Dr. Garofalo inspects the ear of a smiling child


In our last blog, we discussed integrative, functional, and naturopathic medicine as being similar medical approaches to caring for the Whole Person. Most people who access this type of healthcare are adults, but it’s just as important (arguably, more important) to approach healthcare for children holistically. In fact, Whole Child Health is an initiative promoted by the Centers for Disease Control and Prevention (CDC) that many organizations who care for children try to implement – including at Tacoma Public Schools. 


Lifelong health starts early 

We’ll say it again – PREVENTION IS EVERYTHING! It cannot be overstated how important a healthy childhood is for a person’s lifelong health and longevity. Here are a few facts about childhood health that many people find surprising – including some who work in child healthcare: 

  • Most forms of cardiometabolic diseases that adults are diagnosed with – e.g. type 2 diabetes, coronary artery disease – have warning signs that show up before age 18. 
  • Stress and hard life experiences are well-established risk factors for adult cardiovascular disease like heart attacks and strokes. Having high adverse experiences in childhood is directly linked to greater risk of cardiovascular disease in adulthood. Some studies have even shown this association remains when controlling for related risks like poverty and smoking. 
  • Children whose parents/guardians have certain mental health conditions like bipolar disorder, ADHD, and anxiety are more likely to develop these conditions as adults.  
  • Children who receive multiple courses of antibiotics for frequent/recurrent illnesses such as ear infections are more like to develop diabetes and other metabolic health problems in adulthood. 

These are just a few examples of why ‘good’ healthcare for children involves much more than regular visits with a pediatrician. Diligently caring for the health of a child requires care for the whole family.  


Early intervention requires regular healthcare visits 

Right from birth, children grow and develop extremely quickly – it is truly a wonder to behold. This is why we adhere to the schedule for well-child visits that is recommended by the American Academy of Pediatrics and the CDC. Developmental screenings are performed at most early childhood visits so that we can intervene in areas that need support as soon as possible. Our community has a well-connected network of behavioral health and child development providers to call on when needed. 


The hidden burden of stress in childhood 

Adverse childhood experiences are potentially traumatic experiences that occur in childhood, such as suffering physical abuse or witnessing abuse between caregivers. It can also include experiences that threaten the stability of a child’s home or their attachment to caregivers—things like housing insecurity and caregiver substance use. Other stress and life adversity can have subtle but real effects on children when it affects a caregiver’s ability to recognize and respond to their children’s needs. When we meet families, we take time to ask lots of questions so that we can offer support in any of these areas if necessary. 


Children need positive experiences to thrive 

On the flip side, positive experiences in childhood and healthy attachment with caregivers are very protective against the health risks of trauma. The conventional medical model is sometimes overly focused on “what’s wrong” and loses sight of “what’s right.” It is just as important to support healthy relationships and life-affirming activities for children as it is to protect them from harm. Your child’s pediatrician should be actively discussing positive parenting, healthy behaviors, education, and play at routine health checks.  



Basu A, McLaughlin KA, Misra S, Koenen KC. Childhood Maltreatment and Health Impact: The Examples of Cardiovascular Disease and Type 2 Diabetes Mellitus in Adults. Clin Psychol (New York). 2017 Jun;24(2):125-139. doi: 10.1111/cpsp.12191. 

Boursi, B., Mamtani, R., Haynes, K., & Yang, Y. X. (2015). The effect of past antibiotic exposure on diabetes risk. European Journal of Endocrinology, 172(6), 639–648.  

Camhi SM, Katzmarzyk PT (2010) Tracking of cardiometabolic risk factor clustering from childhood to adulthood. Int J Pediatr Obes 5:122–129.  

Rosengren A, Hawken S, Ounpuu S, Sliwa K, Zubaid M, Almahmeed WA, Blackett KN, Sitthi-amorn C, Sato H, Yusuf S; INTERHEART investigators. Association of psychosocial risk factors with risk of acute myocardial infarction in 11119 cases and 13648 controls from 52 countries (the INTERHEART study): case-control study. Lancet. 2004 Sep 11-17;364(9438):953-62. 

What’s the Difference Between Integrative, Functional, and Naturopathic Medicine?

Integrative Medicine is often talked about interchangeably with Functional Medicine or Naturopathic Medicine—it can get confusing. Medicine is “integrative” when it brings together diagnostic techniques and medical treatments, regardless of what tradition they come from, to support your health and healing.

At Link Community Clinic, our physicians are trained in naturopathic medicine, which is a distinct tradition with its own history and established set of principles. Naturopathic medicine often looks a lot like Integrative and Functional Medicine in its emphasis on lifestyle, prevention, and non-pharmaceutical therapies. These disciplines all typically address multiple health issues at the same time, with multiple techniques – for example, promoting exercise and mindfulness-based stress reduction in addition to medication for mental health concerns.

Medical approaches to Whole Person Health

As we discuss in our past blog on the subject, Whole Person Health involves looking at the whole person—not just a single disease or organ—and considering all the factors that influence one’s health. It requires recognizing not only how multiple systems of the body are connected, like the nervous system and the immune system, but also how one’s experiences, environment or habits influence those systems. Integrative, Functional, and Naturopathic medicine have all become distinctive professions with their own unique training programs and boards of certification. In practice, they can be very similar medical approaches to achieving Whole Person Health.

At our clinic, we don’t get too caught up in identity or philosophy. We just strive to put each person at the center of their own healthcare. Here’s how:

One’s medical care must be in line with their goals, values, and beliefs, which are almost impossible to assess in a typical 10–15-minute primary care visit. This is why we spend time to get to know our patients, empower them to take better care of themselves and their families/community, and make medical decisions together. Treatment also shouldn’t be detrimentally expensive or cause more harm than good. We pride ourselves on being the only naturopathic doctors in Pierce County who provide full primary care for people on Medicaid, and we’re very resourceful in seeking the right care for our patients.

How might this look for a patient at our clinic?

Consider someone needing help with chronic back pain. We take time to ask questions and get a thorough history—not just about the back pain, but about other things that relate to one’s overall health, e.g. diet, occupation, activity level, mental health. We perform as much or as little testing as is medically necessary, with an eye for prevention and identifying the root causes of an issue. We may discover the back pain is more prone to flare in times of stress or that certain foods cause more joint pain. The person may want to discuss trying acupuncture before medication for muscle spasms. We also may discover some underlying disease where more testing or referral to a specialist is needed.

Making Integrative Primary Care Accessible for all

Our process is to educate patients and help them feel empowered to make the best decision for them and their community. Unfortunately, a lot of providers that practice integrative or “holistic” medicine endorse tests that come with high out-of-pocket costs and do not help guide medical decision-making. These options should never take the place of a thorough workup, most of which is usually covered by insurance. (Do insurance companies fall short in taking care of people? All. The. Time. But that’s for another day.)

These providers may also recommend therapies that are very expensive and do not have well-established safety, especially when using them with other medications. Our providers stay updated on the scientific evidence and rationale for various supplements and when they’re worth using, or not worth it. We also recognize that not all disease can be prevented—sometimes you do everything right and still get sick. In these cases, we treat acute conditions as we’re able, and we refer to specialists when it’s necessary.

Whatever you label our type of medicine, it’s more satisfying for patients and providers alike. And everyone deserves this type of care.

Graphical representation of the COVID-19 virus

End of COVID emergency measures puts many Pierce County residents at risk of losing health insurance

Tacoma-Pierce County Health Department and several other agencies in Pierce County provide free support for those who need assistance with re-enrollment or to enroll in alternative insurance options.

watercolor picture of two figures facing each other

Breaking the Stigma: Mental Health – Your Guide to Understanding, Coping, and Seeking Help

If you have — or think you might have — a mental illness, know that you are not alone. There is help available. Mental health conditions are far more common than you think.

Link Clinic For Your Family’s Primary Care

Why choose Link Clinic as your family’s primary care provider?

Every family needs access to a caring and knowledgeable primary care provider, which is increasingly difficult to find in our healthcare system these days. But health is also much more than what typically gets addressed in a doctor’s office—it’s the foods you eat, the quality of your relationships, and the ways you work, rest, and play.