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Dr Jeffrey Bland: Healthcare Shouldn’t Be Owned by the Disease-Care System

Dr Jeffrey Bland: Healthcare Shouldn’t Be Owned by the Disease-Care System

The founder of Nutri Advanced, Ken Eddie talks to Dr Jeffrey Bland, the father of functional medicine.  

Prepare to be inspired.

Ken Eddie, founder and managing director of Nutri Advanced Ltd. first met Dr Jeffrey Bland in 1990 in Burford, in the English Cotswolds and they have maintained a close working and personal relationship ever since.

From that initial meeting, Nutri Advanced became UK distributors for HealthComm, which was Jeff Bland’s functional food range including UltraClear, UltraClear Sustain and UltraMeal. And for many years to follow, Ken has warmly welcomed Jeff to the UK to headline at Nutri Advanced’s renowned annual functional medicine conferences.

On Saturday 15th June this year, Dr Bland made a rare and eagerly anticipated appearance in the UK to present his latest findings at Nutri Advanced’s functional medicine conference; The Science of Health¹. He was joined by a world-class line up of speakers including Dr Steven Sandberg Lewis, Jo Gamble and Amanda Hamilton.

Here we share with you a heart-warming, insightful and honest interview between Ken Eddie and Jeff Bland. From his early days of nutrition education at home and always asking why, to operating a start-up medical business on a Tandy model 2 computer with an 8-inch floppy disk, meeting significant guiding mentors including Linus Pauling along the way, his vision of the future of healthcare and insights into his wild adventures at sea; Jeff’s humble, down-to-earth, gentle and wise character shines throughout this remarkable interview which we are incredibly honoured to be able to share with you.

KE: Thank you Jeff for joining us at The Science of Health. It’s an absolute privilege to welcome you back to the UK. Could you share with us what first got you started in the world of functional medicine?

JB: My wife Susan and I were in the Cotswolds about 30 years ago, when we first met you and your wife Caroline. That was the start of this incredible relationship; watching our families grow up, and professionally watching our activities start to develop.

The Institute of Functional Medicine (IFM) was also just starting back then and we’ve now had 150,000 practitioners go through the programme over the last 27 years. IFM is now starting to really scale itself to be an important part of the opportunities in this field.

Looking back, my grandmother was a big believer in natural health and she took my mother to a naturopath. In the late 1920s, naturopaths were neither listed nor recognised so my mother grew up with a direct natural medicines experience. And then, when my sister and I grew up, we were always guided by Adele Davis and by nutrition; no white bread, no desserts, no soft drinks and no snack foods.

"…we were the brown bag kids at school!”

My mother, who sadly passed away recently, was a force of nature and packed a lot of living into her 93 years. I once asked her, “when did you first see my interest in nutrition and in this whole area of healthcare emerging?” And I know now that I was certainly guided by her strong personality. My mother said,

"the thing that I recall most about you, even early on in elementary school, was that you were always asking why people got sick?

And that this was a big thing for you to ask the question why?”

And that went on into high school, and into college, and then into graduate school and I just had this driving force to understand the origins of why people got sick. I would look at statistics, and in an elementary school classroom you might have half the people sick with the flu and we would always concentrate on the half that were sick but then for me, the question was why the other half didn’t get it, when they were exposed to the same infection? And so all of those questions really had been bubbling in my mind; my high school science projects were always related to this. And so finally when I went on to my medical school training and then my PhD work; I would come home to see my parents, and my mother would say, “what are you learning?” and I was so excited about all the anatomy and physiology, pathology and pharmacology that I was learning and she would say, “when are you learning anything about nutrition?” And I said, “we really aren’t being taught that,” and she said,

"well, as soon as you learn something important, you tell me!”

So that was the whole environment I grew up in. My sister is an artist, and if you met her you would see that she is of the same cloth; she looks 20 years younger than her age; is a marathoner, a natural foods devotee and a natural foods gourmet chef. So I think it’s really about the environment that I grew up in. We have three sons and brought them up in the same environment, and now they too are raising their kids in the same environment.

"I think it’s a legacy that gets passed on through the generations”

KE: That sounds very similar to my upbringing Jeff; my father was an osteopath and naturopath. I was brought up for many years as a vegetarian. I’m not a vegetarian now but I have always had a passion for healthy food, and my father was a real believer in natural foods. He also started a nutrition school, so I came from a similar background and I really understand this legacy.

KE: Who would you say was your biggest influence?

JB: Obviously my mother, who I’ve already talked about; but I’d also talk about my father – he was a really important and interesting person in my life. He was a big ideas guy. He was an aerospace engineer and a student of learning, and wanted always to know about lots of things, and so anytime I showed interest, suddenly he was interested in that as well.

I was very interested in photography and the whole concept of colour photography was just coming into place; I was in junior high school at the time, and he said, “if you can make $100, I’ll build you a darkroom in the garage”.  A hundred dollars seemed like a large amount of money at the time, and so I got my first job at 12 years old, going door to door, handing out leaflets. I got several dog bites that summer! But I was able to earn $100, so he built a darkroom and we learnt colour photography together.  I think both of my parents were really significant guides for me.

I was also very lucky, as I moved on in schooling, to meet some very important mentors.  In my senior year of college, my research project supervisor was Professor Sherwood Rowland, who went on to win a Nobel prize in Chemistry for his work on atmospheric chemistry and the role of ozone in skin cancer. So, I was working on physical chemistry as a senior on this concept that later won him a Nobel Prize. He was another really important guide; he taught me about being precise, to ask the right questions and about forming your hypothesis.

And when I later moved on to graduate school, I was very fortunate to meet Linus Pauling early on; I actually took a course from him, and later became one of his mini understudies. This led me in 1981 - 1982 to do a two-year sabbatical as a professor; and his office was right next to mine. He and his wife Helen were just the most remarkable people; you think of Linus Pauling as being this extraordinary scientist (which he was – he is the third most cited scientist in history) but he was much more than that. He won a second Nobel Prize for Peace; demonstrating against nuclear atmospheric testing. He and his wife were incredible humanists, and their whole concept was about reducing human suffering.

That was a great two-year period for me, and I think those would be probably the principal people who guided my thinking and supported me as an ‘out-of-the-box’ kind of guy. And if you think out of the box, especially at University, it’s not an easy path.

"I was a professor and everyone wanted me to be a chemist and stay inside the lines - but I wasn’t very good at painting inside the lines.”

Fortunately, we got a new university president and for whatever reason, he liked me and gave me a chance, for about 7 years, to really spread my wings and to learn more about life than just molecules and chemistry.

KE: Do you have any predictions on what innovations will be informing personalised, precision care in the future, especially thinking about data collection?

Again, I reflect back to the 1980s when I was writing a computer programme with two of my colleagues, on a Tandy model 2, with an 8-inch floppy disk and 24K! We formed a company called Medical Computers International – we took the data from blood chemistry, mineral analyses and dietary analyses and we would interpolate all of that and it gave us a print out to the patient – this was in the early 1980s! I even marvel at myself back then! We had 3000 - 4000 of these software programs in the offices of practitioners, but what I learnt was that ultimately it was the office staff that were given the responsibility of using this, and they were afraid to even turn on the computer, worried it would blow up! So we ended up being a customer service company; not a software company, because there were so many concerns about using computers. I think we were a little bit too early with this; and I think this kind of characterises my life! People have often said to me,

"you know Jeff, the difference between the leading edge and the bleeding edge is an example of your life! You’ve always been on the front edge of these things that can get you into some …. new learnings!”

But, with that said, what’s happened since then obviously is truly remarkable.

We’ve gradually got more computer power for less cost, which means we have been able to bring more content into computer programming. As we have seen the evolution of the capability to take massive amounts of data (we almost have so much data we don’t know what to do with it). For example, think about a Fitbit, or an aura ring; and in one day, this little thing captures as much data from me as you’d get from a year of manual information, if you were just doing a notation of your biorhythms and all the various kinds of data these devices pick up. So now, we have the combination of computer power increasing and the compression of software so that these new languages allow you to compress huge amounts of information into small data sets. All of these various aspects have accelerated the use of data, and now we are moving into the ability to start to predict using large datasets; outcomes that we could only speculate on before. All technological advancement comes with a plus and a minus, right? The minus is, do we really want machines making decisions for us? And there’s lots of speculation on whether AI is going to be the death of the practitioner-patient interface.

"I don’t think it will. Because the more tech we get, the more touch we need. And you can really see it."

Think of the book written almost 30 years ago that talked about high tech, high touch²,and how you really can’t have one without the other, because people still really need the intimacy of relationships.

The information that we can access now, we are just trying to figure out how to put that into a humanistic way that really motivates people to make positive behaviour changes and to be coaching and assisting them; rather than taking over healthcare. I don’t think that healthcare will be taken over by machines. But I do believe that we will get an acceleration of the ability to interpolate lots of information quickly, and with what’s known as ‘dynamic dense data clouds’- these things that we carry in the cloud and contain all of this information about our lives; our health records, biometrics, genomics etc. and can be accessed in real time on our smart devices to be made user friendly. I think when that happens it frees up the clinician to do what they do intimately; the pattern of recognition and the assessment of the individual that is needed for personalisation; the intimacy of the relationship.  What goes on in the physician’s exam room, you are never going to be able to duplicate with a computer programme, so that’s how I see the information technology revolution. And I think about how we, in natural medicine harness this, without pushing it away and calling it bad, but instead how we embrace it in a way that will make our jobs more successful.

"This will help us to accelerate what I think is really emerging, quite honestly, to be the answer to so many of the chronic health problems that are becoming global issues, which are not rooted in the solution of a new drug, they are rooted into understanding the relationship between a person and their lifestyle and environment.  This will mean that the natural medicine world will win out in the end, but we need to embrace these tools in ways that will help accelerate the adoption and the relationship.”

KE: Given that you’ve influenced so many people over your career, how does that make you feel?

I speak to lots of different groups, a number of whom are not what I would call ‘on-side’ with what we’re doing and I’m often the token fugitive outlier that they bring in to feel like they have a balanced program!  However, if a person has any neuronal plasticity and they give us a few moments of space in their mind to describe what we’re up to; they will often say, “I didn’t really want to come, and now you’ve got me!”

I really give my wife Susan a lot of credit, because she was the person that really urged me to consider (we didn’t know it was called functional medicine at the time) putting together those first meetings in Victoria, British Columbia and Vancouver Island in 1989 &1990, to talk about what would really be the ideal healthcare system; we wanted to just idealise on what it might be. We invited about 30 of our friends and colleagues from different disciplines, to come and share three days in two different years; 1989 and 1990. It was from there that functional medicine was born. I came back and said, “let’s call this functional medicine” and people said it wasn’t a good term because it was already being used for either geriatric medicine or psychosomatic medicine and it may have a negative connotation. But I had been looking at the literature and seeing that back then, starting in the late 1980s, there was just the beginning of people starting to publish papers on functional neurology, functional radiology and functional cardiology, and so I thought that maybe this term will take on a new meaning as we move forward?

"So, ‘let’s skate towards where the puck is going, not to where it is’ was my new advocacy and I think I wasn’t too far off.”

But I didn’t know at the time, and shame on me as I consider myself kind of a student of the literature and that I’m pretty well informed, that back in 1871 there was actually an article published in The Lancet on functional medicine. It was lectures on functional medicine by the head of Birmingham Medical School, here in the UK. If you read the lectures on the discourse of functional medicine you will see that although the language is a little more flowery than we use today, it’s very much constructed around the same concepts.

"I don’t claim any novelty here, we reinvent what other people have done and we call it new, but over the years this concept has really started to gain what I call stickiness.”

What I say to audiences who haven’t heard anything about it is this, “how many places can you go, where practitioners who have already been certified, gone through their licensure, paid for their education, and maybe still paying for their student loans, make a decision that they want to go back and study biochemistry, genetics, anatomy and physiology, pathology, and basically be in textbooks that they probably didn’t like being in the first time, and now taking it up under a whole different context, and paying for it out of their own pockets and then spending hundreds if not thousands of hours gaining competency, and being excited about it?” And most people will say, “well those people don’t exist. Once you’re out of school, you’re out of school and thank goodness it’s over”. But this is the nature of what has been so empowering for me to watch; the people who are drawing into this field that are willing to do this self-sacrifice, and to be the best they can be for their patients.

My wife Susan asked me some time ago, “so, this thing about retirement Jeff?!” So we’ve come up with this little thing we now say about retirement,

"I am retiring; I’m putting new tread on the tyres!  Because there’s a lot more miles to go, and when you’re pursuing this path you know you’re doing the right thing. I believe this transformation is a virtuous objective.”

So let me just say one last thing about that; what I have come to recognise is that there is something very interesting about healthcare that I’ve been apologetic about for years and I never fully recognised it until this last couple of years.  I’ve been kind of an apologist because I felt I had to defend this functional medicine model against those that were critical, and so I became the bibliophile; the guy with the 1000 references, the guy who can talk about studies, and I’m not saying that wasn’t valuable but it’s kind of an apologist mode, and I always felt I had to compensate for being a second child at the table.

So in this last year; and maybe it’s because I’ve just had my 73rd birthday, I’ve become more of an advocate, saying I’ve really no need to apologise; I don’t have any need to convince somebody that this is the righteous and clear way to go.  So what I then recognise is that I have been subconsciously tethered to the disease-care model, even though I have been talking about healthcare, because my training was in the disease-care model. When you use language like diagnosis, disease, risk or risk-reduction, you’re suddenly in the disease-care model. Even the term prevention; which I have been using for decades – ‘what did you prevent?’ You don’t know that you’ve prevented something unless you get it. Prevention is a really squishy term; it has no meaning really.

"And so what I now recognise is that it’s time to cut that loose, and to really focus on how we dedifferentiate ourselves from that of disease-care.”

Disease-care is important and needed; but there’s this other side that needs to be about healthcare; and healthcare shouldn’t be owned by the disease-care system. Let me say that again; healthcare shouldn’t be owned by the disease-care system - they are mutually exclusive. They can work collaterally, but they are not the same language systems, training or relationships.

"So, I have come to recognise that in my years remaining I want to really try to be clear about what is healthcare? And I think you can only measure health, not through the lens of disease but through the lens of function.”

When you start asking people to define health it’s amazing to see the variety of definitions. For example, there might be a single definition for heart disease, but there are multiple definitions for heart health. How do you measure health? It’s through function. There are four ways to measure function, which you will know about from the functional medicine model; there’s physical function, physiological or metabolic function, cognitive function and behavioural or psychological function.  Can I be there at my daughter’s graduation? Can I wake up without pain? Can I do this new job? Can I climb a mountain? These are functional characteristics that are beyond the disease model. And the way that I am now spending most of my time is to redefine health as a functional metrices that differentiates itself from the euphemistic concepts of disease-prevention which never leads to good patient compliance. Only recently in the US has the Food and Drug Administration started to allow what are known as patient reported outcomes to be utilised for drug approval. Before, there was never even the recognition that we cared about how a person felt after they took a drug. It was just all about the number, and the person was superfluous. Now we are starting to see patient reported outcomes become part of the assessment.

"This is a time of change when health will emerge to be a separate and equal body of knowledge at the table with the disease-care system, and that’s where I’m going.”

KE: Thanks Jeff. Now on a lighter note, I know that you are an avid sailor, what was your most interesting recent trip?

JB: My wife Susan and I would probably have a different definition of that! I like the adventure whilst she likes the nice, stable, calm sunsets and the anchored, peaceful harbour. We take our dog and cat with us and on our present boat we have done about 35,000 miles. We love being out on the open ocean together. On one trip we spent eleven days out in the ocean and didn’t see a single person or boat; we were basically with nature, and with whales around the boat and bears on the beach.  So we go up to Alaska; there is something about the wilds, that’s why we live in the Pacific North West of America; the transit going north from Seattle to Alaska, it’s about 1,500 miles and there are about 50,000 islands on the way; it’s spectacularly beautiful and you can go for days without seeing anybody – you feel like you’re the first explorer – you feel like you’re Captain Cook! It’s a wonderful feeling of freedom. I’ve written a couple of books on the boat; I think I do my best creative job there.

KE: What’s the one place that you would like to visit but haven’t managed to get there yet?

JB: I would love to go to Angkor Wat, I think it’s a really important part of human history and a spiritual centre. The sophistication of that culture, which many people don’t understand unless you study it a little bit more. I think it’s a fascinating, technologically advanced culture with extraordinarily deep spiritual ties to nature, so that’s on my list of places that we haven’t yet visited. This is a big world, and you would need many lifetimes to see all the things you would like to see, but we’ve also been extremely privileged to see a lot of extraordinary things in the many miles that we have travelled. We did a trip recently, which we would both love to do again. We took a boating trip from Copenhagen to the North Cap on the Summer Solstice; so we were at the northern-most point of the European continent on Solstice at midnight, out there in full sun, with sailboats around us, which was just a spectacular experience. It was a really special trip.

KE: You’ve been leading this field now for at least 40 years, who do you see is going to be the next ambassador?

JB: I think there are many and I think this is the age of the feminine; what we are witnessing now, is women of substance coming into leadership positions in this field and who are going to be the decision makers that go forward in healthcare. And I’m really excited about this, we’re now in the age of co-operation, synthesis and collaboration and I don’t think that’s the strongest suit for most men. We need different skill sets to address these global problems that connect the planet to the people, to posterity and survival of all the plants and animals on our magnificent planet. So I see women really being more and more influential in charting the path forward and when I look at IFM, I think it’s an interesting microcosm, because when we started IFM, we only had two women in our original founding group and the rest were men. And IFM’s meetings were heavily male-centred. Now when I think of the IFM meetings, for example the recent Annual International Conference in San Antonio, it’s about 60% females. I think it’s the fastest growing medical organisation with women practitioners in the US. And now in the US, there are more women in medical schools than men, which is interesting too, and another part of this whole transition process.

So we have many, many emerging stars that are women in the functional medicine movement. I think this is a great sign of change and the men in the field are very supportive of this; it seems that it’s a great example of co-operation between the genders and trying to create the best balance of energy and perspective possible.

"So there will be many different stars that will emerge, but it will be a different culture that will emerge over the next years to come.”

KE: Do you think there will come a time when functional medicine is more widely accepted?

JB: I’m not saying this flippantly, but I think we are already accepted by the right people.  We have to ask the question,

"who do we want to be accepted by? Do we want to speak to the people who have open minds and neural plasticity, and are really there to create the new order? Are we accepted by them?”

The answer is yes, with increasing frequency. I don’t worry about those who don’t understand, I really worry about those that want to understand and those are the people who are very interested in what we are doing. That’s how I view my role.

"You only get one chance to hang out with whatever your tribe or flock may be, and I’m often asked the question, “would you change your life, looking back at what you’ve done?”

"In retrospect, of course there are certain decisions I might change, but on the overall tapestry; on who I’ve had the privilege of hanging out with; people who are passionate, dedicated and don’t want to be fenced in, people who find their own way in life and are not just accepting that which is comfortable; people who are going against the stream, there is no better place to spend a life than with this group of people. I just think that in the end, I keep asking myself the question, is the world coming to us now or are we still begging the world to come our direction? And quite honestly, the world is coming to us. The literature and the medicine is coming to us, and we just have to keep on that one true path. That just reinforces to me, the sacrifice that we make for being on this path and in this field. And I recognise that it’s not easy, but it’s a life well lived; that’s how I see it.”

Thank you Ken, for all these many years; from Burford to here! Thanks a million!

KE: Thank you Jeff, and thank you also for the amount of times you’ve come over to the UK; you’ve inspired a lot of people over the years and have inspired me for over thirty years. Thank you!

Footnotes:
¹ The Science of Health featuring Dr Jeffrey Bland, Dr Steven Sandberg-Lewis, Jo Gamble & Amanda Hamilton is now available to purchase as a high-quality recording.
² The concept of high tech, high touch was first developed by John Naisbitt in his 1982 bestselling book, Megatrends. He theorised that in a world of technology, people long for personal, human contact. He re-examined this idea in a later book entitled, High Tech/High Touch.