Sunday, October 9, 2011

Health and Wellness Programs: Medicine or Marketing?

Shark Cartilage: Cancer Cure?

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
  • Naturopathic Wellness
  • 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.


  1. Yet people still wonder why medical education is so ridiculously expensive (and gets more expensive every year). The previous generation didn't have tuition nearly as high as current ones; despite the fact that they had more direct overhead costs. 30 years ago it was common 4 people shared a cadaver, now it is 8 on a rotating basis. Gone are any sort of hands on biochemical labs (aside from some basic blood draws), everything is done "virtually" at most institutions.

    Yet costs keep going up and programs like the above (adding "wellness" to the curriculum) are partially to blame. My medical school now has more administrative (ie non-lecturing/teaching staff) than it has matriculating students. With such a large mission creep, no wonder education is now so expensive.

    So not quite the same as your argument over patient confusion, but mission creep like this does nothing to address the growing costs of medical care or education.

  2. Hi Michael, You're right about the marketing, and hospitals offering "what people want."

    But I do think traditional docs have failed, to a large extent, in providing guidance for people who aren't critically ill, i.e. in wellness "care." And that would-be branch of medicine isn't necessarily the same as alternative medicine.

  3. The emphasis on wellness vs. sickness?

    I have a cervical discopathy which is causing an annoying amount of discomfort. I go to my physical therapist who manipulates it, an internist who medicates it, and (occasionally) a massage therapist who soothes it. It helps me feel much better.

    My physical therapist has given me a long list of exercises. I would be brutally honest about my compliance with them, but I don't trust my health insurer enough not to use the information against me. My internist has advised weight-loss and other wellness issues. I'm lazy, so I won't mention how well I'm doing with those, either.

    The fact that I'm not getting better very quickly is not the fault of my physical therapist or my internist.

    I'm might go ahead and sue them anyway.

  4. @Elaine, I think the distinction between alternative medicine & 'wellness' is rather murky. @ litigious anonymous commenter, of course you should sue! As you suggest, your doctor's innocence is not relevant. Thanks for comments.

  5. Excellent post Dr. Kirsch. I was just asked today to LIKE a Health and Wellness clinic on Facebook.

    Interesting how the branding is so pervasive.

    I railed about psychiatry on my blog with, "Is Psychiatry Just Amway For Pharmaceutical Companies?" - Metro Hospital is replacing retiring psychiatrists with nurses to keep pumping out the prescriptions. Crazy.

    Love your blog. This will go out on Facebook, Twitter and Google+ ...

    See you at the Double-D

  6. Thanks, Roger. Hope you are wallowing in wellness!

  7. Good article. I will note the absence, however, of the fact that many of the studies for traditional meds are NOT done by disinterested 3rd parties. Pharmaceuticals can choose only the 'good' studies to submit to FDA, and if 80% of the studies show only placebo effect, so what?