Closing my clinical practice last month has led me to reflect on the scope and changes I have seen in medicine and healthcare over the last 4+ decades and to think about what it means to be in good health. COVID and the post-pandemic transformation effecting communities and society has resulted in unprecedented challenges to healthcare delivery causing healthcare providers, public health officials and government agencies to re-think population health.
Clinical medicine focuses on healing patients through diagnosis, treatment and intervention with an immediate need to minimize symptoms. Certain signs and symptoms present themselves and the clinician performs certain investigations and interventions toward healing to cure the patient and prevent disease. However one of the lessons of COVID is that a more integrated model of healthcare is needed when faced with a long-term public health crisis. One that requires an understanding and a level of participation by individuals and communities to increase their knowledge about the basic fundamentals of disease and a realization that health and well-being are not only the responsibility of clinicians and healthcare providers but in one's own hands as well. Accepting that requires we as a medical community reevaluate what it means to be “well' and in doing so educate and empower our patients to fulfill all the dimensions of wellness.
Optimizing wellness involves making our bodies function better and more efficiently. One model for achieving this was developed in 1976 by Dr William Hettler, co-founder of the National Wellness Institute. Hettler and his associates proposed seven key elements or "dimensions" of wellness that contribute to overall health and well-being with the idea that we, as humans, could live better, healthier lives through the principles of balance and awareness. The Institute now includes multicultural concepts of well-being to develop and broaden an understanding of what wellness means for different communities and populations and other researchers are proposing an eight dimension that addresses financial health.
Vulnerability to public health emergencies depends on a variety of factors however a better understanding of how the human body works with more comprehensive patient education about overall health can go a long way toward universal wellness and well -being.