John Dwyer: Promoting wellness

THE recent controversy involving the Swisse Wellness company and La Trobe University should surely have us looking at the broader picture and answering some pertinent questions about Australians and wellness.

Without doubt, unhealthy lifestyles cause much of our burden of chronic and complex diseases, diminishing our quality of life and overwhelming the resources of our health system.

Despite all the rhetoric about the importance of prevention and, when well done, its cost-effectiveness, our doctor-centric, illness-focused primary care system continues to lack the infrastructure to provide the continuity and guidance many people need to minimise the development of “lifestyle” diseases.

People seek help from health professionals when they are sick; not to avoid sickness. Government departments of health are in reality departments of sickness.

There is a worldwide trend focusing on the development of integrated primary care practices where people enrol in a program providing access to teams of multidisciplinary health professionals including some who aim to help patients stay well.

Unfortunately, when evidence-based help is not available an information vacuum develops that is quickly filled by the “supplement” industry claiming that their products can help neutralise an unhealthy lifestyle and provide wellness.

Television coverage of the Winter Olympics was swamped with advertisements telling us we need supplements and vitamins, which can even be bought in lolly formulations.

Vitamin supplementation is expensive and usually — but not always — harmless and despite the oft-repeated claims from many suppliers there is no credible evidence that it provides energy, or relieves stress or generally improves health. Most Australians most of the time do not need to supplement their dietary intake of vitamins.

We do not need to detoxify our bodies, or consume “good” bacteria to keep our immune system healthy.

There is no such thing as a “liver cleansing” diet. Research shows glucosamine is no better for our joints than placebo.

We need to hear more respected voices from the health professions and the community speaking up to help consumers understand that the $100 they spend each month on supplements would be much better spent on gym sessions or even saving for a holiday.

One of those voices should be in the local pharmacy — after all, our pharmacists are well trained about evidence-based medicine. But the profession has diminished itself by having shops full of useless medications and supplements from which they no doubt make a high percentage of their income.

Pharmacists are asking government to allow them to play a more significant role in the primary health care system, but they should first become more responsible and not allow false hope to be peddled in their stores just because ill informed consumers will buy it.

Government is performing poorly in its responsibility to protect consumers from fraud. Frustratingly, Health Minister Peter Dutton is planning to reject recommendations from a review of the effectiveness of the Therapeutic Goods Administration that would have allowed it to do more to protect the public from unsubstantiated claims for “listed” products.

The challenge, brought into focus by the recent Swisse-Latrobe controversy, is not only to better protect consumers from health care misinformation and often outright fraud, but also to provide prevention infrastructure.

Most Australians want to stay healthy and have a sense of personal control of their health (a good thing), but they need valid evidence-based information to do that, coupled with continuous encouragement.

This will be best achieved by developing within our primary care system the opportunity for partnerships between patients and health professionals with mutual and shared obligations to maintain wellness.
 

Professor John Dwyer AO is the president of the Friends of Science in Medicine and emeritus professor of medicine at the University of NSW.

This is the second of a two-part series by Professor Dwyer on complementary medicine. Click here to read part one.