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Fewer Medical Test Procedures and More Wellness Promotion To Save Money and Boast Societal Wellbeing

April 10, 2012 | Comments: 0 | Views: 189

A recent medical foundation identified 45 common medical tests or procedures judged by a dozen medical groups to be unnecessary or overutilized. Now a campaign has been launched by the Foundation of the American Board of Internal Medicine to persuade doctors and patients to be more circumspect about recommending/undergoing test procedures.

I, too, recommend such precautions - and I believe such advice should be on offer from every health educator, fitness coach and other health professional. I'd like to go further than the Foundation, however, by recommending a positive remedy that not only solves a problem but does affirmative good.

My advice is to do more than avoid unnecessary medical tests; I propose wellness assessment by all doctors and other caregivers. After all, why stop with ceasing to do harm? The time is ripe to promote health, as well as prevent waste.

I have a few starter tips for medical practitioners concerning a wellness assessment. There are ways doctors can encourage patients to self-assess if they are well in positive ways, and to consider whether they would be willing to put in time and do the work in order to become healthier in the future.

Before mentioning a few such ways, let me be quite clear about something concerning medical testing. Most, perhaps all 45 overused testing procedures identified by the medical study group can be useful, if employed wisely under optimal circumstances. System reforms that promote provider scrutiny can prevent overuse-but selective testing can be beneficial. Furthermore, informed consumers skeptical of tests can save themselves and society money and grief by being vigilant about medical testing. However, the big gains will come from wellness assessments that necessarily raise consciousness about health beyond the margins on non-sickness, not just reducing unproductive medical tests.

Wellness assessments by doctors can serve three purposes:

  1. Raise positive health consciousness.
  2. Assess patient interest in and capability to do more for their own health.
  3. Spark wellness initiatives that can lead to better health and higher quality of life.

Good news: some of this is underway, in a limited sense. A recent Wall Street Journal article described wellness enhancement initiatives in U.S. corporations that are being conducted under the guise of fun gaming. (See Anna Wilde Mathews article "Playing for Wellness" in Family Finances, Wall Street Journal, April 7, 2012.)

The stated goal of such company programs is to encourage employees to take better care of themselves. This is a clear shift from medical testing to wellness promotion. It should be welcomed. Using digital gaming tactics, enjoyable consciousness-raising efforts are introduced in the form of online team competitions. Departments compete for virtual and real-world rewards by doing things that improve their health. Wow-compare that with CAT scans and colonoscopies!

Why the change in emphasis? Because "insurers are under pressure to show they can bring down costs by improving consumers' day-to-day health." Evidently, some employers are realizing that health improvements will not come from more medical testing. Such offerings are also being developed to appeal to persons who self-insure.

Participants are assessed in terms of how well they are at the start (the procedures are called "Vitality Age" at Humana, "Get Active" at Aetna, "OptumizeMe" at UnitedHealth Group and "DailyFeats" at Cigna) of quality of life programs. Employees then engage in virtual positive initiatives, including exercise and healthy eating and so on. Health coaches are enlisted by department teams. Earn enough points and you not only look and feel better-you will also score cool electronics, sports equipment and/or a prize in a monthly drawing. Of course, you have to play along (i.e., participate in and progress toward a healthier lifestyle) to be eligible for these extrinsic payoffs.) Again, while none of this is ideal, it beats the usual reliance on (often redundant) medical testing.

I realize that most medical practices do not have the time or resources to investigate and adapt sophisticated corporate social programs such as pioneered by the above-noted leading companies. The wellness gaming initiatives highlighted in the referenced Wall Street Journal article would not be suitable in any event, given that all require social support. Medical groups looking for health-enhancement substitutes for discredited medical tests found inappropriate or overused have other options for individuals they treat. The simplest and least expensive would be to offer a fifteen-minute REAL wellness mini-assessment. This positive "test" of sorts simply raises health consciousness. It is designed to assess patient interests in exploring a healthier lifestyle and his/her capability to do so. If the doctor or other medical professional thought there was any chance of success, the patient could be guided to identify alternative paths to better health and a higher quality of life.

At this point, the patient can be referred to a wellness coach or other resource facilitator for getting started with a little help from friends-and for other supports available.

As noted throughout, compared with the unnecessary tests, such a brief wellness overview assessment would be more cost effective and might lead to improved states of well being. That's the idea, in any case.

Be well and make a best effort to look on the bright side of life.

Publisher of the ARDELL WELLNESS REPORT (AWR) - a weekly electronic newsletter devoted to commentaries on current issues that affect personal and social well being from a quality of life perspective. The emphasis is on REAL wellness, which is also the topic of Don's latest book. Read about it here - - The "REAL" acronym reflects key issues embraced and advanced in Don's philosophy, namely, Reason, Exuberance, Athleticism and Liberty. Sample copy of Don's latest edition by request. If you like it, you can sign up - the price is right - free. Contact Don at

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