Wellness is the hottest buzzword in chiropractic these days. Everyone seems to be talking about it and committed to the principles behind it. At least the chiropractors are talking and committed. I'm not too sure about the chiropractic patients. Wellness care sounds like a good idea. Unfortunately, I just don't think it is going to work as well as we think.
I realize I will catch a great deal of flack for this opinion. It isn't that I don't want wellness care to work. I just don't think we can overcome all of the obstacles to the idea. I offer the following as the reasons for my opinion.
* A Consumer Union study of gyms and health clubs several years ago revealed that of every 100 people who joined these facilities, 75 never returned after the third week. Only five are still attending by the end of the year. Everyone knows exercise is good for them, but few follow through.
* An ad for a certain exercise machine claims the machine provides a complete workout in only four minutes. Obviously, the machine addresses the common claim by many that they lack the time to exercise. The ad also states that 92 percent of people who own exercise equipment and 88 percent of people who own gym memberships don't exercise. I cannot help but wonder what percentage of people who own this machine exercise, since you only have to use it for four minutes. I also wonder how many people own this machine, as it costs more than $14,000.
* A study conducted by Michigan State University and published in Archives of Internal Medicine, April 2005, looked at "healthy Americans." The criteria for "healthy" was someone who does not smoke, eats right (five or more fruits and vegetables per day), maintains normal body weight and exercises (30 minutes most days). In the end, only 3 percent of Americans qualified as healthy.
* Study after study shows Americans are overweight or obese. In 2000, data from the National Center for Health Statistics showed 63 percent of Americans to be overweight and 31 percent to be obese. The October 2002 issue of the Journal of the America Medical Association also showed the percentage of obese Americans to be 31 percent.
* A study at Boston's Massachusetts General Hospital, published in Radiology in August 2006, related that the quality of X-rays and other diagnostic imaging studies in America has decreased due to patient size. This is significant, considering the advances in imaging technologies in recent years. Technology is not able to adequately compensate for patient body fat.
* A friend of mine was seeing more than 1,300 maintenance patient visits per month when he retired from practice, which is remarkable. But all success is relative. He had more than 14,000 new patients during his career. The 1,300 wellness patients represent only 9 percent of the total number of patients he treated in his career.
* Chiropractors have been trying to get insurance carriers to pay for maintenance care for decades. The wellness movement will push this agenda even harder. The odds of the carriers paying for wellness/ maintenance care are slim. Why? Consider the study of "healthy Americans" mentioned above. The study looked at diet, smoking, weight and exercise. It did not look at subluxations. Subluxations and chiropractic care aren't even on everyone's radar. Only chiropractors and a small percentage of chiropractic patients think chiropractic care is necessary for optimum health. As I said above, everyone knows exercise is good for you, but how many people know that adjustments are good for you? And even if they figure it out, as with exercise, how many are going to follow through?
* A lack of insurance coverage, whether it is for acute, chronic or maintenance care, is a major deterrent to patients following through with care. Does wellness have a wallet?
* The vendors selling wellness to the chiropractic profession know their customers. They are selling to people who by virtue of being associated with the chiropractic profession already understand the wellness concept. The vendors are the wholesellers. Their customers (the chiropractors) are, in turn, attempting to resell the concept and materials to a completely different customer, the patients. Patients don't think like chiropractors. Remember the numbers above: 5 percent exercise, 3 percent considered healthy and 9 percent on maintenance? The wholesellers selling to the chiropractors leave the chiropractors with the impression that the patient will love their wares just as much as the chiropractors do, and that the wares will sell themselves. Not true. What motivates chiropractors and what motivates the American public are not the same in the majority of cases.
* The difference in what motivates chiropractic patients and what motivates the American public is a big pitfall for chiropractic students. Students spend their time surrounded by fellow "believers"professors, other students, administrators, vendors, guest speakers and seminar speakers. Almost everyone they encounter loves chiropractic and wellness. Graduation and the pursuit of private practice suddenly cast the new doctor into the sea of "unbelievers." It can be a rude awakening.
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