Is wellness simply a hospital marketing term?

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.

Michael Kirsch is a gastroenterologist who blogs at MD Whistleblower.

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  • http://www.facebook.com/people/Frank-Lehman/100002241640186 Frank Lehman

    I do wonder where Michael Kirsch, MD has been for the past 20 years or so in which I have heard the “new term” wellness throughout the medical community.  Wellness may be new to him, but it certainly is not to the rest of us.

  • http://www.facebook.com/knasky Kevin Nasky

    Well said. I’ve always said that there’s really no such thing as alternative medicine. There are simply treatments with supporting evidence, and those without. (I concur that much of this evidence is weak, but the clinical literature evolves, and our clinical guidelines eventually follow suit.) I have no bias towards pharmacological or surgical treatment options. If something “natural” or non-invasive shows efficacy and safety in well-designed studies, I’m all for it. My only bias, as a physician, is towards safety and efficacy.

  • Anonymous

    Wellness = taking responsibility for your own health.

    Despite what people think, doctors are cannot make you “well” if the patient continuously makes poor health decisions. Over 80% of my patients are overweight/obese, and many have a few other bad habits. It’s only a matter of time before these bad decisions result in a major health event. That’s just common sense. Our society is seriously lacking in common sense, or maybe we just don’t care. But, I agree that it is wrong to exploit people with bad intentions. I always shoot my patients straight, no matter the consequence.

    • Kathryn Watson

      So very true!  It is all about responsibility. It doctors would start writing perscriptions for exercise, stress management and healthy eating  and refuse to give people pills until they started participating in their health care you would see a lot less illness in this country.

  • http://www.facebook.com/timrichpt Charles Timothy Richardson

    I agree with Michael Kirsch, MD but not for the reasons he thinks I should: We are risking a wellness overdose – but we need MORE wellness, not less.

    I won’t cite peer reviewed RCTs or consensus guidelines to support the argument in favor of Wellness (although there are reams of data showing typical Wellness activities, like diet, exercise, smoking cessation and alcohol moderation achieve far broader and more enduring health outcomes than comparable investments in conventional medicine).

    Instead, I will point to the money.

    Employers and governments are tired of paying for conventional medicine, provided by America’s hospitals and cottage industry of physicians’ outpatient clinics. So, they are building their own health care systems.

    The prevalence of integrated corporate employee health care is only about 4% of all employer-sponsored health benefits in America because the scale required to build these systems is huge. The list of companies that have built these systems reads like the Fortune 500:

    Perdue Farms (Maryland) – revenues $2 billion.
    Toyota Motor Corporation (Texas) – revenues $231 billion
    Performance Food Group (Virginia) – revenues $6.3 billion
    Pitney Bowes (Connecticut) revenues – $5.4 billion
    …the list goes on.

    The single defining criteria these systems share is a primary focus on Wellness – employees who don’t participate, by smoking, not exercising, not sticking to their diet or whatever, get to pay more in their monthly health insurance premium. It’s that simple.

    The standard metric is a 3:1 ROI to the employer for every dollar invested in Wellness. 

    Employees who DO participate earn credits (usually a dollar-for-dollar match from $100 to $800 per year) towards their employee portion of their insurance premium.

    The point is that the ones who CAN CHOSE (large employers) are OPTING-OUT of medicine, in favor of Wellness. 

    Tim Richardson, PT
    http://www.PhysicalTherapyDiagnosis.com

  • Kathryn Watson

    Interesting that you feel that complimentary medicine exploits people when many believe that is what western medicine does. People are tired of taking pill after pill  and paying hundreds or thousands to try this or that new drug only to find out later that it may have caused an even worse condition than they were treating. The example is some of the drugs used to treat auto immune diseases. They do not cure the disease and may cause kidney diease and liver disease, far worse that what they were treating. Western medicine often does not cure disease either especially for those with chronic illness. It only manages the condition often with devastating side effects.

    There is a place for both western medicine and what you call complimentary medicine. Western medicine is great for acute conditions such as a heart attack, stroke or an automobile accident. For auto immmune diseases,type 2 diabetes, IBS and other such ailments I believe alternatives may hold more hope for the individual.

  • http://twitter.com/latronepic LaTron Brown

    Wellness is not simply a hospital marketing term. Wellness, in the since of medicine, is being free from disease. However wellness, in the alternative medicine sense, means an overall positive well-being that encompasses your mind, body, and spirit. We can agree that the latter really has no place in medicine.  I believe that the use of the term in both hospital and alternative medicine strives for this end result with their respective definitions. However, in mainstream patient thought, wellness includes all three. Any marketing that is done needs to appeal to patients’ perception of wellness.

    Also, I want to note too how quickly Michael Kirsch, MD, attempts to belittle alternative treatments as a rip-off to patients. While there are some alternative treatments that positively affect one’s wellbeing, there are those that do nothing. However, the exact statement can be utilized for medication. Both types of medications(traditional and alternative) can have negative results as well. The author even admits that he and his colleagues prescribe medications based on “scant medical evidence.” So it is irrational to demean alternative medications that at times help patients better than the mainstream. Because patients are turning toward alternative therapies show a disengagement between the patient and the medical community. Traditional medicine can not be all things to everyone; it is obvious as patients are turning elsewhere.

  • Anonymous

    Wellness is a scam.  I am trained to prevent, diagnose and treat disease. A limited remit, but enough.  I am not trained in or even particularly interested in whether other human beings are happy, free from cares, empowered, enthusiastic, politically or sexually satisfied.  I am happy when people do not have a fever.  I am happy when people do not have the inability to move half of their bodies.  I am happy when children do not die before their parents die. Wellness, happiness, a feeling of being loved and having a purpose in life–all these are very important indeed.  Look for your solution to these problems outside the my office. I truly wish you well in your search.

  • http://twitter.com/LHPatientAdvo Loving Heart Pat Adv

    It troubles me how the word wellness can be made into the “enemy”. I don’t think this is a marketing gimmick any more that giving our money to conventional physicians. Wellness, relating to health is the presence of “ease” as opposed to “dis-ease”. The medical system is built around disease. Doctors and trained to treat a disease. The disease is the elephant in the room, often leaving the patient on the fringes. In the article Dr. Michael Kirsch refers to “complimentary medicine” (which should be “complementary medicine”, as in completing each other) as though it is new. How about Traditional Chinese Medicine (TCM)? In fact, in many cultures the ancient traditions are what he may refer to as complementary. Wellness is not just “fluffy”. There is plenty of research out there that supports the mind-body connection. 

  • http://twitter.com/LHPatientAdvo Loving Heart Pat Adv

    It troubles me how the word wellness can be made into the “enemy”. I don’t think this is a marketing gimmick any more that giving our money to conventional physicians. Wellness, relating to health is the presence of “ease” as opposed to “dis-ease”. The medical system is built around disease. Doctors and trained to treat a disease. The disease is the elephant in the room, often leaving the patient on the fringes. In the article Dr. Michael Kirsch refers to “complimentary medicine” (which should be “complementary medicine”, as in completing each other) as though it is new. How about Traditional Chinese Medicine (TCM)? In fact, in many cultures the ancient traditions are what he may refer to as complementary. Wellness is not just “fluffy”. There is plenty of research out there that supports the mind-body connection. 

  • http://twitter.com/sarasteinmd Sara Stein MD

    I treat obesity and was told firmly by everyone asked NOT to use the word obesity in my clinic title, it was offensive. So I used “wellness”, and wondered. Until one day when I was with a patient and her phone rang. She answered, “I can’t talk now, I’m at the Wellness Center”. And I knew everyone was right. It signifies a pursuit of health, rather than an enslavement to illness. Wellness it is, from now on.