I had to smile when I read a recent headline that the Washington Post was creating a Wellness section. When we published our first issue of the Wellness Letter 38 years ago, many people considered “wellness” to be a fringe concept promulgated by Northern California “kooks” sitting around in hot tubs and indulging in peacock-feather massages. But in fact, wellness as a legitimate scientific construct for living a better, healthier life was already taking off.
When I started my medical practice in 1975, the emphasis was on diagnosing and then treating disease. In public health we call it the downstream perspective—for example, tending to a heart attack or amputating a leg because of peripheral artery disease rather than teaching people how to protect their hearts and arteries before they ever become compromised.
Just nine years later, when 1984 rolled around and the first Wellness Letter arrived in people’s mailboxes, the practice of medicine was shifting. Physicians had begun spending more time talking to their patients about lifestyle habits that not only would help prevent illness but also would improve their current health physically and mentally—the upstream perspective. And the conversations went beyond nutrition, physical activity, and stress reduction. The annual physical also started to include discussions about alcohol use, domestic abuse, safe sex, use of seatbelts, and even what it means if you keep a gun in the house.
By the 2000s, even those holding the pursestrings were on board. Medicare began telling physicians that there was a checklist of things to discuss with their patients—optimal eating, weight control, exercise, emotional health, and so on. Now, both Medicare and private insurance companies reimburse doctors for spending time talking about preventive care during patient visits.
This all represents a seismic shift from how medicine was practiced and how health was discussed just a couple of generations ago. The result: a much-improved synergy between medical practitioners, their patients, and those who underwrite the cost of medical care. Today, even those who pay only glancing attention to wellness know at least the basics of what to do lifestyle-wise to keep their cardiovascular system healthy and stave off life-threatening illness.
It’s no small feat. Medicine is a conservative profession, with changes coming slowly and cautiously. Overlay that conservatism with the fact that it takes seven years to train a primary care doctor—four for medical school and three for residency—and you can see why changes in medical approaches don’t occur quickly. Two generations are warp speed for the wholesale shift we have all been experiencing.
Which brings me back to the Wellness Letter. We, just like your doctor, still cover treatment and prevention of all manner of health problems—for example, the newest research in managing skin cancer and diverticulosis; the latest thinking about HDL cholesterol and gastrointestinal reflux disease; and how to avoid medication mishaps. But just like we did in 1984, when Apple’s first Macintosh personal computer went on sale, everyone was tuned into Dynasty and Dallas, and Detroit beat San Diego in the World Series, we continue to bring you advice on how to be healthy better, how to be well.
Over the years, we have published a wide range of in-depth articles related to healthy living—from heart-healthy diets, sound weight-loss recommendations, and our take on dietary supplements to the latest on preventive services and health screening tests—along with some quirkier tips: cursing can have psychological benefits; tongue exercises for sleep apnea; what you should never flush down the toilet; how not to fall prey to negative stereotypes about aging so they don’t become self-fulfilling prophecies; types of yoga that involve dogs and even goats; and how lucky charms (like a rabbit’s foot) can improve athletic performance.
It has been a great ride that you have been letting us share with you these past four decades, and we look forward to continuing with you on the journey toward ever-improved health.
