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The IFM Toolkit is one of the most robust collections of functional medicine resources available to practitioners and offers a variety of dynamic, clinical resources that are continually updated with the toolkit resources with the latest evidence-based research and considerations. Access to the toolkit is included with IFM membership, along with several other benefits.

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Guest Bio 

Brandilyn Binstock, ND, IFMCP, is committed to finding clinical answers for her patients and being up to date on the most effective evidence-based therapies. She uses a functional medicine approach to help her patients stabilize and heal challenging conditions so they may live a more active and fulfilling life. She is a primary care provider and has clinical interests in connective tissue conditions, gastrointestinal conditions, and cardiometabolic disorders. Dr. Binstock has a great interest and passion in working alongside medical students and feels strongly about teaching the merging of efficient diagnostics and conventional standard of care with integrative medicine philosophy and therapies. 

Briana Aspy, PA-C, IFMCP, is a board certified physician assistant with over five years’ experience in the field of pain management providing comprehensive pain care, including health and wellness treatment. Prior to relocating to her hometown of Fort Wayne, Briana practiced in the Pacific Northwest, which gave her exposure to conventional, alternative, and complementary medicine. This experience, combined with long-term management of complex pain disorders, instilled in her a strong interest in integrative medicine and a passion to treat the body as a whole. Her practice provides clients with thorough evaluation and diagnostics to uncover the root causes of disease processes, symptoms, and inflammation. She formulates comprehensive, patient-centered care plans utilizing lifestyle, exercise, nutrition, stress reduction, trauma recovery, and gut health as the foundations. 

Transcript: 

Kalea Wattles, ND: On this episode of Pathways to Well-Being, we’re discussing the ways in which IFM’s Clinical Toolkit can be used in various clinical settings and how it guides patients toward better health outcomes. Joining me today are Brandilyn Binstock and Briana Aspy, who will walk us through how they use the toolkit resources in practice and the impact it has on their patient care and clinical outcomes. So welcome to the show both of you. I’m so delighted to have you here. I can’t wait to hear how you’re using the toolkit in practice.  

Briana Aspy, PA-C: Yes, thank you.  

Brandilyn Binstock, ND: Thanks so much for having us. 

Kalea Wattles: I thought it would be really fun to set the scene for today’s episode with a little functional medicine origin story. I love to hear how everyone becomes involved in functional medicine, their journey through certification. So Brandilyn, maybe we’ll start with you. Tell us a little bit about how you got involved in functional medicine. What brought you to seek your functional medicine training? 

Brandilyn Binstock: Gosh, yeah, well, so I have a degree in naturopathic medicine, and I think I share sort of the perspective that naturopathic medicine sort of falls under the house of functional medicine. And so we learn a lot of the same philosophy. We work from a lot of the same perspective. And so I think just starting my training within naturopathic medicine is sort of the origin of functional medicine.  

Now, I started sort of taking classes throughout medical school, through various institutes, and got into The Institute for Functional Medicine classes in my first year at residency, actually, where I think I had just talked to a colleague that was going through the training and sort of emphasized, actually, the toolkit and the resources available through IFM, and I thought that that was pretty great.   

Starting as a new clinician, you haven’t built a lot of your own resources yet for yourself. And so I started taking the classes through my residency and finished the classes, I think, a year ago, about, and then did the certification and just got certified this past June, which is super, super exciting. And so yeah, it’s kind of, I feel like it spanned the entirety of my medical training, functional medicine has, but in particular during my residency is where I became more involved in The Institute for Functional Medicine. 

Kalea Wattles: Awesome. Well I think you highlighted something really important that I always talk about. I love when we can get students or residents involved in functional medicine training. Because we hear from clinicians all the time, I had to unlearn all these things I thought I knew. So having that foundation and functional medicine early on, I think, can be really practice-changing, and congrats on your recent certification. So exciting.  

And how about you, Briana? How did you get involved in functional medicine?  

Briana Aspy: Yeah. Wonderful. So yeah, I started my career, of course, in conventional medicine. I’m a physician assistant and had earned my degree and started practicing in 2008. And for the first few years of my career, I worked in the field of pain management, which I really enjoyed. And that was really my first exposure to just sort of looking to use any tool in the toolbox to help individuals with chronic pain.  

 So I started learning about complimentary methods and lifestyle approaches and really sparked my interest around that time, kind of began my own personal health journey as well, in which I was kind of learning about functional medicine on my own at home and just was very eye opening, of course, as it is to most of us. About 2013, I was just very, very fortunate to be able to join an already established integrative medicine group here in my hometown, Fort Wayne, Indiana. And it allowed me to join a group that was already practicing functional medicine and just received training with my providers and really with our practice, because we’re larger, we’re part of a community health system. We have multiple providers within our practice. We really needed kind of a good foundation, because we all came from different backgrounds, and IFM was really just the clear answer for us, for really all of us to go through the training. And it allowed us to kind of get together really as a cohesive team and learn these science-based, systems-based approaches to care and offer functional medicine in a large-scale practice. So that’s how we became involved with IFM. And again, most of us receiving our certification, I in particular got mine in 2018 and have remained, of course, involved and after certification in regard to maintaining that and really using it on a regular basis. 

Kalea Wattles: That’s the story that we hear, that functional medicine training can be so helpful in an integrated health setting because it allows different practitioner types to speak the same language, have that commonality. So I’m really glad that you brought that up. And I think that’s the perfect place to add some context as we begin to talk about the toolkit. I’d love to know what your practice setup looks like. So Briana, you gave us a little bit of insight, but tell us what your clinical setting looks like so we can visualize how the toolkit is being used?  

Briana Aspy: Sure, absolutely. So right now, we have five providers; we’re growing to seven by the end of the year. And again, we’re all coming from different backgrounds, but IFM really pulls us together. Support staff, we have nutrition staff on board, and we’re really set up in an outpatient setting. And again, within a health system that we share throughout northeastern Indiana, and for us the way that the toolkit and IFM is kind of integrated into our system is we are able, of course, with maintaining certification, to access that. And we do utilize that each and every day. We’re seeing clients on an outpatient basis all day long, and we really have embedded within our own templates the ability to list handouts. And so we’re spending our time, of course, as much as possible, educating and educating. And we do that on an individual basis as well as a group setting. And generally, with our group visits, as well as individual, almost every visit, somebody is leaving with a handout from that toolkit. 

Kalea Wattles: Well, fabulous. The patient education piece is continuing beyond the patient visit, and Brandilyn, and I know you have a different clinical setting. Tell us about your clinic and how you’re utilizing the toolkit items. 

Brandilyn Binstock: Yeah. So I primarily practice at the university clinic alongside medical students, which is so wonderful because they’re always so excited, and I learn lots from them too. So for the most part, I’m seeing patients with my medical students and how the opportunity to not only go through the handouts and sort of do education for the patient, but also for the students. And then the other sort of a smaller part of my time I spend in my own private practice within the same university-based clinic. But then also I do one day a week at a community health clinic in the Washington area. We have quite a few of them, but Health Point is the one that I round at this year. And so actually, the tools come in quite helpful in that setting, where there are perhaps more financial barriers to what people traditionally think is sort of like functional medicine, which is like nutraceuticals or sort of like expensive products. And so the toolkit [items], they’re super helpful in educating my patients, my students, but then also just providing more of a barrier-free way of taking medicine home for my patients. 

Kalea Wattles: Excellent. I love that you’re using the toolkit with students. I think that’s an important piece that in this case it’s educating the patient, but also that the students are getting some exposure to the IFM Toolkit, because as healthcare providers, we all face this challenge where we have a limited amount of time in our office visits, the visits go by so fast, and the information that we’re talking about, it doesn’t always sink in in that moment. There’s lots of moving parts. There’s so many things, we’re trying to provide this education, since that’s part of our philosophy. And I really think that’s where IFM’s Toolkit shines.  

There’s so many resources that we can send home that talk about lifestyle and behavior change and the nutritional resources, which are some of my favorites. So, Briana, I’ll send this one over to you. How has the toolkit helped to streamline your office visits? So from the practitioner perspective, how has it improved efficacy during your clinical consultations? 

Briana Aspy: It’s definitely a very big time saver in that regard through both our clinical visits as well as with our nutrition staff. As we all know, sometimes when you are cramming so much into these visits, it can be overwhelming for both the client as well as the provider to try to get that information across. So it’s been able to sort of teach us, what do we have in our toolbox? What do I need to get across today? What do I know is gonna be covered by these materials? So it sort of allows you to focus in on what’s most important and reassure that client during that time. Listen, I’m gonna be sending you home with some really, really good material. This is going to further explain what we’ve discussed today. It’s gonna be sort of like a little bit of homework for you. You’re gonna be reading through, perhaps picking a few things that you wanna work on between now and our next visit. And you can also be very confident that this is paperwork, if you will, that people can read and understand. And that’s very, very important. 

 Just like Dr. Binstock, I work with a wide variety of clients. I feel very grateful to be able to offer functional medicine in an insurance-based practice where we can also reach underserved in our community. And it’s very important that I’m able to give things that everybody can understand and start implementing at home. And the material is just very clear in that regard. So it saves time. And I think on our nutrition staff side, it’s very, very valuable. It’s allowed us to really narrow down our therapeutic approaches with food and nutrition and be able to give her clear guidance, “I’d like you to consult regarding the detox protocol or perhaps an elimination protocol or cardiometabolic.” So these are all the food plans that you’re learning about through certification, and then you can literally prescribe it. So it just takes a lot of the guesswork over, “What would you like me to do with this client?” There’s prescriptions available within the toolkit as well as really comprehensive guides. So she knows what to do, and she can also send the exact same instructions home with the individual. So there’s no confusion. 

Kalea Wattles: Well, I really relate to that part of your story. And I think an important component of this, as you mentioned, is getting the patients involved. That’s always our goal is to get them involved in their treatment plan. So having some of this information that we can send home, have them do their homework, as you said, and really pinpoint the questions that they have for you for your next visit, I think, is a really huge benefit of the toolkit. Brandilyn, I remember being an ND student and watching my supervisor running all over the place during clinical shifts. Tell us how the toolkit helps to streamline that process for you when you maybe have multiple patient visits going on simultaneously. 

Brandilyn Binstock: Yeah. It actually has a huge impact in the teaching clinic for me, because as you know, sort of, there’s the portion where the student is kind of doing the history intake. I step in to make sure that everything’s sort of going as it should be and ask additional questions. And then we all step out together to put our brains together and think about what’s going on for our patient, what do we need to prioritize, and coming up with a treatment approach. And oftentimes, especially when you’re working alongside really new clinicians, it can take them a while to sort of gather their resources and type up a plan for our patients. And so that’s where the toolkit handouts come in very, very handy, especially in regard to like the nutrition handouts, the elimination diet, or the various diets, because then my students don’t have to sort of recreate those documents and type them up for our patients; their treatment plan can simply say refer to the elimination plan. And then that leaves a lot more time for our students and myself to be able to go through and do the education portion of the visit, which from my perspective is the most important part of the visit. 

 It’s the visit or it’s the part of the visit where you develop more trust, therapeutic relationship. You can get buy-in from your patient. You can check in with your patient to make sure that we’re sort of like on the same page and make sure that this treatment is something that would practically work for them. And so I like to spend a lot of time, the majority of the visit I like to be that end portion. And so the less time we spend sort of like stepping out and writing up the treatment plan, the more time we have for that. And so, in that way, the toolkit has saved both myself, my medical students, lots of time to be able to educate our patients and really solidify that therapeutic alliance. 

 Kalea Wattles: I think that’s really helpful background, Brandilyn. And I wanna recap the logistics of how you’re using the toolkit, because oftentimes, we have new practitioners who go through our foundational course, Applying Functional Medicine in Clinical Practice, and they have access to the toolkit for the first time. And the question is always, these are amazing handouts, but how do I deliver these? How do I incorporate these into my patient visit? So can you tell us, when you’re in the visit, how you actually deliver those? Are you printing them out and giving them to the patient? Do you have them in a binder? Are you printing them on demand? Do you do it every visit? Let’s talk about the real logistics of it. 

Brandilyn Binstock: Yeah. Well, I do have to say I have a little bit of help. So we at the university are licensed for sort of a list of the handouts. And so the students have access to those handouts as well. And so I have some help with printing, but we do print them on demand. So as we deem, you know, various handouts necessary, I’ll have my students either print them or I’ll email them certain handouts that I’m thinking about to be printed out, so that it’s sort of on demand type of thing. 

Kalea Wattles: Great. And Briana, it sounds like maybe you’re attaching them with your EMR, which is what I do as well. Will you let us know how you’re delivering the toolkit items to patients? 

Briana Aspy: Yes, absolutely. So, yeah, we have the option to do paper and printing. We also do have the option to deliver them electronically, which has been something that’s been very valuable, just saving paper and making this a little bit easier for staff. So ultimately, our process in terms of an office visit, usually, is to kind of let our staff know which ones we would like to provide. And then sometimes upon checkout, that’s where the question will come up. Would you like these delivered? We have a system that uses MyChart, and we’re able to attach them, as I believe, PDF and send them electronically. Or they’ll ask, would you like this to be printed? Because some people are paper-oriented.  

Everybody has a binder that they use through their entire journey with us that they might put a lot of handouts in as they go from visit to visit and they’re learning. And they’re just stuffing this thing full over the years of all this valuable information, but then some people do appreciate the electronic, the other way that we’re gonna utilize it, where it’s less guesswork is just, again with things such as group visits, ours will go by specific topics. So we have some on detoxification, we have some on diabetes, on autoimmunity, on thyroid disease. And so what you’ll find in the toolkit is just an abundance of resources that as you search through, you can kinda gather on each of these topics. And that has made it very easy for us, because we have set handouts that we want these clients to go home with after they’ve spent an hour or so with us educating on those specific topics.  

 And that’s really helpful, because when they can sit in that group, they can listen, they can engage, ask questions without having to worry so much about taking notes or taking pictures of our PowerPoint slides. They are reassured at the beginning of that group visit, “Hey, you’re gonna go home with some fabulous tools that really cover the biggest highlights of what we’re gonna talk about today. Relax, like participate. Don’t worry about taking so many notes.” And so those are just pre-printed. They might, we typically put those in a folder, and we just have everybody take those home after they’ve attended the corresponding group. So we use them like in that regard all the time.  

Kalea Wattles: I think that’s helpful that you’ve brought in the group, the shared medical visit aspect to this, because really utilizing the toolkit items then gives our providers more time to develop the education piece, to do the check-ins. And I think that’s kind of the future of functional medicine is doing group visits. So I’m glad you brought that into this conversation, and I can wait no longer—the question we’ve all been waiting for. I have to know, Briana, maybe I’ll start with you. What are your most favorite toolkit items? What are the items that you’re attaching to the most treatment plans? I know you work in an integrative clinic. So what are, what are the items that you’re attaching most often?  

Briana Aspy: Okay, absolutely. So, yes, there’s so many, it is very difficult to narrow them down, but because I’m on more of the clinical side and not doing the really, really deep nutrition visits, I’d have to say while those have got to be number one as a practice whole, for me, personally, with what I do from visit to visit, it has to be some of the lifestyle factors. And so most of the time at my visits, I’m usually gonna be sending people home with handouts such as suggestions for better sleep, you know, how to do mindfulness. We may use, the handout I love is eating for your microbiome. So lifestyle pillars is really where I use it absolutely every single day. So those are kinda some of my top favorite ones. The other things that we’re going to use a lot of is more in the prescriptive role. And so within the toolbox, you’ll also find some that are basically giving your clients a lifestyle prescription. And those are really helpful, cause we kinda speak about, well, telling someone to do something or encouraging them. It actually might mean a little bit more when you’re putting it on an actual prescription. And so we’re getting into a goal that is something that they feel they can handle. It’s something that’s very, very specific. And the act of writing that down and sending them home with it is really helpful as well. So those are probably my favorite ones. 

Kalea Wattles: Well, I have to agree. I love the lifestyle handouts, and I think you selected some really good ones, brought in SMART goals, which is one of my favorite things to talk about in terms of behavior change. So definitely some great choices. How about you, Brandilyn? Any favorites in the toolkit? 

Brandilyn Binstock: Gosh, we are all on the same page in regard to the handouts on the determinants of health. And so I do love the sleep handout, a lot of the mindfulness handouts, also the mindful breathing, the prescriptive handouts too, in regard to lifestyle. I’m on the same page with Briana, which is that if you can really sit down and practically determine like how this is going to look for your patient on their day-to-day sort of schedule, I think that’s large, like wildly impactful for them to be able to implement some of these things.  

 And so sometimes we go hour blocks by hour blocks determining like, okay, so if you’re going to bed at this time, are you gonna do your breathing practice before that? Or where are we fitting in movement? And so I am on the same page. Those handouts are sort of at the top of my list. And then with my sort of time in the teaching clinic, there is a little bit more time for the students to go through the food plans with our patients. And so we are utilizing a lot of the elimination diet, cardiometabolic diet, core diet. And so we have a lot of those handouts too that we’re using and teaching through in the clinic. And so, but yeah, largely very similar sort of picks.  

Kalea Wattles: Well, I feel like I have to take the opportunity to say some of my favorites too, because you’ve got me feeling so excited. In my largely fertility practice, I’m using the Mito Food Plan quite often. Another one that I have, I give so many people a copy of, is the Factors That Affect Thyroid Function. It’s a beautiful document listing all of the nutrients and lifestyle habits and nutraceuticals that can really support our thyroid health. And then I also love the food sources of documents. So I’m very commonly printing out food sources of iron, vitamin C, all of the cruciferous vegetables is one that I use a lot. So really the variety of tools to choose from I think is so helpful to me as a clinician. I have to also loop into this conversation tools that I think are foundationally important to a functional medicine practice, which is the timeline and the matrix. I cannot live without those tools. I think it’s really what sets this set of resources apart. Briana, you’ve been certified since 2018. So you’ve had some time to digest these tools. Are you using the physical timeline and matrix in your practice at this point?  

Briana Aspy: Sure. So I sometimes, because I am within an electronic medical record system, it isn’t necessarily formatted with an electronic timeline. So the honest answer is, the physical part of it, sometimes that occurs, sometimes it does not. What we definitely do is we do traditional timeline when a client comes in, but how that is documented may not actually be on that physical timeline that’s in the toolbox, but everything about it is the same in terms of how we document. It’s just not the exact same piece that is offered through IFM. However, I will say that within an intake, there are times particularly when it is very complex or we feel that we might be missing pieces that it is actually a piece that we will use as a working document for some clients in which we’ll start filling it out, we’ll save it within the chart. We can reprint it and continue to add and kinda stash that in the media tab. The other way that we might do the physical timeline is we may send it home with people and say, this is what we’ve completed today. And I realize there’s more information that’s pertinent here. You can see how we’re using this timeline, take it home, start thinking about some things in your past and add what you can and bring it back in. And so when that happens, we’ll certainly scan it and get it into the chart. So that’s how we would use the timeline. 

Kalea Wattles: Fantastic. Some of the most amazing tools that exist, in my opinion. Brandilyn, how about you? Are you using the timeline and the matrix with students? Are you able to utilize that in the teaching clinic? 

 Brandilyn Binstock: Yeah, yeah. So in particular, I’m sort of in the process of launching a functional medicine specialty shift within the teaching clinic, and it’s on that shift where I’m really trying more so to implement the timeline and the matrix with our students. And so with some of our follow up patients that are already sort of set on a plan, we don’t necessarily utilize the timeline in the matrix, but with our new patients or with our very complex patients where we seem to be sort of going round in circles and not really seeing so much progress, we’ll take it back and sort of re-chart on the timeline so that we can kind of get this information out from just floating around in our head and see it on paper and determine if there was something that we weren’t putting enough weight on or we’re emphasizing too much just from our own bias. And so that’s sort of how we’re using it in the teaching clinic now. And as the shift sort of grows in popularity or people become more aware of it, I’m hoping to just start everybody with a timeline and a matrix. And we’re really fortunate with the EHR that we have because it has access to the larger hospitals in the area. And so as our students are prepping for patients, they really do, are able to sort of dig into the history and chart it out before even seeing the patient and then go through the timeline with the patient and just confirm that they have the timeline correct, the symptom onset correct, this sort of thing. So it’s quite helpful in that way. 

Kalea Wattles: Yeah. I love that. You’re both using these tools, and I will say something that was kind of a game changer for me was in a very recent development. Most of the toolkit items have become fillable PDFs. So having the ability now to fill those out, re-upload them to the chart, and then, like you said, Briana, maybe later I wanna redownload them, add to it—super helpful. I think we’ve highlighted so many, so many ways that the toolkit can be helpful for patients. And now we’ve kind of shifted into how the toolkit is actually helpful for practitioners. And this is a fun area to explore, because I’ve certainly found, especially in terms of my history collection, with the timeline and the matrix and the medical symptoms questionnaire and the toxic exposures questionnaire and the HPA axis questionnaire, there’s all these tools that actually help me with my clinical decision-making as well. Briana, are there any toolkit items that you find are helpful for you as you’re putting together the patient’s story?  

Briana Aspy: Yes, absolutely. In addition to a couple you’ve mentioned, I do use the detox as well as the Candida Questionnaire quite frequently. And some of those have been really, really instrumental, because I know, as much as we can, we’re trying to use diagnostics to figure out a client’s root causes of their systems dysfunction, but depending on what the resources are, there are times where you may not necessarily be able to dive into some of these really deep functional medicine diagnostics. And these questionnaires have been very instrumental in that regard, because you’re able to have them completed, really see kind of a scoring system for a likelihood of concern in these areas. So it functions on its own as a diagnostic to really give you more information and help you understand if you’re kind of heading down the right path. You mentioned as well the MSQ (Medical Symptoms Questionnaire), and I would also say that’s been definitely paramount to our practice. We’d use the MSQ as our reviewer systems. And we were fortunately able to have that embedded within our EMR system. And we can have our clients do that electronically, but it, in our journey of trying to figure out how to document in a system that didn’t actually, or EMR system that didn’t align really with the way that we do intakes for functional medicine, it was so difficult. And then, one day, the light bulb goes on, and it’s like, we have to use this MSQ, and we’re going to figure out how to get it in here. So now it’s finally part of our template and very helpful, of course, on the clinician side for assessment and figuring out as well which systems we need to kinda be focusing on first and foremost, but also, as we’ve all found, it’s that scoring system that allows you to track progress as well. So we get that objective number, looking at that months, years, etc., beyond their first visit. And you can really help them see as well as yourself, what progress are we making here? Where are the numbers at? So that’s been really, really valuable to us.  

Kalea Wattles: That’s a great point. I was hoping someone would bring that up, the tracking component of something like the MSQ, because when we’re in the midst of the treatment plan, it can be hard to remember what we felt like when we started. So I think that’s a really important consideration. Brandilyn, how about you? Are you utilizing any toolkit documents that really help you as the provider?