Presenter: Leo Galland, MD, FACP, FACN
Format: Video of slides with synchronized audio

“Diagnosis”: a Greek word meaning “to know through the center,” is essential for all human problem-solving activity. Conventional medicine is built upon the process of Differential Diagnosis, which attempts to answer the question, “What disease does this patient have?” Treatment is therefore based upon the disease, with no inherent regard for the individuality of each patient. Diseases as entities are peripheral concepts to all ancestral and alternative healing systems, which view illness as imbalance and disharmony. Patient-Centered Diagnosis, developed by Dr. Galland 25 years ago, integrates the ancient search for understanding imbalances with modern biological and social science to create a system that has become a cornerstone of Functional Medicine. Illness arises from the interaction of Mediators, Triggers and Antecedents, which together create each person’s unique illness. A Mediator is anything that produces symptoms, damage to tissues of the body, or the types of behavior associated with being sick. Biological and psychosocial mediators do not occupy separate realms but are inseparably intertwined in the formation of illness. A Trigger is anything that activates a quiescent Mediator in this individual. Antecedents are the risk factors, genetic and acquired, that predispose each patient to acute or chronic illness. The utility of this system will be illustrated with clinical case presentations, in which people with different “diseases’ share similar triggers or mediators and people with the same “disease” present with different triggers or mediators. In each case, integrative therapy is based on Patient-Centered Diagnosis rather than the differential diagnosis of disease entities.

Learning Objectives
- Understand how reliance on the process of Differential Diagnosis creates the limitations and inadequacies of conventional medicine
- Learn how to understand each person's unique illness by assessing the mediators, triggers and antecedents that form it
- Realize how knowledge of each patient's mediators, triggers and antecedents can guide integrative treatment.