Wednesday, November 23, 2011
Health and wellness programs: medicine or marketing?
There's a new term that has entered the medical lexicon. The word is wellness. Hospitals and medical offices are incorporating this term into their mission statements, corporate names, business cards, medical conferences and other marketing materials. The Cleveland Clinic Foundation has appointed a Chief Wellness Officer, an intriguing fluffy title that does not clearly denote this individual's role and function. This is deliberate, as the word wellness is designed to communicate a feel good emotion, not a specific medical service.
Just a click or two on Google will lead you into the wellness universe. Here's a sampling.
--Institute of Sleep and Wellness
--Wellness Institute of America
--National Wellness Institute
--Physicians Health and Wellness Center
--Physicians Wellness Group
There's even a sponsored ad on Google where one can search for physicians, presumably trained in the medical specialty of wellness. I was dismayed that my name didn't appear in a wellness search of the Cleveland, Ohio region. Does this mean that I don't offer my patients health and wellness?
Where is all of this wellness coming from?
It's coming from marketing departments who understand the public mood. While conventional physicians view complimentary medicine warily, the public can't swallow it fast enough. Patients want a softening of the medical profession and are willing to accept new genres of care based on promises, testimonials and faith.
I admit that much of what my colleagues and I prescribe and recommend is based on scant medical evidence. I don't have satisfying treatments for irritable bowel syndrome or chronic abdominal pain. I understand why such patients look beyond me and my colleagues for healing and relief. They are spending billions of dollars on herbs, colonic hydrotherapy, Reiki, massotherapy, holistic medicine, naturopathy, aromatherapy, biomagnetism, guided imagery, medication and homeopathy.
Hospital and medical marketers may not know how to cure disease, but they sure can count. The vast majority of Americans have pursued alternative medicine for one reason or another. The medical establishment has expanded its healing mission to gain access to this huge and growing market. Conventional hospitals, where cardiac catheterizations and colonoscopies are performed, now offer a variety of wellness programming to extend their branding into the surrounding communities.
I think that we are risking a wellness overdose, and there is no antidote. My concern is that it confuses the public between ways to improve their lifestyles and state of mind and actual medical care and treatment. I concede that many alternative medical treatments make folks feel better, but I'm not sure they cure disease.
There's a danger in medicine when faith overtakes reason. An extreme example is when cancer patients were spending precious time and resources for shark cartilage or other high-cost alternatives that have no scientific basis. These opportunities exploit desperate people who have no way out. They shouldn't have to spend money to pray for a miracle. They can do that for free, and they should.
I know there is spirited belief and support for unconventional medicine to complement traditional medicine's failings. If they want to turn skeptics like me into believers, then they'll have to pursue a more conventional approach. Test your treatments in high-quality clinical trials. If scientific studies determine that these treatments, or any therapies, offer no benefit, then abandon them rather than assail them as flawed and biased studies.
I'm in favor of any intervention that makes people feel good, provided it is safe and doesn't exploit folks. Just because the word medicine is in the label, doesn't make it so.
This post by Michael Kirsch, FACP, appeared at MD Whistleblower. Dr. Kirsch is a full time practicing physician and writer who addresses the joys and challenges of medical practice, including controversies in the doctor-patient relationship, medical ethics and measuring medical quality. When he's not writing, he's performing colonoscopies.
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Ira S. Nash, MD, FACP, is the senior vice president and executive director of the North Shore-LIJ Medical Group, and a professor of Cardiology and Population Health at Hofstra North Shore-LIJ School of Medicine. He is Board Certified in Internal Medicine and Cardiovascular Diseases and was in the private practice of cardiology before joining the full-time faculty of Massachusetts General Hospital.
Zackary Berger, MD, ACP Member, is a primary care doctor and general internist in the Division of General Internal Medicine at Johns Hopkins. His research interests include doctor-patient communication, bioethics, and systematic reviews.
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Suneel Dhand, MD, ACP Member
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