HyrSelf Functional Medicine The Truth About ‘Holistic’ Healthcare: How Insurance Codes Keep Doctors from True Healing

The Truth About ‘Holistic’ Healthcare: How Insurance Codes Keep Doctors from True Healing

Discover why treating symptoms alone can lead to ongoing health issues. Learn how the limitations of specialized healthcare overlook interconnected organ distress, allowing chronic illness to persist. Explore the need for a holistic approach that truly addresses the root causes.

When our organs are distressed or not functioning as they should, the body sends us signals in the form of symptoms. These symptoms are our body’s way of indicating that something is wrong internally, and often more than one organ can be involved. However, the way our healthcare system is structured, especially when it comes to diagnosing and treating health issues for insurance purposes, tends to limit a doctor’s ability to address the whole picture.

Doctors often diagnose based on symptoms that match specific diagnostic codes (ICD codes) and prescribe treatments that align with procedural codes (CPT codes). These codes are required for reimbursement by insurance, which can pressure doctors to focus only on the symptoms that fit these codes. Because of this, a doctor might address only one symptom or organ at a time, often within a single medical specialty, without considering how multiple organs might be affecting one another.

In reality, our body’s systems are interconnected. For instance, hormones, which play a crucial role in our overall health, can influence both our immune system and other organ functions. Hormonal imbalances can lead to either an overactive or suppressed immune response, which in turn can impact various organs. Yet, because each medical specialty focuses on particular organs, doctors might only treat the organs relevant to their field—without exploring how other organs could be involved.

This approach can lead to ongoing organ distress, as treatments often target only symptoms or compensatory organs rather than addressing the root cause. For example, one specialist might prescribe a drug to support a compensating organ without realizing it could worsen the distress in the original, more affected organ. Although each specialty claims to take a “holistic” approach, the structure of the healthcare system restricts their ability to genuinely connect these dots.

As a result, people often continue to experience symptoms and discomfort. A more integrated approach to healthcare, where different specialties can work together and view the body as a whole system, would help prevent the ongoing cycle of organ distress and bring true relief by focusing on the primary sources of dysfunction.
In essence, while functional medicine should offer a more personalized, root-cause approach to health, the current insurance-based system forces these practitioners to squeeze their findings into a less flexible diagnostic coding framework, potentially limiting how they diagnose and treat under insurance coverage. This can mean some of the most innovative or personalized aspects of their care might need to be paid out-of-pocket by the patient or not pursued at all due to these restrictions.

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