It's true. It's true. Holistic health has made it. Why? How? Simple.
Insurance companies have come up with studies that endow the wellness movement with that most coveted of establishment sobriquets: Cost Effectiveness.
In a number of studies -- one released last summer by the American Health Insurance Association and several done in California by affiliates of the Kaiser Permanente Health Maintenance Organization -- it has been determined that where wellness programs exist, there is a distinct drop off in "sick" care.
Kaiser, which moved into the Washington area to rescue the ailing Georgetown University Health Maintenance Organization, is now in the early stages of incorporating holistic wellness programs into Kaiser-Georgetown.
Dr. Elliott Dacher, who remains head of the Reston branch of the burgeoning HMO -- 60,000 members in the metro D.C. area--has been an active leader in holistic medicine for about four years. The serendipity of a group like Kaiser absorbing, as it were, a physician with Dacher's orientation has almost inevitably led both doctor and company to the brink of what could be a national pilot program for pre-paid stress management. Something a few years ago that might have been dismissed as pre-paid mumbo-jumbo.
The holistic movement, which -- stated simply -- presupposes that each of us must take primary responsibility for our own health, has been in a snowballing mode over the past few years, with a few pushes from established medicine, but mostly because of the desperation and need of a whole lot of people.
By the time Harvard Medical School conceded (about five years ago) that perhaps 85 percent of people seeking care of a physician had a psychological component to their ailment, thousands of Americans were seeking alternative approaches to managing the stresses of the late 20th century.
Dacher, a traditionally trained internist, has been running a pilot holistic program for about four years. Participants, who began as "worried well," more or less self-centered and self-indulgent, are now branching out, he says, into such areas as hospice care or teaching fitness. In fact, he's had to keep a rein on their prosetylizing urge. "Be a model," he advises.
Dacher and Kaiser-Georgetown have just run a joint workshop on stress management, the key, as Dacher sees it, to self-health.
"What we try to convey," he says, "in addition to ways of managing stress and working with relaxation is that, in fact, there is a positive value, not merely in reducing stress. We try to shift the motivation from those that come in looking at relaxation as a way of dealing with a problem, but as a way of beginning on a path to promote health -- because that's valuable, independent of the issue of stress."
Physicians, too, says Dacher must learn not to reinforce the helplessness patients may have.
"There are," he says, "two sides to this coin: The individual has to learn to help himself and the professional has to learn to facilitate that process--and learn not to take responsibility for fixing things and feeling bad when they can't . . .for example, saying to somebody, 'Why don't you go home and relax,' is like saying to my 3-year-old daughter, 'Why don't you go home and read a novel . . . you have to learn skills."
Kaiser administrators, whose own studies have convinced them that wellness pays -- in hard cash -- envision ongoing programs to incorporate the principles Dacher has been teaching.
The first workshop (in Virginia), which took place last month, will be followed by a similar one in Maryland, probably in January. After that, Kaiser-Georgetown officials and doctors will assess evaluations and, according to K-G Vice President David Pockell, may approach area companies with large K-G memberships and propose on-site wellness programs.
Indeed, these are the kinds of programs that produced millions of dollars in savings according to the Health Insurance Association. The HIA report, for example, cites nine disease-prevention programs for the 80,000 employes of New York Telephone Co., credited with saving $2.7 million a year, money that would have been used for taking care of ills which were prevented.
"And," says Dr. Wayne Alberts, medical director of Kaiser-Georgetown, "look nationwide. Look at the minuscule proprotion of resources put into maintennance of health and prevention of problems related to stress and anxiety. We could probably save incredible amounts of money nationally just by funneling a small portion of resources into prevention, rather than illness."
Pockell, a transplant to Washington from Kaiser's California base, says their study "shows people use fewer traditional health services when they're in this kind of program. And," he says, "one thing we've noticed in D.C. is the frequency with which people go to the doctor here . . . and it's probably not because there's a sicker population. I would have to assume a lot of those people are coming because they want something. There's something missing . . ."
The announcement of the Virginia workshop in the K-G newsletter brought an instant sell-out. Those who attended, says Pockell, had these sample reactions:
"I hope there will be more . . ."
"Having been introduced to relaxation, I am somewhat discouraged no more are available . . ."
"A real turnaround for doctors to talk about what used to be non-medical methods of health."
It is true, says Dacher, that "there are a lot of people calling themselves 'alternative' who are doing a lot of kooky things. One of the problems we've found in the field is that there are so few with real credibility.
"The organization (Kaiser-Georgetown) will provide the opportunity for a credible organization with credible staff to lend credibility to the value of promoting your health . . ." Although Kaiser-Georgetown workshops are limited to members, the organization is making available to the general public a booklet which includes an article on stress and relaxation techniques prepared by Dr. Dacher. For a free copy, write: RELAX, Kaiser-Georgetown Community Health Plan, Suite 300, 4200 Wisconsin Ave. NW, Washington D.C. 20016.