 pm
22. Fairmont Royal York | Toronto, ON
Tickets available online at DrRogersPrize.org
“If I have seen further, it is by standing
on the shoulders of giants.”
2017 Call for Nominations
Nominations are now being accepted for the $250,000
Dr. Rogers Prize for Excellence in Complementary &
Alternative
Medicine. The winner will be announced at a Gala Award
Dinner in
Vancouver, BC, in September, 2017.
Nominations close: Wednesday, May 31, 2017, 5:00 pm PST
Nominations and information: DrRogersPrize.org
Dr Rogers Prize IMCJ ad 5260.indd 1 30/11/2016 12:13 pm
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23. 1
Writing Summaries
A note: CUSSW instructors vary greatly in what they ask of
students when writing
summaries; therefore, what follows should be read as a guide,
not as a directive.
The goal of writing a summary of an article, a chapter, or a
book is to offer as
accurately as possible the full sense of the original, but in a
more condensed form. A
summary restates the author’s main point, purpose, intent, and
supporting details in
your own words.
The process of summarizing can help you to better grasp the
original, and your
summary will show the reader that you understand it as well. In
addition, the
knowledge gained will enhance your ability to analyze and
critique the original.
determine the approach
you will want to take in writing your summary. Most journal
articles are structured
and written according to one of five types:
24. 1. Empirical studies are reports of original research containing
four distinct
sections. You will want to locate and write about the purpose
of the study or
the problem under investigation; the methods used; the results;
and the
conclusion the author makes from the results, including
implications for the
field of practice.
2. Review articles evaluate studies already published. You will
need to describe
the question or problem being addressed; summarize the
literature review,
which is a major part of a review article; and describe the
author’s
suggestions for the next steps in dealing with the problem.
3. Theoretical articles examine research literature to assess and
or advance
current theory. The summarizing process is similar to that for a
review article.
4. Methodological studies focus on approaches and analyses of
new or existing
methods of conducting research in comparison to alternative
methods. Your
approach is also similar to 2 and 3 above: describe the
approach, its
applicability, supporting details, conclusions, and implications
for the approach
or analysis under study.
25. 2
5. Case studies describe work with an individual or organization
to illustrate a
problem, indicate a way of solving a problem, or point to areas
of needed
research. Again, your approach will be similar to 2, 3, and 4
above.
questions in
mind:
1. In the introduction: What is the author’s purpose, or goal, or
thesis? Why is
she writing this article? What does she want to say?
2. What are the author’s methods or key points? How does the
author go about
making her points? What method is she using to conduct her
study?
3. What are the results, the findings?
4. What are the conclusions? What does the author say about
her findings?
What are the implications of the results? What do the results
mean for the
26. field, for further research?
of the above.
Good study skills help produce good writing; that is, learning
how to identify key points
(how to discriminate, how to decide what is important and what
is not), and taking note
of them, will help you improve your critical thinking skills.
Due to the structure of these articles—and because you have so
many of them to read
and summarize—try not to read them as you would a traditional
narrative, for example, a
novel or an essay with an opening position on some issue,
followed by supporting
details, and conclusion (though this is not true for all social
work journals).
1. Check the length of the article; then read the headings,
subheadings, graphs,
tables, pictures. Next, read the introduction and the conclusion,
or the first and
last paragraphs. Next, read the first and last paragraphs of each
section—
between the headings. This approach will provide you with a
preview of the work,
helping you to effectively engage with it.
27. 3
2. Read each section, jotting down notes on or highlighting the
important points.
Write the central idea and the author’s reasons (purpose and
intent) for holding
this viewpoint. Note the supporting elements the author uses to
explain or back
up her main information or claim.
3. If you choose to write an outline, include in it the main idea
and any supporting
details. Arrange your information in a logical order, for
example, most to least
important, or chronological. Your order need not be the same
as that in the
original, but keep related supporting points together. The way
you organize the
outline may serve as a model for how you divide and write the
essay.
4. Write the summary, making sure to state the author’s name in
the first
sentence. Present the main idea, followed by the supporting
points. The
remainder of your summary should focus on how the author
supports, defines,
and or illustrates that main idea. Remember, unless otherwise
stated by your
instructor, a summary should contain only the author’s views,
so try to be as
28. objective as possible. A note: prudent use of the author’s terms
and data does
not constitute plagiarism, but the use of phrases (of three or
more words) very
well may.
5. As you revise and edit your summary, compare it to the
original and ask
yourself questions such as: Have I rephrased the author’s words
without
changing their meaning? Have I restated the main idea and the
supporting
points accurately and in my own words?
6. If the assignment calls for you to write a critical summary or
to include a
critique, you may want to ask yourself questions such as: Does
the author
succeed? How and why or why not? What are the strengths,
weaknesses?
Why? What did the author do well? Not well? Why? In
addition, you might
want to include a statement on the article’s conclusions—their
applicability to
social work policy, practice, and or research.
Integrative Medicine • Vol. 17, No. 1 • February 201812
Bland—Creating Synthesis
The Natural Roots of Functional Medicine
Jeffrey S. Bland, PhD, FACN, FACB, Associate Editor
29. CREATING SYNTHESIS
Jeffrey S. Bland, PhD, FACN, FACB, is the president and
founder of the Personalized Lifestyle Medicine Institute in
Seattle, Washington. He has been an internationally
recognized leader in nutrition medicine for more than
25 years. Dr Bland is the cofounder of the Institute for
Functional Medicine (IFM) and is chairman emeritus of
IFM’s Board of Directors. He is the author of the 2014 book
The Disease Delusion: Conquering the Causes of Chronic
Illness for a Healthier, Longer, and Happier Life.
People often ask me about the origins of the functional
medicine concept. The Institute for Functional Medicine
has captured worldwide attention in the last several
decades, and it continues to expand its reach in ways that
I watch with great pride and pleasure. Like the creation of
many new ideas, the functional medicine concept cannot
be tracked to a well-defined business plan or an organized
management structure. Rather, it emerged organically
from conversations and collaborations, and then it
continued to evolve due to the shared visions—and hard
work—of many dedicated health professionals.
Humble Beginnings, an Open Mind, and
Unexpected Attention
In 1971, I took my first “real job.” I was an assistant
professor of chemistry and environmental science at the
University of Puget Sound in Tacoma, Washington, where
I had the opportunity to teach a number of different
chemistry-related subjects, including biochemistry and
environmental science. One of my first research students
was interested in doing work with vitamin E. I knew very
little about vitamin E at that time, only that it was an
30. interesting family of molecules with the name tocopherol,
which—from the Greek—means “to bear offspring.”
Why this name? When vitamin E was discovered in
1922 by Herbert Evans, MD, and his research assistant,
Katharine Bishop, MD, at the University of California,
Berkeley, their studies indicated that rats fed a diet
containing highly purified fat were unable to successfully
produce live offspring.1 With additional research, they
discovered that the process of purifying fat removed a
fat-soluble family of nutrient molecules, which they later
called vitamin E or tocopherols. My student and I decided
to evaluate the effect of vitamin E on the human red blood
cell in both controlled in vitro studies and in vivo human
intervention trials. Our work, which took place between
1972 and 1975, revealed how vitamin E protects red blood
cells against damage associated with aging; we were
among the first investigators to report a mechanistic link
between vitamin E and a health benefit in humans.2,3
The publication of this work generated significant
interest from the medical and nutrition research
communities, and even among the general public. My
visibility was rising, and I was invited to speak at a number
of professional meetings. I suddenly found myself being
described as a nutritionist, when in reality my training and
background made me more a clinical biochemist and
environmental scientist. These new opportunities brought
me into contact with a number of very interesting groups
that would change my life and career forever.
An Invitation, a Life-changing Introduction, and an
Open Door
In 1975, I attended the inaugural meeting of the
Northwest Academy of Preventive Medicine, which was
31. founded by Leo Bolles, MD. The conference took place in
Seattle, Washington, and Linus Pauling, PhD, 2-time
Nobel Laureate in chemistry and peace, was the keynote
speaker. It was my honor and privilege to meet Dr Pauling
for the first time at this event, and this encounter was the
This is a very exciting time for medicine. We are
witnessing the creation of a new approach to the
prevention and treatment of cardiovascular disease. It is
an omnigenic approach—powered by systems biology—
to assembling patient-specific information about how
genes and lifestyle interact. When combined with other
new technologies such as artificial intelligence and
machine learning informatics, the result will be the
development of a precision form of personalized lifestyle
medicine applied to cardiovascular disease. This
advancement will be a gateway for change throughout
the entire segment of the health care system that is
focused on the many complex chronic conditions
affecting our world population.
Abstract
Integrative Medicine • Vol. 17, No. 1 • February 2018
13Bland—Creating Synthesis
beginning of a long-term professional relationship, which
ultimately led to my work at the Linus Pauling Institute of
Science and Medicine in Palo Alto, California, in the early
1980s. While I was still at the university, however, I
answered a knock on my office door one memorable day
in 1977. In my doorway stood Joseph Pizzorno, ND—to
this day, a lifelong friend and colleague—along with a
32. group of naturopathic physicians. In retrospect, I recognize
that I hosted an impromptu gathering of naturopathic
superstars in my small office that day. The ensemble
included Bill Mitchell, Les Griffith, Jenefer Huntoon,
Cathy Rogers, Irv Miller, Cathy Naughton, and even the
esteemed father of naturopathic medicine in the Pacific
Northwest, John Bastyr, DC, ND.
Decades later, time now allows me to recognize that
my interaction with this group of young, energetic,
dedicated, and very intelligent naturopaths was my first
introduction to the field of naturopathy and natural
medicine. They had come to me with a request: Would I
teach a class in botanical pharmacology—they would be
my students—to help facilitate renewal of the ND licensure
law in the state of Washington? Naively, I took up the
challenge, and for 3 months we came together regularly to
complete the course. With a great deal of amusement, I
now think back to the scene: There I was—a young
hotshot professor of chemistry—trying to teach
Dr John Bastyr about botanical pharmacology when he
was a respected world expert in this field. It is a testament
to Dr Bastyr’s character that he thoroughly engaged in the
discussions and never held himself above the material;
rather, he not only contributed richly to the class dialogue,
but also to my own education in the process. When I
shared the news of this collaboration with my mother,
who was living in California at the time, she indicated that
she had gone to a naturopath as a child growing up in
Los Angeles; her mother—my grandmother—had been a
big supporter of natural medicine. This uniquely personal
endorsement of the field somehow solidified the positive
impression I had already formed about my new colleagues.
A Sabbatical, Transformative Lectures, and a
Chance Encounter
33. My association with the leaders of the emerging field
of naturopathic medicine led to an important introduction
and opportunity. Richard Liebmann, ND, was dean of the
National College of Naturopathic Medicine in Portland,
Oregon, in 1978, and he inquired whether I would teach a
course in nutritional medicine at the college. I agreed, and
1978 turned out to be a pivotal year for my career as an
educator. I took a sabbatical from my permanent university
position. A group of students at Evergreen State College—a
school known for innovative course design—had
nominated me to teach nutritional biochemistry at the
campus in Olympia, Washington. I organized a companion
course that was team taught by me, Dr Joe Pizzorno, and
Betty Cutter, PhD, that we called “Is there a Healer in the
House?” Together, we coordinated weekly guest lectures
about topics connected to the healing arts, and our
speakers represented a diverse range of specialties, from
natural medicine to surgery. That year—splitting my time
between NCIM in Portland and Evergreen in Olympia—
my personal knowledgebase expanded well beyond my
clinical biochemistry and environmental science training.
I was fascinated by the many rich perspectives I was
exposed to about medicine, health, disease, and healing.
With each lecture I listened to, with each book I read, and
with each new relationship I established, my own unique
perspective on these topics was taking shape, and my
excitement about the future was building.
During this same period of time, I attended a meeting
of the Northwest Academy of Preventive Medicine. By
chance, I sat next to another “young turk”: David Jones, MD,
a family physician from Ashland, Oregon. In the course of
the meeting, Dr Jones and I became increasingly
dissatisfied with our experience at this conference. The
34. presentations often seemed to lack a thematic direction
and we had questions about the scientific rigor of some of
the research. Dr Jones and I talked about what we would
like to do to make future meetings of this group more
successful. As a pair, we were outspoken and unabashed;
as a consequence, I became the president of the Northwest
Academy of Preventive Medicine in 1979, and Dr Jones
started the Southern Oregon Academy of Preventive
Medicine. During the next 10 years, Dr Jones and I
collaborated on growing our 2 networks. Breaking away
from closely held traditions of exclusivity that govern most
professional organizations, we were united in our belief
that our groups should be open to all upstanding members
of the healing arts: naturopaths, medical doctors,
chiropractors, dentists, acupuncturists, dietitians,
nutritionists, nurses, physical therapists, and physician
assistants. We hoped to engage those members of each
profession who were dedicated to excellence and life-long
learning from one another and from emerging science.
New Ventures, Exciting Times, and a Big Decision
This era was a very dynamic time in the Pacific
Northwest, especially in the evolution of natural medicine.
I established a monthly study club that served as a
gathering place for the leaders of the natural medicine
movement. We frequently recorded these sessions, and
audiotapes would be shared among people who couldn’t
attend in person. A decade later, I began producing a
monthly audio series based on my experience with the
study group, and “Functional Medicine Update”—the
name of my recording—became a regular part of my life
for more than 34 years. At our study group meetings in the
late 1970s, Dr Pizzorno and I frequently discussed the
need for a science-based naturopathic medical college,
and we believed that Seattle would be the ideal location.
35. Other leaders in the field agreed with the worthiness of
this project, and in 1978 the establishment of the
Integrative Medicine • Vol. 17, No. 1 • February 201814
Bland—Creating Synthesis
John Bastyr College of Naturopathic Medicine moved
from discussion to implementation. I joined Bastyr’s first
board of trustees and became founding president of the
Council of Naturopathic Medical Education. Jointly, these
organizations applied to the US Department of Education
for official recognition and accreditation, which was
ultimately granted.
By 1981, I was once again on sabbatical from my
teaching position at the University of Puget Sound. At the
invitation of Dr Linus Pauling, I was working under his
mentorship at the Linus Pauling Institute of Science and
Medicine. For 2 extraordinary years, I had the opportunity
to engage in research and program development that was
foundational to the integration of systems biology into
medicine. I interacted with an amazing group of innovators;
Dr Pauling himself was the leader of the institute, and he
invited scientific leaders and colleagues from around the
world to visit the institute as guest faculty. During this
period, I studied the history of medicine and the healing
arts in greater detail. I read voraciously about the concept
of natural medicine and naturopathy.4 In 1983, a conference
that was organized as a tribute to Dr Pauling took place in
San Francisco. The proceedings from this event were
edited by Richard Huemer, MD, and published in a book
titled The Roots of Molecular Medicine. My contribution
was a chapter based on my presentation,
“Lipid-Peroxidation-Induced Diseases: A Model of
36. Molecular Disease.”5 Among the many personal and
professional milestones I achieved during my years at the
Pauling Institute, a project of particular pride was my
work with the noted Scottish cancer specialist, Ewan
Cameron, MD, on the development of an integrated
approach to cancer therapy that culminated in our
completion of an animal study on the differential effects of
omega-6 and omega-3 fatty acids. We published our
results in 1989, and the findings were surprising: In a
mouse model of breast cancer, an omega-6-enriched diet
produced a procarcinogenic effect, whereas an
omega-3-enriched diet produced a cancer-protective
effect.6
After completing my second sabbatical year in 1984, I
made a dramatic decision: I resigned from my faculty
position and relinquished my university tenure. I started a
company—HealthComm International—with the
intention of teaching practitioners how to implement
preventive nutritional medicine in their practices. Why
did I move away from academia? Because Dr Pauling had
asked me a pointed question when our time together came
to an end: “Do you think your classroom will be big
enough for you and your vision to bring science-based
nutritional medicine to the practitioner?” I decided to rise
to the challenge, and so I made the life-changing decision
to redefine my professional identity. A new chapter
started: I was now an entrepreneur whose focus was to
build a new discipline of science—as well as a business—
around the concept and power of nutritional medicine.
The Origin of Functional Medicine and the
Institute for Functional Medicine
By 1988, HealthComm was well established as a
leadership organization in nutritional medicine education
37. and development. My wife, Susan Bland, suggested that we
bring together some of the remarkable people I had met
through the years—innovators and leaders—to discuss
our vision for the future and objectives for collaborative
efforts. We convened a meeting in 1989 in Victoria,
British Columbia, Canada. A group of key opinion leaders
from different backgrounds, and with different perspectives
and expertise, were invited to discuss and freely exchange
ideas about what the “best practices” of health care in the
future might look like. Sponsored by HealthComm, the
attendee list was as follows:
• Sid Baker, MD
• Stephen Barrie, ND, PhD
• Jeffrey Bland, PhD
• Susan Bland, MA
• J. Alexander Bralley, PhD
• Leo Galland, MD
• David Jones, MD
• Jeff Katke
• Martin Lee, PhD
• Hakeem Lewis, ND
• Peter Madill, MD
• Wayne Matson, PhD
• Darrell Medcalf, PhD
• Jean Munro, MD (England)
• Stephen Paul, PhD
• Joseph Pizzorno, ND
• Graham Reedy, MD
• Scott Ridgen, MD
From the discussion among this diverse group of
experts, the concept of functional medicine as a systems
biology approach to health care was born. Systems biology
was just emerging as a conceptual way of thinking about
the complex interactions in biology and molecular
38. medicine that give rise to function; once established,
innovators such as Lee Hood, MD, PhD, would go on to be
acknowledged as pioneers in this field.7 Among our group,
there was considerable discussion as to whether
functional medicine was an appropriate term; this
description was already in use in geriatric medicine and
also in reference to psychosomatic illness.8,9 It was the
consensus of the group that the use of the term functional
in medicine was starting to change in the late 1980s,
especially due to the development of important new
technologies and approaches, such as functional MRI and
functional cardiology. Our assembled group also believed
that functional medicine would honor the molecular
medicine concept of Linus Pauling and its connection to
system biology10 as well as the roots of science-based
natural medicine.11 All these years later, the word functional
Integrative Medicine • Vol. 17, No. 1 • February 2018
15Bland—Creating Synthesis
now applies to states of health that span physiological,
physical, cognitive, and emotional issues in health care;
the accumulated loss of function across those 4 functional
domains defines the early signs of what is later diagnosed
as pathological disease.12
Nearly 2 decades after our summit in
British Columbia, a colleague discovered a stunning
article in the medical literature: an editorial published in
Lancet in 1871 by Sir Willoughby F. Wade, MD, professor
of medicine at Queens College in Birmingham, England,
titled “Clinical Lecture on Functional Medicine.”
Professor Wade wrote the following words: “Whenever
we come to treat a case, to prescribe drugs or particular
39. diets, rest or action, we should first of all consider what
function of the body it is that is improperly performed.”13
As a copy of this article was emailed and shared digitally
in a future world that the distinguished Professor Wade
most likely never envisioned, my colleagues and I came
to recognize that functional medicine is a concept that
makes sense in any era when the right questions are
being asked. We’ll never know what kind of reception
Professor Wade’s lecture received when he presented it in
March of 1870, but given the silence that followed for
more than 100 years, one can assume he was a unique
thinker in a time that preferred conformity to innovation.
For a truly successful application of functional medicine
to take place—one with widespread impact and clinical
success—the science of systems biology and molecular
medicine, in combination with a focus on
patient-centered health care, represents the right soil for
the concept to take root and thrive.
Natural Medicine Education and the Connection to
Functional Medicine
In 2016, journalist John Weeks, who is well known
for his in-depth reporting on topics related to natural
medicine, wrote a column about the early leadership
within the naturopathic profession and the later
emergence of functional medicine.14 In this review, he
acknowledged the modern rebirthing of a science-based
naturopathic profession in the late 1970s and early 1980s
and described the significant role this era played in the
development of both integrative and functional medicine.
What I have written here today is an insider’s view of key
events that transpired during that period and the very
real people we should honor and credit as we reflect on
this history. For me, it all started with a knock on my
door. I opened it to find a friendly and smiling group of
40. quiet revolutionaries, and I hold each one in the highest
regard to this day. Their work led to the first graduates of
distinction from the National College of Naturopathic
Medicine in Portland and John Bastyr College of
Naturopathic Medicine in Seattle. Later, the movement
spread, and I had the opportunity to work with the
founders of the Canadian College of Naturopathic
Medicine in Toronto on the development of their
science-based curriculum. Later still came the Southwest
College of Naturopathic Medicine in Scottsdale, Arizona,
and Bridgeport University College of Naturopathic
Medicine in Connecticut.
With my wife, Susan Bland, I founded the Institute for
Functional Medicine in 1991. The forward-looking
dialogue that began with natural medicine has never
stopped: How do we balance science with experience, the
individual with the average, the diagnosis with the
prognosis, the intervention with the intention, the
technology with the intuition, and the genes with the
environment? More than 100 000 licensed health care
practitioners have participated in education programs
offered through the Institute for Functional Medicine
during the past 26 years. Millions of patients have
experienced the functional medicine approach to the
clinical implementation of systems biology, as well as
personalized prevention and treatment during this
period.15 In 2014, the Cleveland Clinic Center for
Functional Medicine was established; hundreds of patients
are now seen annually and the success of the functional
medicine operating system is being closely measured.16
For me, this has been a remarkable 40-year journey, and it
was the convergence of 3 paths—natural medicine,
molecular medicine, and systems biology, viewed through
the lens of patient-centered care—that elucidated not only
41. the case for the development of the functional medicine
concept, but also the need for it as a logical step as an
operating system for the transformation of health care.
Personalized lifestyle health care, a dynamic field that will
introduce even more people to the value of functional
medicine applications, is a success story that is just
beginning to be fully revealed.17,18 A new year has just
turned, and therefore the journey—for all of us—continues.
The past is important to me and I like to honor the history
and lineage that brought us to this time and place, but like
so many others, I also look forward with great anticipation
to the emergence of a new era of discovery, progress, and
empowerment.
References
1. Niki E, Traber MG. A history of vitamin E. Ann Nutr Metab.
2012;61(3):207-212.
2. Bland J, Canfield W, Kennedy T, et al. Effect of tocopherol
on photooxidation
rate of human erythrocyte membrane in vitro. Physiol Chem
Phys.
1978;10(2):145-152.
3. Bland J, Madden P, Herbert EJ. Effect of alpha-tocopherol on
the rate of
photohemolysis of human erythrocytes. Physiol Chem Phys.
1975;7(1):69-85.
4. Krause H. A review of the history of naturopathy. J Natl
Malar Soc. 1946;2:18.
5. Huemer, Richard P. The Roots of Molecular Medicine. A
Tribute to Linus
Pauling. New York, NY: W. H. Freeman and Company; 1983.
6. Cameron E, Bland J, Marcuson R. Divergent effects of
42. omega-6 and omega-3
fatty acids on mammary tumor development in C3H/Heston
mice treated
with DMBA. Nutr Res. 1989;9(4):383-393.
7. Editorial Staff. Interview with Leroy Hood. Bioanalysis.
2013;5(12):1475-
1478.
8. Wessely S, Nimnuan C, Sharpe M. Functional somatic
syndromes: One or
many? Lancet. 1999;354(9182):936-939.
9. Jeffcoate WJ. Chronic fatigue syndrome and functional
hypoadrenia: Fighting
vainly the old ennui. Lancet. 1999;353(9151):424-425.
10. Pauling L, Itano HA. Sickle cell anemia a molecular
disease. Science.
1949;110(2865):543-438.
Integrative Medicine • Vol. 17, No. 1 • February 201816
Bland—Creating Synthesis
11. Pizzorno JE. Naturopathic medicine—a 10-year perspective
(from a 35-year
view). Altern Ther Health Med. 2005;11(2):24-26.
12. Bland J. Functional medicine: An operating system for
integrative medicine.
Integr Med (Encinitas). 2015;14(5):18-20.
13. Wade WF. Clinical lecture on functional medicine. Lancet.
43. July 1871;1:1.
14. Weeks J. The Leadership of the naturopathic profession in
the emergence of
integrative and functional medicine…plus more. Integr Med
(Encinitas).
2016;15(2):16-18.
15. Hyman M. A look at the Institute for Functional Medicine
with David Jones,
MD. Altern Ther Health Med. 2008;14(1):10-11.
16. Weeks J. Tipping point? Cleveland Clinic announces
partnership with
Hyman/Hanaway and the Institute for Functional Medicine …
plus more.
Integr Med (Encinitas). 2014;13(6):12-15.
17. Hyman MA, Ornish D, Roizen M. Lifestyle medicine:
Treating the causes of
disease. Altern Ther Health Med. 2009;15(6):12-14.
18. Bland JS, Minich DM, Eck BM. A systems medicine
approach: Translating
emerging science into individualized wellness. Adv Med.
2017;2017:1718957.
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44. How to Summarize a Research Article
Research articles use a standard format to clearly communicate
information about an
experiment. A research article usually has seven major sections:
Title, Abstract,
Introduction, Method, Results, Discussion, and References.
Determine your focus
The first thing you should do is to decide why you need to
summarize the article. If the
purpose of the summary is to take notes to later remind yourself
about the article you may
want to write a longer summary. However, if the purpose of
summarizing the article is to
include it in a paper you are writing, the summary should focus
on how the articles
relates specifically to your paper.
Reading the Article
Allow enough time. Before you can write about the research,
45. you have to understand it.
This can often take a lot longer than most people realize. Only
when you can clearly
explain the study in your own words to someone who hasn’t
read the article are you ready
to write about it.
Scan the article first. If you try to read a new article from start
to finish, you'll get
bogged down in detail. Instead, use your knowledge of APA
format to find the main
points. Briefly look at each section to identify:
• the research question and reason for the study (stated in the
Introduction)
• the hypothesis or hypotheses tested (Introduction)
• how the hypothesis was tested (Method)
• the findings (Results, including tables and figures)
• how the findings were interpreted (Discussion)
Underline key sentences or write the key point (e.g., hypothesis,
design) of each
paragraph in the margin. Although the abstract can help you to
identify the main points,
you cannot rely on it exclusively, because it contains very
condensed information.
46. Remember to focus on the parts of the article that are most
relevant.
Read for depth, read interactively. After you have highlighted
the main points, read each
section several times. As you read, ask yourself these questions:
• How does the design of the study address the research
questions?
• How convincing are the results? Are any of the results
surprising?
• What does this study contribute toward answering the original
question?
• What aspects of the original question remain unanswered?
Plagiarism. Plagiarism is always a risk when summarizing
someone else’s work. To
avoid it:
• Take notes in your own words. Using short notes or
summarizing key points in
your own words forces you to rewrite the ideas into your own
words later.
• If you find yourself sticking closely to the original language
and making only
minor changes to the wording, then you probably don't
understand the study
47. Writing the Summary
Like an abstract in a published research article, the purpose of
an article summary is to
give the reader a brief overview of the study. To write a good
summary, identify what
information is important and condense that information for your
reader. The better you
understand a subject, the easier it is to explain it thoroughly and
briefly.
Write a first draft. Use the same order as in the article itself.
Adjust the length
accordingly depending on the content of your particular article
and how you will be using
the summary.
• State the research question and explain why it is interesting.
• State the hypotheses tested.
• Briefly describe the methods (design, participants, materials,
procedure, what was
manipulated [independent variables], what was measured
[dependent variables],
how data were analyzed.
• Describe the results. Were they significant?
• Explain the key implications of the results. Avoid overstating
the importance of
48. the findings.
• The results, and the interpretation of the results, should relate
directly to the
hypothesis.
For the first draft, focus on content, not length (it will probably
be too long). Condense
later as needed. Try writing about the hypotheses, methods and
results first, then about
the introduction and discussion last. If you have trouble on one
section, leave it for a
while and try another.
If you are summarizing an article to include in a paper you are
writing it may be
sufficient to describe only the results if you give the reader
context to understand those
results.
For example: “Smith (2004) found that participants in the
motivation group scored higher
than those in the control group, confirming that motivational
factors play a role in
impression formation”. This summary not only tells the results
49. but also gives some
information on what variables were examined and the outcome
of interest. In this case it
is very important to introduce the study in a way that the brief
summary makes sense in
the larger context
Edit for completeness and accuracy. Add information for
completeness where necessary.
More commonly, if you understand the article, you will need to
cut redundant or less
important information.
Stay focused on the research question, be concise, and avoid
generalities.
Edit for style. Write to an intelligent, interested, naive, and
slightly lazy audience (e.g.,
yourself, your classmates). Expect your readers to be interested,
but don't make them
struggle to understand you. Include all the important details;
don't assume that they are
already understood.
50. • Eliminate wordiness, including most adverbs ("very",
"clearly"). "The results
clearly showed that there was no difference between the groups”
can be shortened
to "There was no significant difference between the groups".
• Use specific, concrete language. Use precise language and cite
specific examples
to support assertions. Avoid vague references (e.g. "this
illustrates" should be
"this result illustrates").
• Use scientifically accurate language. For example, you cannot
"prove"
hypotheses (especially with just one study). You "support" or
"fail to find support
for" them.
• Rely primarily on paraphrasing, not direct quotes. Direct
quotes are seldom
used in scientific writing. Instead, paraphrase what you have
read. To give due
credit for information that you paraphrase, cite the author's last
name and the year
of the study (Smith, 1982).
• Re-read what you have written. Ask others to read it to catch
things that you’ve
missed.