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The Functional Approach to Accountability in Holistic Healthcare - Blog Image

The Functional Approach to Accountability in Holistic Healthcare

BY: Andrea Nakayama

DATE: 2018-07-03

Recently, I had the opportunity to address the topic of accountability on stage at a health event. In writing my speech, I realized that the conventional approach to accountability is often practiced in a way that lacks functionality in the context of health and wellness. In this article, I’ll share insights into what functional accountability truly means, how it can transform your leadership skills in practice, and how it will help your clients gain ownership over their bodies and lives.

To achieve a functional or holistic healthcare model, we need to flip the concept of accountability on its head. That’s because accountability as we know it, only works some of the time, for some of the people. And that’s because accountability, as we’ve come to know it, is not functional…

As a Functional Medicine Nutritionist teaching thousands of others in the science and art of the Functional Nutrition practice, I’ve often said that I have zero interest in being anybody’s accountability partner. That’s right, zero.

Why would I say that? Isn’t accountability supposed to be a good thing? Helpful? Supportive? Shouldn’t I be holding people to the change they want to be with their diet and lifestyle modifications? Does my lack of interest mean I don’t want to help?

No. It doesn’t. Quite the opposite. I want to help so much that I believe a new approach to accountability is necessary to get us the results we want.

The conventional approach to accountability

In the evolving landscape of healthcare, it’s time to reimagine the concept of accountability. Conventional accountability as commonly practiced, falls short because it relies on external factors to drive change. The question arises: Is this approach, with its emphasis on being accountable to avoid punishment, shame, or reprimand by an external authority conducive to long term results? Or does it merely yield temporary compliance?

Is answering to a ping on your cell phone or to someone you are reporting your activities to effective? Does it yield fleeting or sustainable results? What happens when that notification is gone? These are the questions I ask myself when it comes to creating a functional paradigm and a model for holistic healthcare.

“Because I said so”

I don’t know if you grew up in the generation where parents, particularly dads, would tell you to do something because they “said so.” (I certainly did). But I can tell you, as a parent of a GenZ adult, the “because I said so” approach rarely works.

Whether coming from your dad, your doctor, or a coach, is “because I said so” a reason to do the right thing? Would you do something because I “said so?” Is this the approach we want to advocate for in healthcare? Are recommendations without reason (i.e., because I said so) functional?

Sure, a conventional practitioner will have a reason for issuing a prescription or recommendation, but to the patient experiencing the conventional approach to accountability, they are primarily being asked to do something because you “said so.” In this case, the checks and balances value “compliance” over transformation.

I’ve learned that health and healing happen not because someone follows rules, but because they transform on multiple levels. Their diet and habits transform. Their relationship to their body transforms. Their sense of empowerment transforms. Often the lens through which they view all of life transforms. Transformation doesn’t happen because I said so.

The truth about accountability

The truth is that when we make decisions in our everyday, we either approach or avoid. The question for the practitioner therefore becomes: How can we inspire patients to avoid further disease and dysfunction and approach true ownership of their own choices and behaviors? The answer lies in taking a functional approach to accountability.

Functional accountability

Instead of the conventional approach to accountability, which again focuses on rewards and punishments doled out by an external authority, functional accountability puts 3 critical E’s into practice:

  1. Empathy

  2. Education

  3. Empowerment

Empathy: For empathy, you must understand what’s going on in your client’s life—their current situation, health history, spiritual and cultural beliefs, relationship to habit change, and more.

Education: Education is to swap out “because I said so” for an understandable explanation of how the body works, why it’s in a state of dysfunction, and how, with the recommendations you’re making, your client will be able to move their health in the right direction.

Education requires you to answer questions like:

  • Why is gluten harmful to my particular immune system?

  • How is my bedtime related to the function of my thyroid?

  • What effect does eating breakfast in the car have on my digestion?

Empowerment: Once your client trusts you’re a true partner and truly understands how their body works and what actions they can take to move their body towards resolution, they’ll be empowered to make the changes they need to achieve their health goals.

Embracing functional accountability dismantles the tradition of external control in favor of an alternative approach. Instead, it fosters a therapeutic partnership, where clients are intrinsically motivated to take action towards theirgoals.

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Andrea Nakayama

By: Andrea Nakayama, FxNA Founder & Functional Medicine Nutritionist

Functional Nutrition Alliance provides the comprehensive online Functional Nutrition training in the Science & Art of the Functional Nutrition practice. Learn to address the roots of your clients’ suffering with client education, diet & lifestyle modifications.


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