About Dr Stephan Neff

I am a medical doctor practising functional and integrative medicine in New Zealand. Before moving into this field, I spent most of my medical career in conventional medicine. I trained and worked for many years as a specialist anaesthetist and also worked in pain medicine, perioperative medicine and hyperbaric medicine.

I have enormous respect for conventional medicine. I spent much of my life working in it and have seen first-hand what it can achieve. If I have a heart attack, develop sepsis, suffer a serious injury or need an operation, I want the very best of modern medicine looking after me.

Where I became increasingly dissatisfied was in our approach to chronic disease. I kept meeting people who were clearly not well, yet their investigations did not always explain why. At other times we had a diagnosis and a medication, but still very little understanding of why that particular person had become unwell. I became increasingly interested in that question.

This curiosity eventually led me into functional and integrative medicine. I started looking much more closely at metabolism, nutrition, inflammation, sleep, hormones, environmental exposures, psychological stress and the other things that influence how our bodies work.

The more I learned, the less sense it made to look at the body as a collection of separate organs. Sleep affects metabolism, our metabolic health affects hormones and inflammation, the gut interacts with the immune system, and what happens in our minds affects our bodies. Of course, none of this means that every symptom has some mysterious underlying root cause waiting to be discovered. Human biology is far too complicated for that.

I don’t see functional medicine as an alternative to conventional medicine. It has simply added to the medical toolkit I already had.

I still take a medical history, examine patients, order blood tests and imaging, make diagnoses, prescribe medication and refer to specialists. Functional medicine has taught me to look more broadly at the same time. I want to understand what has changed, what may be contributing to the problem and, most importantly, whether there is anything useful we can actually do about it.

My particular interests include metabolic health, environmental medicine, healthy ageing, chronic inflammation, nutrition, hormonal health, chronic pain and complex illness.

Many of the people who come to see me don’t fit neatly into one diagnostic box. Fatigue may sit alongside poor sleep, brain fog, gastrointestinal symptoms, metabolic problems or pain. Others already have a perfectly clear diagnosis but want to know whether there is more they can reasonably do to improve their health.

I enjoy this kind of medicine. Sometimes there is an obvious explanation. Sometimes there isn’t, and we have to do a little detective work.

That does not mean ordering every exotic test available or sending someone home with a cupboard full of supplements. Tests should answer a useful question and treatments should have a purpose. I would much rather identify a handful of things that matter than produce an impressive-looking plan that nobody can realistically follow.

A growing part of my work is holistic oncology and integrative cancer care. This has become an area of particular interest to me, both clinically and academically.

I do not practise alternative oncology. If surgery, chemotherapy, radiotherapy, immunotherapy or another conventional treatment offers a patient a meaningful chance of living longer or being cured, that matters enormously. Complementary medicine should not make people lose sight of that.

There is, however, much more to a person with cancer than the cancer.

I am interested in the health of the person going through treatment. Their nutrition, metabolic health, muscle mass, sleep, physical fitness and psychological wellbeing all matter. Treatment itself can take an enormous toll, and there may be sensible ways of supporting recovery and reducing some of that burden. I am also fascinated by cancer biology and by the growing number of metabolic, supportive and complementary approaches being investigated alongside conventional treatment.

This is also an area full of exaggerated claims. Patients with cancer are particularly vulnerable to people promising certainty where none exists. I think we have to be very careful about that.

I am curious by nature and quite prepared to investigate an idea that sits outside mainstream medical practice. That does not mean I automatically believe it works.

One of the traps in functional and complementary medicine is confusing a plausible biological mechanism with evidence that a treatment actually helps people. Something can work beautifully in a petri dish and achieve very little in a human being. On the other hand, medicine also contains plenty of unanswered questions, and lack of definitive evidence does not always mean that an idea has no value.

I am comfortable saying that we don’t know.

Where the evidence is strong, I will say so. Where it is preliminary or conflicting, patients deserve to know that too. The same applies to risks, costs and the possibility that a treatment may simply do nothing.

That is particularly important when people are frightened or seriously ill.

My own life has influenced the doctor I have become. I have written and spoken publicly about my experiences with mental health, trauma, addiction and recovery. I don’t hide that history and I don’t regret talking about it.

Being on the other side of medicine taught me things that medical school never did. I learned what vulnerability and shame feel like, and what happens when your life suddenly bears very little resemblance to the one you thought you were going to have. It also changed the way I listen to patients.

Those experiences are part of my story, but they are no longer the centre of my professional work. My work today is focused on functional and integrative medicine and, increasingly, holistic oncology and integrative cancer care.

When I meet someone for the first time, I want to understand what has happened rather than simply collect a list of symptoms. I want to know what has already been investigated, what has worked, what hasn’t and whether there are important pieces of the puzzle that have been overlooked.

Sometimes the answer lies firmly within conventional medicine. Sometimes looking more broadly adds something useful. Quite often we use both.

Ultimately, I want you to leave with a better understanding of what may be happening in your body and a practical idea of what we can do next. I don’t believe you should have to choose between good conventional medicine and a doctor who is prepared to look beyond it.

There is room for both.

That is the medicine I am trying to practise.