Many pharmacists, physicians, and other providers throughout the country believe that the U.S. healthcare system is focused on anything but health. Rather, they make the case that healthcare is focused on sickness: more specifically, treating the symptoms of said sickness and approaching it with surface-level solutions. While targeting the symptoms of illnesses can be helpful in some cases, like with the common cold and flu, the majority of sicknesses that are plaguing the healthcare system go deeper, especially chronic diseases.

Chronic Disease: The Leading Cause of Death and Disability

According to the CDC, 6 in 10 Americans (over 200 million people) have a chronic disease. 4 in 10 (132 million people) have at least two chronic diseases. The most common chronic diseases are heart disease, cancer, chronic lung disease, stroke, and diabetes, among others. Chronic disease is the leading cause of death and disability in the United States, and it consumes 90% of all healthcare expenditures every year. Given these numbers and their implications for both physical and economic health, chronic disease is an ongoing issue that all providers — pharmacists included — must address with urgency.

When it comes to the causes of chronic disease, the CDC reports that lifestyle factors like poor nutrition, lack of physical activity, and alcohol and tobacco use are among the most significant. As providers work to treat chronic disease, then, interventions should be centered around the factors that matter most. In this case, that means getting to the root of the issue and treating health as a holistic issue, with lifestyle-centric solutions. Then, and only then, can the chronic disease epidemic be properly addressed and can patients start getting back on track to health. Enter the world of functional medicine.

Working to Find the Root

According to the Institute for Functional Medicine, functional medicine is an “individualized, patient-centered, science-based approach that empowers patients and practitioners to work together to address the underlying causes of disease and promote optimal wellness.” Unlike traditional health models, functional medicine isn’t focused on masking symptoms or “putting a bandaid” on more serious issues. Instead, this model prioritizes finding the root of the problem and then creating a personalized treatment plan. Functional medicine is designed to increase health and wellness to the optimal level for every individual, making for a more effective long-term treatment option.

Functional medicine is also considered to be less risky than other health models, as it steps away from drugs and procedures that often have adverse side effects. Rather than solely relying on prescription drugs and masking the actual issue at hand, it treats patients with alternative methods, like diet adjustments and natural supplements. And, by enabling patients and providers to work together, the functional medicine model gives patients more control of their own health, which increases their sense of self-efficacy and ability to make healthy choices in the long run.

As issues like chronic disease continue to persist, functional medicine offers a more promising alternative to treating patients. And, with a projected annual growth rate of 22%, it is one of the fastest-growing fields, making it one to seriously consider venturing into.

The Functional Pharmacist: Josh Rimany

But how does pharmacy fit in? Dispensing prescriptions is the bread-and-butter of most pharmacies — which, at the surface level, may seem contradictory to the goals of functional medicine. As practitioners of clinical services, though, independent pharmacies have a unique opportunity to align themselves with functional medicine and treat their patients in a new and different way. After all, functional medicine doesn’t aim to displace prescription medications altogether. It simply tries to show that, in some cases, like with chronic diseases, providers can do more than just provide medications. They can treat patients from the inside out; and so can independent pharmacies.

One example of a pharmacist who has embraced the power of functional medicine is Josh Rimany, Founder and Chief Wellness Officer of Dilworth Drug & Wellness Center in Charlotte, NC. On the Catalyst Podcast, Josh discusses his passion for holistic health and his strategy for helping his patients at Dilworth Drug & Wellness improve theirs.


Throughout his career in pharmacy, Josh has treated countless patients with chronic diseases. Early on, though, he discovered that simply pushing pills isn’t enough. He explains, “Medications don’t fix the problem of chronic conditions; they mask the symptoms. When pharmacists go to school, they learn drugs and disease states: they hear, ‘If you have this disease, you need to take this drug to treat it.’ If you look at why those diseases persist though, it’s the blood pressure, it’s the diabetes, it’s the lifestyle.” 

Seeing how ineffective traditional models of medicine were, Josh began to explore alternatives and discovered functional medicine — which goes much deeper than the solutions he had been accustomed to. Now, several years later, his pharmacy has fully made the switch to functional medicine: “It’s been twelve years since we’ve been open and we’ve evolved organically into this great pharmacy that’s diversifying and moving to a direction where prescription medications will no longer be emphasized in our business model. And that’s what I’m really excited about nowadays.”

Josh acknowledges that the concept of a fully functional pharmacy is new, and that many providers remain skeptical about its viability. However, he remains optimistic about the future. He explains, “The pharmacist that doesn’t like drugs but wants to prescribe medication is a novel idea. Patients expect good healthcare and independent pharmacies to deliver it, but we have to go beyond the pill. We have to come up with this new idea that says, ‘The pill is where we start, not stop.’ Whether it’s supplements or nutritional products, the pharmaceutical side is key, [especially] in chronic care management.”

By offering alternative treatment options that focus on the root causes of health problems, prioritizing holistic health, and working with patients to optimize theirs, Josh believes that pharmacies can make a shift in medical practice. He says, “People are really wanting to be the driver of their wellness. They just don’t know how. And that’s what our job is [as pharmacists]: to really start delivering ideas.”

Josh goes on to discuss the direction that pharmacy practice is headed, under the functional medicine model. He says, “The future of pharmacy is very different from what you expect or from what you’re getting at the big box stores. Our job as pharmacists, in my view, is to start educating patients on the things that they can do and empowering them to do it — so that the old way of just filling [prescriptions] and filling them fast [is replaced].”

Countless pharmacists, technicians, and professionals all across the field agree: the future of pharmacy is functional.

Joining the Movement

By aligning with the goals of functional medicine and making the move to treat patients in a different way, traditional pharmacies can start to implement practices of a functional pharmacy. This is done primarily through collaborative-practice agreements (CPAs), in which pharmacies can work with physicians and other providers to expand their range of services (although some services don’t require a CPA). Among other things, a functional pharmacy can provide the following services:

  • Diagnostic testing, including areas of pharmacogenetic, nutrigenomic, and microbiome testing
  • Health and lifestyle coaching
  • Advice on therapeutic alternatives, like nutraceuticals (including herbal supplements and probiotics)
  • Dispensing therapeutic alternatives

The benefits of becoming a functional pharmacy are numerous. To begin with, it allows pharmacies to expand their range of services to patients. The National Community Pharmacists Association (NCPA) reports, “Relying solely on filling and dispensing prescription medications is no longer sufficient for maintaining a business’ success. By offering expanded services like those under the functional medicine umbrella, pharmacies can create niche spaces for themselves in their community.” With these “niche spaces,” pharmacies can improve patient health by acting as a center for both prevention and treatment — increasing their accessibility and appeal. With more services and more patients, pharmacies can also generate a consistent new stream of revenue and see greater financial success.

For more information on the benefits of functional medicine in community pharmacies, read NCPA’s introduction to the topic.

Getting Started: Requirements and Resources

Whether you want to become a full-fledged functional pharmacy or simply incorporate a few new practices in your already-existing pharmacy model, it is easy to get started with functional medicine. Because it is a newly emerging field in pharmacy, functional medicine typically has fewer requirements and restrictions than other niche services.

First, if you plan to offer services like testing and dispensing therapeutic alternatives, you will need to enter into a CPA with a provider in your area. If you plan to focus on services like counseling and selling natural remedies, though, you can forego the CPA.

Regardless of the services you decide to offer, you may find it helpful to start a certification process through the Institute for Functional Medicine (where Josh Rimany received his certification). IFM offers the first and only accredited functional medicine certification program, which can arm you with education, resources, and connections as you step into the world of functional medicine — although it is not a requirement to practice.

Aside from IFM, a number of other resources can help you to learn more about the ins and outs of the field, including the Functional Medicine Pharmacists Alliance (FMPhA), NCPA’s “Thinking Outside the Vial” functional medicine series, and select episodes of PioneerRx’s Catalyst Podcast and Beyond the Scripts Podcast such as:

Creating a Culture of Health with Dr. Kathy

Small Wins. Big Impact.

The Greatest Medicine of All

Planting the Seed of Wellness

The Pharmacist That Doesn't Like Drugs

With the help of these resources, you will be well on your way to discovering the benefits of functional medicine for yourself and treating patients at your pharmacy in an innovative, impactful way.

With the rise of conditions like chronic disease, and a myriad of other common health issues, functional medicine is key — and you can be a key part in proving it to patients.

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