Sunday, March 29, 2009

Your Daily Rant: "Wellness Model"

There's something in the language typical of healthcare debates that makes a lot of people zone out. I sense a pervasive attitude of, "wake me when they get to the part about keeping insurance affordable."

Confusion comes in two flavors: the kind that prompts you to ask a question and the kind that makes you feel so lost and stupid you don't dare say anything --i.e. "please clarify" verses "totally over my head."

Healthcare issues provoke a lot of the latter. Some topics are quite technical --e.g., stem cells, anti-retrovirals, cancer risks. If you don't have a basic familiarity with the science, it's probably best for all concerned if you STFU.

However much of the confusion lately can be chalked up to vague or meaningless verbiage. Speakers often go on for paragraphs saying nothing at all to an audience apparently listening respectfully. Truly amazing to behold.

Case in point:

There are many physicians working at the front lines of health care delivery that embrace both the wellness model and clinical outcome based science. In many cases they have chosen their specialties because they consider understanding medical science an essential part of their professionalism and hold ethical decision-making a higher priority than financial profit. Seems obvious, but it may inform arguments that consider the middle ground in this debate negligible. Certainly, generalization, sensationalism and vilification of physicians is less likely to lead to the improved health status all parties seem to want to argue for.

Reading the above you might think to ask, what does the speaker mean by "wellness model"? But estimating the odds that the answer will bore you to tears while leaving you none the wiser, you probably won't bother.

Here's my model: we figure out the risks and benefits of some intervention, then base our recommendations on that.

I call it the "what is true" model. It kicks the wellness model's ass then steals its lunch money.

7 comments:

  1. I call it the "what is true" model. It kicks the wellness model's ass then steals its lunch money.

    LOL!

    But what did I say elsewhere? Something along the lines of the "what is true" model of reality is but one option of many.

    Some people are just so closed-minded that they can't accept something like a "wellness model" of reality. Why is it that what is real for you has to be real for me too? We are all different, so our realities are different. ...... Sorry, I can't go on.

    Sometimes I wish it was the case that reality-based reality could actually kick the ass of made-up-based reality. The logic thing just doesn't seem to work.

    I suppose it does come down to a physical reality when the CAM treatment doesn't do what it is supposed to and the illness worsens.

    Keep fighting the good fight.

    ReplyDelete
  2. Reading the above you might think to ask, what does the speaker mean by "wellness model"? But estimating the odds that the answer will bore you to tears while leaving you none the wiser, you probably won't bother.

    Plus you might supply the answer yourself and wonder watsup with the bifurcation? Can’t we all just get along??

    For non-physicians like me it just brings to my mind ‘well woman’ preventative stuff. Not fun,(by any stretch of the beeping imagination) but it is all about screening to stop you going from ‘well’ to ‘sick’. Who is going to go against that?

    ReplyDelete
  3. ...it is all about screening to stop you going from ‘well’ to ‘sick’. Who is going to go against that?

    That's what wellness means to me also --Pap tests, vaccinations, dental cleaning, etc. Pretty boring stuff, right? Not so much teh controversial.

    So this speaker must be talking about something else. Note that he contrasts "wellness" with "clinical outcome based science." Then he contrasts "ethical decision-making" with "profit."

    Had I not heard these buzz words before I'd have no idea what he was on about.

    "Wellness" and "prevention" are euphemisms for chiropractic and naturopathy. The vitaministas can't speak plainly because most Americans don't want quacks for primary care doctors.

    Here's a talk Senator Harkin gave to the Northwestern Health Sciences University, a chiropractic college. Note the conflation of "prevention and wellness" with "alternative medicine."

    ReplyDelete
  4. Tricky and tricksey things are words.

    I had a look at the University - page very interesting.

    Concentrated on the massage page - as I learned some absolute basics many moons ago. I'm not an expert by any means, it's just something I do for family and friends when they are feeling glum or in pain from sitting funny etc.

    Massage can be a good thing, so was I was prepared to look at their course and see useful stuff.

    Indeed, there was some useful stuff - first aid, anatomy etc. However, I didn't see words that I was expecting like say "effleurage", but instead 'trigger point therapy'.

    I saw some confusing and contradictory stuff looking that one up. They seem to think it works though.

    ReplyDelete
  5. Massage is awesome.

    What is not awesome: claiming all disease is due to mysterious "subluxations" no one can reliably demonstrate to exist.

    What is not awesome: claiming massage can treat asthma, diabetes, etc.

    What is not awesome: claiming vaccines "weaken the immune system," and denying the germ theory of disease.

    This is why MDs and chiropractors can't talk to each other.

    ReplyDelete
  6. What is not awesome: claiming massage can treat asthma, diabetes, etc.

    Yes, it's very interesting how there are no modules on helping with specific complaints (the only one mentioned is myofascial pain).

    No section on sports injuries say, or even (if you want to get holistic) one on being part of palliative care team. Nope, just mention of rehabilitation and lots of use of the term therapeutic which can mean absolutely anything.

    It's very swish and looks impressive, but what isn't said is as interesting as what is.

    Keep up the good work Dr. B!

    Proper doctors needed on this. I can tell when something smells, but don't have the expertise to pin point whether the smell is coming from the bin or the toilet.

    ReplyDelete
  7. Awesome post! Now I need a massage!

    ReplyDelete