There is no “I” in Wellness

Look up “Wellness”.
Bam. 270,000,000 results.

Enough for all 114,000,000 United States households.
Plenty of wellness is available.

Wellness must be very important. Every healthcare provider in America, from cardiologists to chiropractors, emphasize it on their website. And every insurance company sells a program for it. You’ve seen the ads. That much caring could make a person cry.
In fact, you should be downright ashamed if you’re not promoting wellness. Right?
If not, you must be one of those people that promote sickness. What? That’s silly.

What is Wellness?

The National Wellness Institute defines wellness:
an active process of becoming aware of and
making choices toward a more successful existence.

Now that’s deep. Boring, but deep. Like a well.
I get it… wellness is well… OK, I don’t get it.
Neither does anyone.

When you google “Wellness Programs”, you will get 57,600,000 results.
That’s about 57,600,000 more results than the actual wellness programs get.

Employers spend over 2 billion dollars each year on wellness programs, not counting the money spent on in-house policies, rewards, and initiatives. Money that could be used to facilitate primary care. That’s enough to pay for one office visit for each of the 25 million uninsured that we’ve turned our economy upside down trying to help.
It’s enough money to raise the income of every practicing primary care physician in our country by $10,000 a year.
Primary care… you know… those people that provide the real preventive care for our country. The ones that are getting harder to find.

Primary care physicians, in contrast to wellness programs, have been shown to improve healthcare and to lower costs. Real data. Real science.
But wellness programs market more effectively. They’re out there selling their stuff.

Our country seems determined to buy wellness.
As if the more money we spend, the more well we can be.
The bleeding edge of wellness.
The most wellness you can buy.
“You need the latest version of wellness.”
“You don’t want last year’s wellness.”

Businesses feel obligated to purchase some type of comprehensive implementation of wellness protocols, with onsite biometric analysis and real time maternalistic nurturing feedback. If a company cares about its employees, it will invest in wellness. It’s right there in the brochures. There are actual contests to see who has the biggest wellness program. Spending more equals caring more. Right, parents? Oh? That explains a lot.

There is no consistent evidence that wellness programs work.
Sure, lots of companies sell these programs by quoting data of $3 returned for every $1 spent on wellness. But this data compares the worker’s who participate with those who don’t. Motivation is what made the difference, not a specific program. And even the data on those engaged has not yet shown statistically significant healthcare cost reduction.

Motivation drives outcomes. It also skews results.
Science calls that bad research. Salesmen call it marketing.

Physicians are expected to practice “evidence based medicine.”
Wellness programs, well, not so much.

The Rand Corporation research in 2013 reported that “statistical analyses suggests that participation in a wellness program over five years is associated with a trend toward lower healthcare costs… but the change is not statistically significant.”

The health promotion movement didn’t start with Forrest Gump running.
Dr. Kenneth Cooper published his life changing book, Aerobics in 1968.
We’ve known for a while what we need to do. Let’s review it.

Exercise more. Eat less. Drink less. No smoking. Any questions?

Has anyone noticed that obesity is more prevalent now than ever?
Despite four decades of wellness programs.
According to the CDC:
2000:    0 states had an obesity prevalence of 30%
2010:  12 states had an obesity prevalence of 30%
Americans are getting fatter.
Still smoking, drinking, and making bad choices toward a more successful existence.

If only they had primary care physicians. Evidence has proven that PCPs help.

But don’t worry, your neighborhood corporate insurance giant has got a program for it.
A Wellness Program. Just buy it. We can talk about obesity at today’s lunch meeting with our new wellness coach. And they have cookies.

Thomas Jefferson said in 1785:
“Give about two hours everyday to exercise:
for health must not be sacrificed to learning.”

2013 translation: “Just move it. Don’t over-think it.“

Picking up his walking stick and curiously lifting his eyebrows,Thomas Jefferson might be heard adding, “Wellness. Seriously?”

Guy Culpepper, MD