Functional medicine, MD-led — the workup behind 'we treat the root cause.'

Functional medicine is a way of practicing medicine that asks 'what's driving this across all the systems involved?' instead of 'what's the diagnosis and the treatment for it?' In practice that means longer visits, broader labs, and treatment plans built around what the labs actually show — across hormonal, metabolic, thyroid, inflammatory, micronutrient, and gut systems. It uses the same labs, medications, and evidence base as conventional medicine, just deployed differently and with the time to interpret across systems. The Institute for Functional Medicine (IFM) and the American Academy of Anti-Aging Medicine (A4M) maintain the rigorous certification pathways. Dr. Scribner holds the A4M Fellowship.

Naturopathic doctors (NDs) train in four-year programs that cover both conventional and natural medicine, with a strong emphasis on lifestyle, nutrition, and botanical interventions. They do excellent work and are an important part of the Bellingham healthcare ecosystem. Functional medicine — as practiced at MBM — is MD-led. Dr. Scribner is a board-certified emergency physician (FACEP) with nearly two decades in medicine, fifteen of those in emergency medicine, plus the A4M Fellowship. That training brings full prescribing authority (including compounding and controlled substances), acute-care pattern recognition, hospital privileges, and specialist relationships built over fifteen years at PeaceHealth St. Joseph. The right choice depends on what you're optimizing for. Both approaches have their place.

Yes, when practiced with evidence-based rigor. The concerns about functional medicine are real and worth taking seriously: some practitioners over-order tests that don't change clinical decisions, and some over-prescribe supplements for financial rather than clinical reasons. Both happen and both are failures of practice, not inherent to the discipline. MBM tests when the test will change what we do, prescribes supplements when labs document a deficiency, and grounds treatment recommendations in published evidence. The A4M Fellowship requires rigorous coursework and re-certification. Functional medicine isn't a replacement for conventional medicine — for acute infection, surgical conditions, cancer, and many other categories, conventional medicine is the right tool. Functional medicine fills the gap where conventional primary care has too little time and too narrow a lab panel to properly investigate complex chronic symptoms.

Three main differences. First, time: 60-minute initial visits versus 15-minute slots, because complex multi-system problems can't be unwound in 15 minutes. Second, lab breadth: full hormonal, thyroid, metabolic, inflammatory, micronutrient, and methylation panels versus a CBC plus a basic metabolic plus TSH plus lipid panel. Third, treatment philosophy: protocols built around what the labs actually show — across systems, often in combination — versus prescribing for the diagnosis that fits the chief complaint of the visit. Conventional primary care is excellent for acute care, common conditions, and routine screening. Functional medicine is better suited for complex, chronic, multi-system problems that haven't responded to the conventional approach. We use both where they fit.

Functional medicine at MBM is part of concierge primary care membership at $300/month (individual) or $570/month (couple). That covers unlimited 60-minute visits, the comprehensive lab workup, ongoing protocol adjustment, direct phone and message access to Dr. Scribner, and member pricing on every service in the menu (HRT, TRT, GLP-1, ketamine, NAD+, IV vitamin therapy, and others). Labs and medications are billed separately at member rates, typically lower than retail. Most members find this replaces multiple disjointed care relationships — primary care plus a hormone clinic plus a weight clinic plus a supplement store — at a roughly equivalent or lower total spend, with significantly better continuity of care.

Yes — and we recommend it. Insurance is required for everything outside of primary care: hospitalizations, specialists, imaging, expensive prescriptions, surgery. Many members keep a high-deductible plan to cover catastrophic events. This is usually the most cost-effective configuration. Switching insurance is an annual-enrollment decision — your benefits administrator or a broker can help optimize the pairing. Functional medicine at MBM does not replace insurance; it replaces (or supplements) the primary care relationship while leaving everything else in your existing insurance ecosystem.