don's report archive

by Donald B. Ardell, Ph. D.

Wellness in the Headlines
(Don's Report to the World)

The first six suggestions were presented in an essay that appeared here on October 16. This article contains the final six suggestions. All twelve ideas were included in a keynote I gave in Des Moines on October 18, 2007 to the Iowa Academy of Family Practitioners.

7. Increase your presence in the lives of patients. Explore a variety of communication technologies that facilitate and encourage prevention, wellness and a better quality of life. Send out a stream of personalized wellness-related material on a regular basis. This will keep patient motivation high and assist all who want to assume more responsibility. A website is highly useful for this purpose, as are electronic newsletters, public lectures (free for patients) and giving interviews/writing columns for community media outlets. 

8.  Keep things light and positive, when possible. Humor, a playful spirit, and an informal environment will render change easier to manage. Go out of your way to address popular misconceptions in attention-getting, creative and memorable ways. Examples include having fun with signature expressions that involve doctor/patient relationships, such as:

• "Get your doctor's approval if you decide NOT to exercise." This is the reverse of the lawyer-like warnings we have all seen that imply exercise is dangerous. The latter message paints exercise as a health risk, and states that a physician's clearance is appropriate before engaging in such hazardous activity. The truth is just the opposite: It is so dangerous to live without a daily exercise regimen that nobody should consider such a perilous course without an estimate, from a qualified doctor, about how long he might last in this perilous condition.
  
  
• "No medicine is good medicine, as a bendable rule." Most people are overmedicated and rely excessively on meds to cope with life. Of course, drugs are great, if properly used, but there is enormous abuse in all developed nations.
  
  
• "Modern medicine is a wonderful thing but there are two problems: People expect too much of it and too little of themselves." This is self-explanatory but unrecognized by most people who place too much responsibility in getting fixed rather than avoiding problems. Better to promote responsible behavior that minimizes the need for much medical attention in order that resources can go to difficulties that are unavoidable. 
  
  An entire industry has come into being to help doctors do this, featuring humor consultants to business and medical institutions, popular books on humor applications in medical settings and conferences and training programs targeted to use by the health professions. Make a habit of conducting frequent celebrations. Create occasions and rituals that honor the successes of patients. Successes are easy to identify, and patients are never shy at self-reporting, if given a little encouragement. Whoop it up for patients who are coping well with difficulties, or who have realized wellness plan goals or overcome difficulties or otherwise made quality of life advances through conscientious efforts. 

# 9. Assist patients to think more clearly. This is a biggie. If I were ranking the dozen suggestions (I'm not), this one would be way up there. Be an advocate for science, reason, empirical evidence and free inquiry. Consider the influence of modern advertising. Your patients are bombarded with ads daily for quick fix solutions for whatever ails them. The message is always the same "Ask your doctor" about one drug after another. Well, when they ask, give them an earful of good counsel instead of a handful of pills. Encourage patients to become a lot more skeptical. 

The sad fact is that large numbers of people believe in really crazy things, from tooth fairies to elves, astrology, UFO abductions, conspiracies, quack remedies and, of course, demented politicians. I'll skip some of the more colorful and blindingly irrational supernatural beliefs, the better to avoid a holy war. Check out the level of insanity for yourself -- go to Snopes.com or any urban legend website. Peruse the variety of mind-boggling stories people believe, and circulate, as gospel truth, which in itself is suspect. Ooops, there I go again.

Offer an incredible personal responsibility service not usually considered a part of the practice of medicine, namely, encourage folks to develop, however late in life, better critical thinking skills. Not what to think, but rather how to think. A good starting point might be to distribute copies of Carl Sagan's Baloney Detection Kit to all patients. http://www.noah.org/science/reason.html

# 10. Reach out to healthy people. Just because someone is not at your door complaining of one misery or another does not mean she is a well-camper. Au contraire - "normal" is a sorry state of physical and psychological mediocrity. Create a welcome mat and varied opportunities for those in your community who recognize that while they are not sick, they are a long way from being hale and hearty. Most people do realize that their lifestyle is nowhere near as developed as it could be with more care, attention and guidance. Many who think they have no reason to see a doctor for symptoms or check ups nevertheless know that reducing risks of illness is not the same as enhancing prospects for well being. You could be functioning nicely at both ends of the illness/wellness continuum by promoting the embrace of personal responsibility.

Thirty years ago I wrote a couple articles in Prevention Magazine about a family doctor who created a practice exclusively for healthy people! That's right. He opened a center in Mill Valley, California that catered to healthy people who wanted to get healthier. He refused to see sick people, referring them to other doctors.

You surely won't want to go that far, I suspect, but you might want to consider some of the assessments, principles, modalities and tools that are applicable and attractive to seemingly healthy as well as truly ill patients. Unlike the good doctor in California three decades ago, you need not think in either/or terms. Both sick and well people need your guidance.

# 11.  Think big. Promote good health for patients as noble and logical. Recall the immortal words of the Hippocrates of urban planning. I have forgotten most of what I learned in the early sixties at UNC in Chapel Hill studying for a master's degree in city planning. However, I well remember what the patron saint of planning, Daniel Burnham, recommended: "Make no little plans; they have no magic to stir men's blood and probably will themselves not be realized. Make big plans; aim high in hope and work, remembering that a noble, logical diagram once recorded will not die."

Don't write anyone off. You never know who will turn out to be a success story as an enthusiast for healthy living. Many who have high-risk habits (for example, habituated to being sedentary) are surprisingly aware and supportive of the wisdom of pursuing higher quality of life behavior patterns, but have not yet found the necessary support or otherwise resolved to initiate changes. In my experience, many people whom you would not mistake for positive lifestyle enthusiasts are quite supportive of others who seek healthy changes. This was true of several of my own mentors over the years. From a cursory look, they did not seem likely enthusiasts for wellness but they were, in their own fashion. Bottom line - encourage everyone you encounter to consider adopting more responsibility for changes toward healthier choices. You might find more receptivity than you expect.

While thinking big, go all the way, at least in your own mind. Attempt bold, big plan changes ala Daniel Burnham. Personally, I'm going for the Nobel Prize for these dozen suggestions. You've heard people say, "If we can go to the moon, we ought to be able to ... (fill in the blanks). Well, my attitude is "If Al Gore can win the Nobel Prize, why not me?" Make no little plans.

# 12. Last weekend in New York City at Radio City Music Hall, another recent Nobel Peace Prize winner, the Dalai Lama, called for a path to enlightenment that entails such wellness-friendly tendencies as giving more and seeking less, peace, cultivating tolerance and compassion for all living things (even veracious humans) and striving to free the heart from hatred, the mind from worries and society from suffering. That sounds like a wellness message to me. Maybe you can work some of these notions into your expanding medical practice. 

Well, that's it - A dozen suggestions for Iowa doctors who wish to make personal responsibility more appealing to patients. I hope it works out. Be well - look on the bright side of life.

(Note: This essay will be filed in the archives in the PHYSICAL DOMAIN under the skill area of adaptations and challenges. Additional articles related to this theme may be found there.)

(Ed. Note: Views expressed in this and other columns are those of the author and not necessarily those of the SeekWellness Editorial Board.)

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