Thanks Sally, its a very good video. I have been interested in systems approaches since the 80s. I embraced them in the 90s. I tried to apply them to CFS but my knowledge was lacking (late 90s) yet my approach was not hugely different from what is discussed in this video, I just didn't have the tools.
Now on causation, diagnoses and mechanisms I agree with the speaker (Mark Hyman). Its how I think about it myself, which of course makes me biased.
However, I do recognize the concerns raised by Esther12. BPS arose out of an attempt to apply systems theory to medicine. It failed. Its still failing us. This arose, in my view, because they tried to tack existing medical paradigms onto the BPS model, rather than applying the BPS model to improve existing paradigms. To get advances here takes time, research and communication. It will not, it cannot, happen overnight.
Its a process not an algorithm, and this distinction has been lost along the way.
So functional medicine is still in its infancy. However, I do agree this is the way forward, particularly in dealing with chronic disease. Treating symptoms of a patient because some patients with those symptoms improve on a particular treatment is statistical medicine: to put it another way its Russian Roulette. Identifying causes (with appropriate testing) and treating causes has to be better. Treating systems of causes is better again. I do see this as the future of medicine, even the future of psychiatry.
This is a roadmap, a diagram for medicine. Here is the analogy I was going to develop in my book, and now I think I need to look more closely at functional medicine, because its their analogy too. Conventional medicine, especially psychiatry, is based on heuristic algorithms. Patient presents with lack of activity and drive ... ergo its depression: thats an algorithm. Its an if-then presumption. However, looking holistically at the patient (which is what BPS is supposed to do but fails) we would have to look at diet, biochemistry, social factors, psychology, the whole system of issues. This includes pathogens, immune problems, etc. The problem is this is complex, and complex in a way that most doctors are not trained to reason about. Their entire paradigm is algorithmic and statistical.
Put it another way. You need to get to a village called Wellness. One doc looks up a book that says turn left in 3 klicks, turn right after the big tree, go under the bridge and turn left, proceed 20 klicks and .... you get the idea. The next doc says, hey, wait a minute, I will generate a map, and then we can navigate a path to the destination.
One has instructions. If anything goes wrong along the way, you wind up lost. Next thing you know you will be blamed for not following instructions.
The other has a map. If you get lost you simply create an updated map, and renavigate.
Bye, Alex