What is Functional Medicine?
The short answer is conventional medicine asks “What?”, and functional medicine asks “Why?”
The functional medicine model of care provides an operating system that works to reverse illness, promote health, and optimize function by addressing underlying causes, symptoms, and functional imbalances in interconnected biological networks. These imbalances may impair principal biological functions (assimilation, defense and repair, energy production, biotransformation, communication, transport, and structural integrity) that result from gene-environment interactions, including lifestyle, environmental toxins, and the microbiome. Functional medicine removes triggers for illness and provides inputs to restore and optimize health. Functional medicine also addresses social determinants, including the psychological, emotional, and spiritual aspects of health and disease. A foundation of functional medicine is the use of food as medicine to prevent, treat, and reverse chronic disease. The functional medicine model of care may have the ability to improve patient’s health-related quality of life, including physical function and well-being.
What's the difference in Functional Medicine and Regenerative Medicine?
Functional medicine and regenerative medicine are two different, yet complementary, approaches to wellness. Regenerative medicine focuses on the body’s ability to heal itself. With regenerative medicine, treatments are focused on enhancing and assisting the body’s healing process in an effort to minimize more invasive treatment approaches. Functional medicine is an individualized approach to treatment, which is focused on healing the entire body to alleviate various conditions and symptoms. By understanding the activities and factors that relate to a person’s health, a functional medicine doctor can identify a more natural and effective treatment solution. Functional medicine and regenerative medicine are often used together to find natural treatment solutions that take advantage of the body’s natural abilities.
What does a Functional Medicine doctor do?
A functional medicine doctor works to understand your health, your lifestyle and other characteristics to identify the root cause of your conditions, diseases or symptoms. By considering your overall health and wellness, a functional medicine doctor may discover treatments and solutions that are overlooked elsewhere. After considering all of the different factors that contribute to your well-being, a functional doctor can recommend a more natural treatment solution to help improve your health with less surgery or medications.
Does insurance pay for Functional Medicine?
By the time you find your way to us, you have probably realized insurance based medical care is not working for you. For that reason, we do not accept money from or directly work or negotiate with any insurance companies.
We are not a participating provider with any insurance, and Dr. Katherine is opted out of Medicare. If you have private insurance, you may request an invoice with ICD-10 and CPT codes to submit for reimbursement. However, if you have Medicare you are not allowed to submit anything for reimbursement. Medicare patients can bill standard labs to insurance if necessary. If you are a participant in a sharing plan we will fill out forms describing your care. If you need documentation of your supplement expenses for your HSA we can do that for you. Please fill in any information you can before asking us to complete our part.
We do not provide Superbills.
We will NOT negotiate with your insurance company for coverage of our fees. If medical records are requested, we will provide you with instructions on how to download them from your portal and you are responsible for submitting them. We occasionally get reimbursement checks for patients from insurance companies that we have to send back, so please make it clear that OSMD does not accept insurance reimbursement and that it needs to be delivered to you.
How do I know this will work for me?
What are your rates?
Please see the consultation page for more information. Dr. Katherine works with a limited number of clients at a time which allows her to concentrate on your case and work closely with you towards your goals.
How do I send you my medical records?
Medical records can only be released with your authorization. It is your responsibility to obtain previous medical records from other physicians or health care providers that you want Dr. Katherine to review. If you feel your medical records are pertinent to your appointment with her, please contact your physician or other health care provider to obtain these records and make sure that she has received them at least 14 days prior to your initial appointment. Your medical records can be mailed or faxed to Dr. Katherine office at 864.626.0609 or uploaded directly to your patient portal if you are a registered patient.
Do I have to buy my supplements from you?
There are no requirements that you buy them from Dr. Katherine, only that you use the ones she recommends or approves. She uses the highest quality, purest supplements in order to guarantee results and reduce potential reactions. If you buy other brands in order to save money, you take the risk of getting substandard or contaminated products. Don’t bargain shop when it’s your health that’s on the line. You’ll end up wasting money, or worse, damaging your health.
What happens if I need to go to the hospital or see a specialist?
In providing patients with superb care and unprecedented access to her as their functional medicine physician, Dr. Katherine intends to prevent or reduce hospitalizations and specialty referrals. In those circumstances, she will certainly continue to serve you however she can during your hospital stay or visits with specialists. In most cases, due to the level of care and the expertise required, she will rely on those specialized caregivers to manage your treatment.
What kind of labs do you do?
Dr. Katherine uses specialty laboratories for much of her testing, but she also uses Quest and Labtech Diagnostics for more conventional testing. During your consultation, she will determine which tests are needed and then review the testing recommendations, the instructions and cost. Some testing can be performed at home with test kits to collect urine, saliva or stool samples. Others may require a blood draw at a specific time of day. OSMD does all of your blood draws in our office.
Do you take insurance?
Dr. Katherine does not accept any insurance, including Medicare or Medicaid.
THERE ARE MANY INDIVIDUAL FACTORS INVOLVED IN HEALTHCARE COSTS AND PRICING:
- The fraction of the total cost that your insurance covers, which varies by plan (ex. 80:20)
- The amount you have already paid for healthcare expenses this year (your deductible)
- If your insurance provider is “in network” or “out of network” with the lab performing the testing
- Whether you meet medical criteria required by insurance for coverage of your testing
Dr. Katherine recommends that you check with your insurance provider about your “out of network” benefits and deductible to better understand any restrictions or financial obligations you may have under your current plan. For instance, if you have to meet a large deductible before labs are covered, you may decide that paying cash is a more affordable option and may apply to your deductible for the year. She offers all labs to you at a discounted cash price, but some lab companies will take a co-pay and bill your insurance depending on your coverage.
Her practice is highly specialized and uses advanced and sometimes controversial diagnostic studies and interventions, many of which are not covered by the average health insurance plan, nor should they be. Insurance coverage is really meant for emergencies, non-elective surgeries, expensive medications, routine labs and radiology, and injuries – not health improvement and maintenance.
A growing number of doctors have moved away from accepting insurance because they are tired of insurance companies dictating the amount of time and type of care they can provide their patients.
In the insurance system, every encounter must be submitted as a billing claim to the insurance carrier in order for the doctor to get paid. The doctor only gets a small portion of the billing as payment. Therefore, doctors in the insurance system must see 3,000 patients or more per year (that’s about 30-40 visits per day) just to generate enough billing claims to pay for an office and make a living. This is why you wait so long for an appointment, only to get a few rushed minutes with your doctor.
The insurance system also limits the type of care you get. Your doctor is only able to discuss issues pertaining to the specific visit type so the encounter can fit into an insurance billing claim. Many labs aren’t covered if you don’t have a particular condition that justifies checking them. If you have another issue, you have to schedule another appointment. Most doctors are as frustrated as you are about it.
Dr. Katherine won’t sacrifice her patients’ care. She chooses her patients’ well-being over insurance payments. Because of this choice, she has complete freedom to provide highly personalized, cutting-edge, and unrushed care. Her patients know they can reach her with questions almost any time of the day, any day of the week. She doesn’t need extra staff just to handle insurance claims. Any issue can be discussed that needs to be addressed at any appointment. The focus is on building optimal health, not doing the “bare minimum” or just treating the symptoms of illness after it happens. In this kind of high-value health care practice, you truly get what you pay for.
CAN YOU BE MY PRIMARY CARE DOCTOR?
DO YOU ONLY SEE PATIENTS IN SOUTH CAROLINA?
Can you be my primary care doctor?
Dr. Katherine’s services are limited to that of consultation only. She requires that you maintain a working relationship with a primary care doctor for routine screening exams such as physical exams, pap smears, mammograms, colonoscopies, prostate exams, vaccinations and acute illness care or emergency situations requiring immediate attention or hospitalization. If you have a team of specialists, Dr. Katherine respectfully asks you continue to see them as needed. Her services are an enhancement to – not instead of – your standard medical care.
Do you only see patients in South Carolina?
Dr. Katherine has the ability to work with patients wherever they may be by way of virtual office visits. The first visit must be in-person, and at least once yearly after that to maintain a formal doctor-patient relationship. In-person is always preferred when the visit is more complex or there are many labs to review. Quick follow-ups can be by phone or virtual.