Did Texas just take a big step toward normalizing root cause medical care?

In functional medicine, we're all about root causes, but prescriptive medicine generally hasn't picked up on that, right? So Texas just passed SB 25. So what that, one of the things, many things included in there is that nutritional education will be required in medical schools if they receive any money from the state of Texas. But if you dig deeper into it, that goes all the way down through high school and junior high and to some degree even into elementary, I think. But what I'm talking about today, at least in this part, is that at the graduate level, at the doctorate level and nursing schools and things like that, we'll have to teach some nutritional curriculum. So that sounds good. We've kind of complained for years that medical doctors get no training in nutrition, yet they seem to claim to understand lifestyle issues and health and chronic disease and all of that.

(01:14)
We firmly believe that chronic disease is much more lifestyle related and that prescriptive approaches or the traditional medical approach is just generally not that effective in chronic disease. So this would be a step in educating doctors, at least the ones taught in Texas about nutrition and maybe some root cause medicine and maybe that lifestyle issues can affect chronic disease. At least that's the hope. But will it really turn out that way? I have my doubts. I am trying to be optimistic. I think they've set it up fairly well. But let me point out a couple things. First of all, my first question was what curriculum is going to be taught if you're going to teach nutrition? Who's nutrition, right? And this is not to bash anybody, but the registered dieticians and the clinical nutritionists have had vastly different views of nutrition traditionally for decades. Now bring into the picture of functional medicine doctors who are more on the clinical nutrition side of things, but not quite where they are.

(02:24)
You've got, I don't want to say opposing necessarily, but varying different approaches to nutrition and manipulating nutrition to change overall health. So there have been arguments every couple of years in the Texas legislature, someone will try to pass a law that says that only registered dieticians can give nutrition advice in Texas or only clinical nutritionists can do it. They're each trying to get an exclusive on that. First of all, let me say, I think that's terrible. Obviously I'm a Texan, so are most of you. I think we deserve a choice. If you feel like the registered dietician approach to nutrition is what aligns with you, you should be able to seek that out. If you think the clinical nutrition approach or the functional medicine nutrition approach aligns more with what works for you, you should have options. You should have choices. I don't generally agree with the way registered dieticians see nutrition, but I don't want them outlawed.

(03:24)
I don't want it to disappear. I think you should still have a choice, right? I mean that's kind of what we're about. Anyway, that being said, back to SB 25, whose nutrition is going to be taught, there's all of a sudden going to be a mad rush to influence this process and everybody's going to want to plant their flag in this and say, my nutrition is the one that needs to be taught. Again, obviously I disagree with that. I think we should have a more broad based approach to this. But let me tell you how the state of Texas has decided to set this up. There will be, according to SB 25, a Texas nutritional Advisory Committee set up, that's going to be a seven member committee and one member must be an expert in metabolic health, not defined what that is, but an expert in metabolic health.

(04:16)
Another one has to be a licensed physician, which means MD or do in Texas chiropractors can't use the term physician. So that rules out chiropractors and naturopaths. So it's going to have to be an MD or do a licensed physician certified in functional medicine. So that's a good step. One member representing the Department of Agriculture and one member representing a rural community and one member representing an urban community. Now that's five. You heard me say seven. There are two seats that are undefined. All of those will be appointed by the governor. They will sit for alternating or offset two year terms. So every couple of years, half the board goes away and gets appointed new people Two years later, the other one does. So anyway, offsetting two year terms, they are going to be setting the curriculum for the medical schools. They will be setting the curriculum for nursing schools and any other professional health related schooling in Texas that receives any state funds, if I understand this correctly.

(05:20)
And then down into the high school and middle school levels and presumably college as well. So there's going to be some power involved in this. If I have some financial interest in a particular nutritional viewpoint, I'm going to want that represented in here. And if I'm some major corporation, I'm going to put money toward trying to get someone on there. And they have some safeguards. You can't own more than 3% ownership of pharmaceutical or nutritional or ag company or whatever. They have some things like that. But what's happened forever in places like the FDA is someone will work in the pharmaceutical industry for a certain number of years. They'll quit their job or retire wait a year, and then they'll get appointed to a board, an approval board on the FDA, and they'll sit there for several years as whatever term on that board. And then when they're done there at the FDA, they take a little time off and then they get appointed to some board position at a pharmaceutical company like this.

(06:20)
Revolving door has happened repeatedly at the FDA. It's embarrassingly bad, but I'm wondering if that doesn't eventually happen here. My prediction, although I want it to be much better, I think in the first couple of terms of this, maybe the first two to four years, I think it looks about like we would want it to look. I think we're all happy with it and we pat ourselves on the back and life goes on. But then when you get 5, 6, 8 years down the road, I think you see more industry influence coming into this. I think you see this shifting. I think you see the recommendations going back to standard medical nutrition. If you've ever eaten a meal in a hospital, like if you've been a patient, they've served you food. That's what I'm talking about, right? It's old school, low fat, high carb, calories of calorie. It doesn't matter where it comes from. Marshmallows and steak are the same as far as their caloric content and the way your body handles it, all of it. That's what I'm concerned about. Will it end up that way? I don't know. I really don't.

(07:20)
Licensed physician certified and functional medicine can be problematic. It can also be fantastic. There are some very good ones out there, so don't misunderstand what I'm saying. But when you get a medical education, when you become a medical doctor or an osteopathic doctor or a do that education is largely reductive and pharmaceutical based. It is symptom-based. It is algorithm based. It is medication for symptom, medication for disease. It is a disease-based education. Very, very little emphasis on any root cause or underlying factors. In functional medicine. It's the reverse. I don't even care what you name something sometimes as long as I can understand how it developed, there are things we can do to undo that. I don't treat the disease. I treat the underlying dysfunction that led to your body manifesting those symptoms that we categorize as a disease. So two very different paradigms. So having a licensed physician who goes and gets a certification in functional medicine doesn't always mean that that physician embraces that whole root cause philosophy.

(08:31)
It means they understand some of the nutritional applications that we use in certain situations. Now, it doesn't mean that they didn't go to the functional medicine course and have this life-changing epiphany and become a real functional medicine oriented doctor. And I think in many cases that happens. I've known doctors where they've come out of functional medicine and kind of said, this is what I thought I was going to school for. So some doctors do shift gears or they were looking for that in the first place. They just didn't know it existed. But there are others who still embody the medical pharma driven reductive process of a standard modern medicine. Getting a certification in functional medicine just might not change that, or it might just qualify them to be on the board. So anyway, time will tell what it turns into. Do I like the fact that we're going to be addressing some nutrition with school age kids and high school kids?

(09:27)
Absolutely. I do. I really do. I think it's a long time coming. The physical education requirements or physical fitness requirements personally, if they don't want to take a gym class, I think that's fine. Pass certain physical fitness tests and then you don't have to take the PE class. You should be able to opt out of it, I think, right? If you can go in and perform a certain set of tasks, a certain number of pushups and pull-ups and run a mile in a certain amount of time, almost like PT in the military, if you can pass that, you advance place out of the PE class for that year, go take an elective, do something academic. I think something with some flexibility would be nice. I don't think that's what we've got right now.

(10:09)
But anyway, I think all of that's good. I think it's overdue. Will this make the changes that some people involved with it are trying to imply? This is the beginning of an entire rebuilding of the medical system. I had love to see that, but boy, I've been disappointed so many times in the past. Right? So anyway, chime in. I'd love to hear your thoughts. Please. If you live in Texas or if you live in another state and you want something like this in your state, what would you want it to look like in your state? Let's have a conversation about this, but I just wanted to bring you up, Dan, on SB 25. You're welcome to go look it up, see what you think. But that's my take on it. You guys have a great one.