The “Wellness” Paradigm:Where do we fit into America’s Perception of Vitality?

Dr. Ronald J. Farabaugh

A special thanks to Dr. Greg Palkowski who designed this lecture

What is WellnessWhat is the definition of Wellness? More than

ever before, we hear this word in the news, on billboards, in conversation and even at work. Interestingly, there is no universally-accepted definition of wellness. There is, however, a set of common characteristics seen in most thoughtful attempts at a definition of wellness. We generally see a reference to a “state of well-being,” which is vague, to say the least. Also frequently seen is a “state of acceptance or satisfaction with our present condition.”

What is WellnessThe truth is Wellness is a tough word to define.

That said, according to Charles B. Corbin of Arizona State University his definition of Wellness: “Wellness is a multidimensional state of being describing the existence of positive health in an individual as exemplified by quality of life and a sense of well-being.”

The WHO definition of Health: A state of optimal physical, mental, and social well-being, and not merely the absence of disease or infirmity.

Dimensions of WellnessWellness is an active process of becoming aware

of and making choices toward a more successful existence.

Process means that improvement is always possible .

Aware means that we are continuously seeking more information about how we can improve.

Choices means that we consider a variety of options and select those in our best interest.

Success is determined by each individual to be their collection of life accomplishments.

Wellness Dimensions:The Wellness Wheel: If wellness is multidimensional, what

then are the dimensions of wellness? The most commonly described sub-dimensions are the following:

Social Wellness Occupational Wellness Spiritual Wellness Physical Wellness Intellectual Wellness Emotional Wellness Environmental Wellness Financial Wellness Mental Wellness Medical Wellness

Social Wellness emphasizes the interdependence with others and nature.

Social Wellness Facts and Tips

Socially isolated people are more susceptible to illness and have a death rate two to three times higher than those who are not socially isolated.

People who maintain their social network and support systems do better under stress.

Approximately 20 percent of Americans feel lonely and isolated during their free time.

Touching, stroking, and hugging can improve health. Laughter really is good medicine. Cholesterol levels go up when human companionship is lacking. Warm, close friendships cause higher levels of immunoglobulin A

(an antibody that helps keep away respiratory infections and cavities).

A strong social network can create a good mood and enhance self-esteem.

Occupational Wellness

Occupational WellnessOn your Occupational Wellness journey you'll begin to value

the importance of not only your own personal gratification, but your contribution to the well-being of the community at large. The choice of profession, job satisfaction, career ambitions, and personal performance are all important components of your path's terrain. As you travel the wellness path, you'll begin to believe that - occupationally.

It's better to choose a career which is consistent with our personal values interests and beliefs than to select one that is unrewarding to us.

It's better to develop functional, transferable skills through structured involvement opportunities than to remain inactive and uninvolved.

Spiritual WellnessThe spiritual dimension of wellness involves seeking meaning and purpose in human existence. It includes the development of a deep appreciation for the depth and expanse of life and natural forces that exist in the universe.

Spiritual WellnessAs you begin to develop the spiritual wellness

dimension of your life, taking the Wellness path, spiritually, you'll start asking the question, who am I and what is meaningful in my life. You'll observe the scenery along the path, the world around you with appreciation and wonderment. You'll ask many questions about the scenery, the world, as well as your everyday experiences, and learn to value that which cannot be completely understood. Growing spiritually, you'll try to find peaceful harmony between internal personal feelings and emotions and the rough and rugged stretches of your path.

The physical dimension of wellness encourages cardiovascular flexibility and strength and also encourages regular, physical activity.

Physical development encourages knowledge about food and nutrition and discourages the use of tobacco, drugs and excessive alcohol consumption.

Physical WellnessBy traveling the wellness path, physically, you'll be

able to monitor your own vital signs and understand your body's warning signs. You'll understand and appreciate the relationship between sound nutrition and how your body performs. The physical dimension of wellness provides almost immediate beneficial results-both physical and psychological. The physical benefits of looking good and feeling terrific most often lead to the psychological benefits of enhanced self-esteem, self control determination and a sense of direction.

The emotional dimension of wellness emphasizes an awareness and acceptance of one's feelings. Emotional wellness includes the degree to which one feels positive and enthusiastic about oneself and life.Emotional Wellness allows you to be aware of and accept a wide range of feelings in yourself and others.

Emotional WellnessYou'll be able to express feelings freely and

manage feelings effectively. You'll be able to arrive at personal choices and decisions based upon the synthesis of feelings, thoughts, philosophies, and behavior.

On the wellness path, you'll live and work independently while realizing the importance of seeking and appreciating the support and assistance of others.

Financial wellness is an intricate balance of the mental, spiritual and physical aspects of money.

Financial wellness is having an understanding of your financial situation and taking care of it in such a way that you are prepared for financial changes.

When searching the literature on mental health, it is difficult to find a straightforward definition of mental wellness. Instead, we define it by its absence.

So are we all a little bit crazy?

Mental WellnessMental wellness can be influenced by:

Biological factors - changes in the central nervous system, medications, illnesses and family history

Social environment - losses, traumatic events, stress and low economic status

Mental wellness is promoted through: Physical activity Good nutrition Adequate rest and sleep Stress reduction An optimistic attitude that can include humor, creativity and faith Optimal medication management Emotionally enriched environments For people to savor their later years, maintaining mental wellness is an

essential charge, both for themselves and for those who work with them.

Medical Wellness, as defined by the Medical Wellness Association, is the practice of health and medical care relating to wellness outcomes. Medical wellness is an approach for delivering health care that considers the multiple influences on a person's health.

“Medical” WellnessProvides a balanced, appropriate application of Wellness practices within the clinical setting that are based on evidence-based practices.

Promotes a cross-disciplinary approach to patient care, based on informed consent and decision support between the practitioner and patient.

Establishes a foundation for dialogue and collaboration between conventional and complementary practices with the primary goal of promoting optimal health and well-being.

Promotes the development and application of professional standards for wellness practices across clinical practices

Chiropractic Philosophy and practices encourage a drug-free approach attractive to many Americans who seek an alternative health care approach

But, is the rest of our society ready to put our philosophies on the wellness bandwagon?

Chiropractic WellnessIf you Google “Chiropractic Wellness”, you

are directed toward an assortment of individual practice websites and yellow page listings that all have listed wellness somewhere within their text.

Further investigation of these sites highlight neuromusculoskeletal treatments, nutritional supplementation , acupuncture, etc., and a personalization of the clinicians’ opinion on wellness based upon his/her practice philosophy.

Chiropractic WellnessPaul Zane Pilzer wrote the book “The Wellness

Revolution” and “The Next Trillion” over a decade ago, and chiropractors were then enthusiastic about the opportunity to become the Wellness leaders in their communities. Wellness is the first word to become a trillion dollar industry without ever being defined and without a trusted brand associated with it.

We as a profession are facing numerous challenges to find our place in the Wellness Movement and DCs struggle every day to stand out from the evolving Wellness crowd.

Chiropractic Wellness Inconsistencies There exists significant variation between

Subluxation-based practices, nutritional-based practices and Neuromusculoskeletal practices and their approach to patient education and the concept of wellness. This has resulted in no clear branding of Chiropractic Wellness at this time. Given that there exists an evolving body of research and clinical chiropractic based evidence, particularly directed through the efforts of James Chestnut, DC, and in cooperation of the ICA, when do we embrace any accepted concept as Chiropractic Wellness?

Chiropractic Wellness Inconsistencies (cont.)Presently, most Wellness marketing comes

from individual Chiropractic practitioners with limited budgets vs. multimillion dollar campaigns created by and directed toward large corporate entities. While individual DCs may be distressed from these inconsistencies and this public confusion, medical buildings and hospitals are popping up around the country with the word “wellness” on their signage.

Chiropractic Wellness Inconsistencies (cont.)In Ohio, the OSCA tried to market our own statewide,

Wellness based public education and marketing campaign from 2008-2009, at ultimately it sucked our financial reserves dry. To my knowledge, presently there is no prominent national, state wide, or local Wellness campaign, that is diverse enough to fulfill the wide variety of chiropractic perspectives within our profession at this time. I personally wonder if the public is ready to accept the chiropractic viewpoint of Wellness, given the fact that less than 10% of the Americans even are under chiropractic care during any one time.

Chiropractic Wellness Inconsistencies (cont.)There is now a growing concern that the

chiropractic profession is being ambushed by Wellness and that within five years this word will be owned by the pharmaceutical industry in the mind of the consumer and that it will become synonymous with the word medical. How can Wellness be owned by the pharmaceuticals, and be in direct opposition to the chiropractic paradigm in which wellness is directed toward drug-free?

Chiropractic Wellness Inconsistencies (cont.)Finally, from the financial point of view, we must

beware of the non-existent reimbursement by major players in the health care insurance industry who will not recognize the chiropractic concept of Wellness, as opposed to programs created and funded by the AMA and the large pharmaceutical industry. Historically, the insurance industry has evolved from being an industry which used to pay for the subscribers’ healthcare to one that know purchases the healthcare for that consumer. Therefore if you practice Wellness, you must become a strong cash-based practice.

Our Challenge:If you truly desire to go in the direction of a

wellness practice with your services and products , you must market your practice and educate the individual patient and public in general, in order to make yourself stand out in the crowd, because there is no lead voice within chiropractic who is leading the wellness campaign.

So I ask you,….can you walk the walk and talk the talk, and can you afford it? It seems like another David vs. Goliath scenario to me.

Copyright © 2012 Dr. Ronald J. Farabaugh