From 25 Years in Derm to a Functional Medicine Practice
PAs Buchi Neita and Lisa Weiss open the conversation with a story many longtime clinicians will recognize: Kerry Jenkins never planned to end up in dermatology. She graduated PA school in 2000 aiming for internal medicine or family practice, and only took a dermatology interview because a classmate suggested it. She admits her initial attitude was 'I don't want to pop pimples' — a stereotype she now recalls with humility. That interview turned into a 25-year run at the same practice.
Eight years ago, Jenkins started her functional medicine practice on the side and slowly weaned down her dermatology hours from three days a week to two, to one, before finally leaving conventional practice completely in December 2025. She describes the shift as a 'terrifying leap of faith,' driven by the sense that functional medicine is her true calling.
Her origin story has two threads: her daughter's digestive issues, and a pivotal encounter with a 16-year-old newly diagnosed lupus patient — details Neita and Weiss return to later in the episode.
Defining the Terms and the Gut-Skin Connection
Weiss asks Jenkins to sort out the overlapping vocabulary — functional, integrative, and alternative medicine. Jenkins frames functional medicine as identifying how the body's systems are functioning, with the goal of optimal function rather than opposition to conventional care. She's explicit that she is 'not anti-drug, not anti-medication, not anti-vaccine.' In her view, integrative medicine is the marriage of conventional medicine with traditional practices like Chinese medicine.
The through-line of her practice is the gut-skin connection. Jenkins tells patients the skin is 'a window' into the gut — if the gut is inflamed, the skin will be inflamed. She points out that gut microbiome science was largely absent from PA training a generation ago, and calls the gut the body's 'first brain.' When she evaluates a chronic, stable skin condition, she starts with the gut microbiome.
How She Works Up Acne and Hair Loss
For acne, Jenkins starts by individualizing the patient — a 17-year-old male athlete, an 18-year-old with PCOS, and a 32-year-old with papulopustular acne are three different cases. She notes location matters, too (face only vs. chest, shoulders, and back). Her workup combines conventional blood work (CBC, CMP) with serum nutrient labs including vitamin A, zinc, and vitamin D, which she describes as nutritional co-factors for a healthy immune system.
She adds two functional diagnostics: a comprehensive digestive stool analysis to assess the gut microbiome and screen for opportunistic overgrowth (H. pylori, Candida) or parasites (Giardia, Blastocystis), and a urinary organic acids test to identify a yeast overburden — distinct from acute thrush. From that data, she builds an individualized plan around what she calls the four pillars of health: nutrition, sleep, movement, and stress management. As she puts it, acne is never caused by just one thing — hormones, cortisol, and insulin are all drivers.
Hair loss follows the same logic. Jenkins first identifies the type — androgenetic, autoimmune (alopecia areata, alopecia totalis), or scarring (lichen planopilaris) — because the discussion differs by bucket. But every patient gets the same foundational work: nutrition, sleep, stress, movement, hydration, and sun exposure. Weiss notes the parallel to lifestyle medicine's six pillars, which add avoiding risky substances and social connectedness.
Autoimmunity, Leaky Gut, and the Lupus Patient Who Changed Everything
Autoimmune disease is one of Jenkins's central passions. She describes autoimmune drivers as a combination of genetic predisposition and a breach in the GI lining — 'leaky gut' — where broken tight junctions allow undigested food proteins, toxins, and microbes into systemic circulation, triggering an immune response. She walks through the cascade: antigen-presenting dendritic cells sampling and presenting to T and B cells, until the immune system turns on self-tissue. She ties the increasing intestinal permeability to the standard American diet — processed foods, sugar, dyes, preservatives, and pesticides.
Weiss raises the frustration many patients feel when conventional visits don't ask about sleep, diet, or stress. Jenkins is careful not to throw shade at colleagues — she says she was simply 'trained differently' — and argues the real fix is upstream in how clinicians are educated.
The emotional core of the episode is the 16-year-old African American patient who came in already diagnosed with lupus, with an aunt and grandmother who had it too, asking how nutrition could keep her disease from progressing. Jenkins didn't have the answer that day but promised they'd 'figure it out together.' She describes it as lightning striking in her exam room — the moment she knew her path.
Answering the Skeptics — and Where to Start
Neita plays devil's advocate on the two most common criticisms: that functional medicine isn't evidence-based and that it's only for the wealthy. Jenkins responds that she once wasted two years afraid of the label — even Wikipedia, she recalls, once described it as 'voodoo witchcraft.' She counters with the growth of published literature: a search for atopic dermatitis and the gut microbiome that returned a handful of studies a decade ago now returns hundreds in PubMed. Her frustration is that it takes roughly 17 years for research to reach conventional training.
On access, Jenkins points to work happening 'behind the scenes' to bring integrative care to the masses, citing the news that Parsley Health, founded by Dr. Robin Berzin, was recently picked up by major insurance carriers.
For clinicians who want to learn, Jenkins names the Institute for Functional Medicine (IFM.org) as her gold-standard resource, and Dr. Mark Hyman's podcast (The Doctor's Farmacy). She closes by making herself available to any PA or NP considering this path — 'it takes an army'