Concierge Medicine

Concierge medicine, in its essence, is a kind of one to one service provided by a primary care physician to a patient in a set up where the patient pays a yearly or an annual fee, also called as a retainer to the doctor. This retainer is in cash and insurance might have no role to play in concierge medicine.

In addition to this retainer, there might be other charges. In lieu of this retainer, the doctor provides for personalized, one-to-one care inclusive of increased time and availability to the patient.

It is also known as ‘retainer medicine’, ‘boutique medicine’, ‘membership medicine’, ‘cash only practice’ etc. There are differences in the practice of concierge medicine in terms of the fees charged and the services provided but at a basic level the idea is the same. These variations are mainly seen from one practitioner to another. However, the differences are not so great or widely varied and hence, the essence of concierge medicine is not diluted by these ever so slight variations.

Concierge medicine is often confused with Direct Primary Care (DPC). While both concierge medicine and direct primary care are different forms of traditional practice or primary care, there are certain similarities and differences between the two. The two are NOT the same.

Direct primary care and Concierge medicine are similar in philosophy, where they diminish or completely overrule the role of insurance in primary care. They both have a one to one or direct financial relationship with patients and provide personalized primary care by building a trust-based relationship between the patient and the doctor.

However, they are different in the fact that Direct primary care is mainly aimed at providing services at a flat rate fee which seems to cost lower at face value, but on seeing minutely one would realize that this is at the cost of lower grade services and lesser interaction between the doctor and the patient. It limits the patient’s access to the doctor as compared to concierge medicine practice. In the latter, an annual retainer fee is taken from the patient and far more comprehensive care is provided. There is more transparency and interaction between the doctor and the patient in the latter and the patient is likely to feel more satisfied with the time and care provided to him by a practitioner of concierge medicine.

A lot of people argue that concierge medicine is not for the masses but only for the classes. This is a false charge against concierge medicine. The only thing that concierge medicine aims for is quality as opposed to quantity and practitioners of this form of medicine truly believe that every single human being deserves and merits a superior grade of primary care.

With insurance coming into picture, primary care had slowly become impersonal, cold and businesslike towards patients. There was hardly any attention given to the patients by a doctor because of lack of time and resources. There was a dearth of patients who were left dissatisfied and disillusioned with this kind of treatment. The “care” from primary care was slowly disappearing.

And hence, about 20 years back, in the year 1996; doctors decided that it was necessary to provide to patients a system of care in which they would feel fulfilled, happy and healthy after a visit to the doctor instead of feeling dissatisfied and cheated of their time and money.

Medicine was becoming business-like and hence, care was being denied to the patients because the doctors could only provide treatment on the basis of what would benefit the insurance companies and not the patients. The focus was how the insurance companies could profit. These companies were providing “lesser” care at a lower cost and duping the patients. It was a feeling of being trapped for both the doctors and the patients. The doctors more so, because they took an oath to take care and put the needs of the patients before anything and anyone else but, they were being forced to put the benefits of insurance companies ahead of anyone else.

As Dr. Thomas LaGrelius has rightly said that discount-based insurance is like a hamster wheel which is morbidly destructive for the morale of the doctor, the care of the patient and the health care system as a whole. This was clearly the “businessification” of medicine. At every level of care there was an insurance coming in between the patient and the doctor and as stated earlier, insurance companies are for profit which they created often by denying care in the form of rejecting the claim, increasing load of paper work etc. The doctors were in a fix and had to collaborate with them despite not agreeing to the method being employed by them. It was clearly the case of big fish (insurance companies) eating the small fish (doctors) in the sea. This system was neither good for patients nor the doctors. Also, as physicians, they were taught how to provide for a patient and not how to generate business out of patients. With the involvement of insurance companies, primary care was business which most doctors had no aptitude for and they had to rely on the hospital administrators with their MBA degrees and follow blindly what was being told to them.

All of this led to the breakdown of the doctor-patient relationship which is of prime importance in any healthcare set-up. There was erosion of the primary care system due to lack of time. The primary care physician had no time and so ended up referring a patient to a specialist. Now, this does not seem to be a wrong practice. In fact, it is the correct thing to do. Send a patient to a specialist for special care. But that is not what medicine is about. A specialist is a doctor you refer a patient to when the primary care physician is out of sorts in treating you or when it is out of his scope. The specialist aids your primary care physician. With the lack of time however, the primary care physician was unable to dedicate enough time to each patient, which led to one patient being referred to multiple doctors and he ended up taking a dearth of medications. There was lack of coordination and the patient was at the suffering end. “Too many medicines, too little care.”

This also affected the quality of life of the patients. Too many medicines made him end up lying in bed all day, spending time focussing on when to consume which medicine, which precautions to take, how to live a life with trying to manage all the things that every doctor has asked to consume or avoid or completely give up. Conflicting opinions, mountains of medicines, too little time focussed on care and prevention, but too much time focussed on disease and treatment; all led to a poor quality of life for the patients and they struggled to live. It was all about illness and not about wellness.

The role of a primary care physician is to take all these opinions, put them down in a concise manner so that the patient is capable of understanding them and applying them practically. It is his job to mould all these opinions into a manageable lifestyle so that the patient not only lives longer but does so with excellent quality of life.

Being a doctor is not a job! It is a relationship you share with your patient. The moment it is considered as a job is the moment when the empathy is lost. There is just a point to point connection and once you finish the number of hours you have to give in, your ‘relationship’ with your patient ends. That was never the aim of primary care. And with time the aim was being lost and shrouded by unnecessary paper work, insurance claims and impersonal contact between the doctor and the patients.

To overcome all these hurdles, concierge medicine came into being. Concierge medicine is aimed at making primary care more personal, well-directed and well-meaning. The advantages of concierge practice over insurance based practice of medicine are far greater than one can imagine.

Concierge medicine constitutes the “care” in primary care. Because of no interference of insurers, the practitioners of concierge medicine can dedicate ample amount of time to the patient. There is never any rush. The doctor is completely dedicated to the care of his/her patient and the patients can have all their questions answered without being ignored, rushed or given half-baked answers due to the lack of time. It is never necessary for the patients to run from pillar to post for every other ailment. Treatment is not made a task for the patients but it is made easy and convenience-based. “Too many cooks spoil the broth” is an apt phrase to describe how too many specialists with no coordination amongst them spoil the quality of life of a patient. But there is no such danger with concierge medical practice as the primary care physician takes care of all the problems of a patient with involvement of a specialist at the requisite time, for the optimum benefit of the patient. Even when specialists are involved, the primary care physician is constantly in the loop and integrates all the medical advice given to the patient in an easily understandable manner so that the patient is not overloaded with medicines with no significant relief.

Concierge medical practice is a promise to the patient that they will be attended to at all times, provided with proper answers and they will not have to spend long hours waiting for their turn to meet their primary care physician. It is also a promise that when the patient meets his/her primary care physician, he/she will not be rushed and will be given adequate time with the physician. This practitioner knows all your details, knows your story, your medical history and what can or cannot be given to you. This practitioner cares for you in the true sense and will never make you run from pillar to post. He is your doctor in an emergency as much as he is your doctor at the time of a regular health check-up. Concierge medical practice is very dedicated and intense in their approach to a patient.

The practitioners of concierge medicine work for the patient. They do not work for insurance companies or corporations or large health-care organizations. The motto is to nurture the “doctor-patient relationship”. Care given is highly personalized and it is given in an environment where you need it or the environment that is best for you, whether it is the hospital, home, emergency room, office or elsewhere. Communication is possible 24×7 in most of these practices via any and every mode including calls, SMS and emails. The patient is identified as a human being or a person that this doctor cares about and not as a mere diseased individual. And all the other aspects related to the patient and his life, are taken into consideration at all times, carefully remembered, given adequate time and value to and never ignored or down-played. All the above mentioned aspects are carefully taken into consideration and merged together to make an appropriate decision for any medical condition that the patient has.

Concierge medicine is not only beneficial for the patients but also to the practitioners. Practitioners of concierge medicine have a sense of fulfilment after a day’s work. There is no rush, there is building of a relationship, there is greater time spent with a patient and hence more opportunity to get to know them and hence, once the patient feels better it is a feeling of true triumph and happiness for the physician as well. The doctors are not rushed or over-burdened. The paper work is minimal and the use of skills and clinical knowledge is maximal, which is what doctors are trained to do as opposed to what insurance based practice makes them do. Any person, who thus loves their job, is more likely to do better and fare well at what he/she does. And that is seen in most of the practitioners of concierge medicine as well. They are happy with what they do and hence, do it well and with their whole heart and soul. Practitioners of concierge medicine do not work under pressure or treat their work as a job. The practitioner sees a limited number of patients, dedicating more time to each patient. The doctor is not in a hurry, the patient is not rushed and hence, concierge medical practice helps fulfil the needs of both the patient and the doctor.

Another set of people who benefit greatly from concierge medical practice is the doctor’s staff. The staff that earlier had to deal with an overload of patients now deals with a significantly lesser number. This means that they no longer have to act as a barrier between the patients and the physician. They can now do their job pleasantly and without any stress as well. Guiding and facilitating the patients now becomes smoother and easier. They can also now focus on actually helping the patients as opposed to dealing with them like a shepherd would deal with a herd of sheep. They do not ‘control’ the patients but guide and facilitate them.

Thus, concierge medicine benefits every single person involved.

There are however certain myths about concierge medicine. One of them is the fact that it is for the affluent and not the poor. If you view the insurance based practice of medicine, you will realize that a lot of the money in such practice is directed towards crisis management, invasive procedures or expensive investigation due to lack of time with the primary care physician. So a good amount of money is still being directed into healthcare by every single patient whether affluent or poor. However, by the time the patient realizes this it is too late and the patient is stripped of money, time and quality of life is compensated.

There is a great disparity in healthcare and many barriers to accessing basic healthcare. The access to basic healthcare and to preventive healthcare measures is marred by inequality. The quality of care received is dependent on various factors like the age of the person, the financial status, the insurance status etc. In the age of insurance based medical care it was noted the world over, that primary healthcare and preventive health services were accessible to and utilized by only a certain category of people. Most people missed out on this due to common barriers such as lack of education, lack of adequate finances, language barriers, communication barrier and age barrier (the elderly were seen having lesser access to preventive healthcare and basic healthcare as compared to the youth). These kinds of disparities made primary health care less and less available to the disadvantaged groups. They statistically had lesser access to primary healthcare services, preventive healthcare services, immunization programs and other medical care. It was also seen that uninsured people tended to visit their doctors less often and waited till the disease had progressed to a serious stage or had become chronic before reaching out to a doctor for help. Also, insurance cannot be used for multiple cases of preventive care. Insurance companies aim at sick care more than preventive care and thus, a lot of preventive healthcare services are not covered under the umbrella of insurance. Thus, insurance has created a barrier between basic healthcare and the patients. Insurance became a boon for the common man, the underprivileged sections of the society and the doctors alike.

If we understand this well, then we can easily grasp the fact that concierge medicine in fact is offering primary care in a manner in which lesser amount or the same amount of money is directed into taking good care of health and aiming the care at wellness rather than illness and end stage disease management. The money is being utilized to gift the patient a great quality of life. And practitioners of concierge medicine truly believe that whether a person is rich or not, every single one of them deserves a good quality of life. The model of concierge practice reduces hospitalizations, emergency room visits, use of prescription drugs and unnecessary investigations. And thus, the total cost of the patient does significantly reduce or is at par with what they were spending with insurance. Also, there are no restrictions as to what the money can or cannot be used for. Once a member of the concierge medical services; the patient can avail of all the services that the particular concierge medical practitioner is providing inclusive of preventive healthcare measures, routine check-ups, treatment costs, hospitalization costs etc.

Concierge medicine is the future of medicine. As time is progressing more and more people understand the need for more dedicated time and effort from their primary care physician. The patience to sit for hours in a waiting room is gradually diminishing. Patients are demanding good care, dedication, attention and better services. And this is not something that only the affluent want or need. This is fundamental to primary care and even working class people who earn in 9 to 5 jobs are willing to invest in good healthcare. People understand the importance of health, the necessity to maintain it and the value of a healthy lifestyle. Everyone deserves a good quality of life. Health is an experience and once people realize that they will not be scared to invest in it. And hence, concierge medicine is here to stay. It is the future of healthcare and will serve as a strong pillar in the development of good primary healthcare set-ups all over the world.

With advancing technology, human touch is gradually being lost. People know each other by profiles and what someone shared as opposed to sharing what is going on in their lives face to face. There is no emotional connect. In such times, losing out on talking comfortably with your physician and sharing your problems just leads to further suppression and frustration. It is hence imminent to have a primary care physician who has time to let you share what you are experiencing instead of rushing you so as to move on to his/her next appointment. One to one interaction is much needed. People need to know that they have a listening ear, a sounding board, someone who cares. Patients need to be told that they are not just one in a queue of millions; that every single one of them deserves the care and attention due to them. This kind of personalized care can be provided by concierge medicine. And this is where we can see how concierge medical practice is increasingly becoming the need of the hour and is only beneficial to all in the long run.

Eternesse Medical Centre is the first of its kind Concierge Medical Clinic in India. Biotex Life is pioneering the introduction of this revolutionary form of medical practice in India and this is the future of medicine. By introducing concierge medical practice in India, we plan to further the progress that has been made in the field of healthcare so far in this country. The world is moving forward and we hope to keep at pace with it in the field of healthcare. Eternesse Medical Centre will bring to you a healthcare experience that you might never have imagined. A state of the art healthcare set up with a modern approach to medical care without losing touch with the traditional aspects. We retain that which is good, eliminate that which is unwanted and embrace the new developments in the field of healthcare to bring the best to our patients.

At Eternesse Medical Centre, we offer tailor made healthcare packages for you. Everything that suits your needs is the priority in these packages and they are created in a manner in which your benefit is kept prior to everything else. On joining our concierge medicine program, you will be given a Membership Card which will be a lifetime membership for you, if you choose. With a lifetime membership you can avail of multiple benefits like regular upgrades, discounts, earning of bonus points that can be used for obtaining more discounts in the future as well as many other perks. However, if you do choose any of our other membership packages, you will still benefit. Every single membership package has its own set of perks. As stated earlier, your comfort is out topmost priority. In addition to this, constant upgrade in facilities, the ability to use your membership card anywhere in the world and obtain premium healthcare facilities anywhere and everywhere is what we also offer.

At Eternesse medical centre, we focus on the needs of each and every single patient. With a dedicated team of primary care physicians, specialists, nutritionists & dieticians, wellness coaches and a great support staff; we provide the best in the field of primary care.

Our doctors are available for you 24×7. They are more than willing to answer your queries, clear your doubts, share your experiences and treat your illnesses. Every single patient is the primary at Eternesse. The programme is centred on you i.e. the patient. Individuality is the foundation at Eternesse clinics and every single patient is treated based on a model specifically created for them. There is no overlapping; there is no single model or structure that is being used for everyone. What the patient needs is of prime importance and then the treatment model is built around it. No two patients with the same disease will be treated in the same manner. This is because every single one of you comes from different backgrounds, has had different experiences, lived different lives and hence, is very varied as an individual. You are not the illness and that is not how you will be identified or treated. You are an individual suffering from a particular illness and your reactions to the same might differ from another individual with the same illness. This is determined by a lot of factors including, as mentioned earlier, your lifestyle, your experiences, your environment etc. And hence, your treatment plan will definitely differ from the treatment plan of another individual who might have the same illness or diagnosis.

It is essential to understand that people are not the diseases they have; people are the experiences they have had and that determines their reactions. There is a steep rise in lifestyle disorders all over the world. Stress is at its peak in all its possible forms and the capacity of people to deal with stress and stressful situations is limited. Age old methods are not working in the fast paced lives that we lead in the current times and with progress in every other field; we are progressing with the negative effects of our own lifestyles as well. The boons are accompanied with equal number of banes, if not more. It is therefore necessary to get innovative in our approach towards lifestyle disorders and all other diseases in general.

At Eternesse Medical Centre, we want to empower people to make informed, healthy and responsible choices. A very important step in achieving this is education. And via the means of this and many such other articles, talks and awareness programmes we hope to provide people with the tools and information required to make healthy life choices. In this cause that we are undertaking; education about positive health, impact of lifestyle and what are lifestyle disorders, the concept of wellness and what we can offer to achieve it, the concept of prevention & its importance and the role of diet and nutrition etc are some of the points that we will throw light on.

Let’s start with shedding a little light on what lifestyle disorders are and how they are managed in the conventional set up. As the term in itself suggests, lifestyle disorders are diseases that develop or are linked to the kind of life that an individual leads. More than half of all the chronic diseases found in major countries of the world are linked to factors such as an unhealthy lifestyle or environmental factors. In the current times, we are all leading a life of excesses. Nothing that we do is in limits or controlled. We might go out for a meeting with friends and end up eating more than the share of food required or consume an excess of alcohol; or stress ourselves by over thinking about issues at our respective workplaces; push ourselves to work more than our body and mind can take; over analyze a situation or a relationship; lead an unhealthy lifestyle with little or no physical activity. In doing all of this, we are digging our own graves, metaphorically.

All the actions that we take impact our lives positively as well as negatively. A certain amount of balance has to be achieved in order to lead a healthy life. With industrialization, technology boom and sedentary jobs; we are being marred by a variety of lifestyle diseases. These include coronary heart diseases, hypertension, obesity, type II diabetes, stroke etc. Depression, osteoporosis, arthritis, PCOS, cancers are also results of an unhealthy lifestyle. All these diseases have risen by a significant margin in the last few decades and going by the way we still continue to live, it only seems that they are here to stay. These are life threatening illnesses and will stay with you as an unwanted companion all through life if they are not managed adequately right in the beginning. The only way to overcome these lifestyle diseases is by modifying the way we live and leading a healthy lifestyle.

At Eternesse medical centre this is a major focus and a goal we aim to achieve. We aim at promoting a healthy lifestyle, focussing on wellness and creating a future that is full of health, hope and happiness.

Lifestyle is a major contributor to one being healthy. What you eat, what you do and what you think are the things that constitute a major chunk of who you are. Now, what does an unhealthy lifestyle really comprise of you’d ask? One of the major contributors is diet. Consuming foods with artificial sugars, fats, too much of processed food, excessively fried and oily stuff, foods containing too many preservatives; are all bad for health. Excessive consumption of meats, dairy products, aerated beverages, alcoholic beverages is also part of an unhealthy lifestyle. We start abusing our bodies from a very young age. The availability and increased marketing as well as sale of all these products are slowly making health a distant dream. Also, drug abuse, use of tobacco and smoking of cigarettes is on the rise. These accompanied by a sedentary lifestyle also affect health adversely. Behavioural and environmental factors have a major role to play in maintenance of health and causing disease, as well.

With urbanization, we aim to live a “modern life”. Lifestyle disorders are also a result of this. Sleeping lesser number of hours, having no set pattern to life, poor exposure to sunlight, constantly staying in closed rooms with air conditioners leading to no exposure to fresh air etc. are culprits too. In addition to these, there are other factors that pose as a risk and are responsible for either causing and/or maintaining lifestyle disorders. These include the type of work you do, the number of hours you put in at work, the stresses you deal with at your workplace and home, the time you spend for exercise, if you undertake any hobbies or recreational activities, your posture, daily physical activity etc.

Not all lifestyle disorders present immediately or with grave symptoms. They stay dormant for years together showing no signs or symptoms at all. The person appears to be in apparent health while the body is deteriorating internally due to abuse of any of the above mentioned factors. These are hence silent killers. How or when they will appear cannot be predicted. But the risk factors can be predicted and hence, it is these that we need to educate people about. At Eternesse medical centre this is another one of our initiatives: ‘To create awareness and impart education in relation to such disorders, how to best avoid them and lead a healthy life.’

Health is another concept that is not well understood or most often misunderstood. For hundreds of years the concept of health was related to the absence of this or that instead of defining it as a positive concept. Health was not treated as an independent entity having its own set of conditions for existence. It was instead defined in terms of disease and the absence of it.

Now, as defined by WHO, “Health is complete physical, mental, social and spiritual well-being and not merely the absence of disease or infirmity.” As times progressed it was recognized the world over that health is not just a state where a person is devoid of disease. This concept was introduced by Dunn where he said that being healthy is not merely being devoid of disease. There are different states where a disease might not be present but an individual might not feel well. And this state is not health. The spectrum of health has widened significantly and one can easily see that health is not just physical. There is a great emphasis now on mental and spiritual well-being. And the social aspect of health cannot be undermined either. With all these into play, it can be seen that health is no longer composed of just a single sphere but has many integrated and interwoven layers, all of which need to be addressed and taken care of. If there is an imbalance at any of these levels or in any of these spheres, a state of health can no longer be achieved.

When talking about health, it is important to talk about the concept of “positive health”. The approach to positive health works in a fashion where the focus is on the things that are currently right with an individual and how to maintain and enhance them. Positive health comprises of “health assets”. A health asset is any factor which helps in building a stronger state of health. This state of health is such that it rises over and above the risk factors and helps in maintaining health. Positive health aims at discovering the health assets which help in producing a longer and healthier life. Another aspect of positive health is the discovery of health assets which lower the risk of a disease and lower the cost of healthcare. Positive healthcare has a goal which is the achievement of an optimal or balanced state of health. This is beyond the absence of mere illness or disease.

At Eternesse Medical Centre we strive to recognize the health assets that produce better health and help in integrating these into your daily life activities. This is done in a manner in which the merger of these health assets into your life is smooth and you do not need to make too many uncomfortable changes or modifications in your routine. The transition from health to optimal health is an arduous journey, but we aim to make it easy and natural for you.

The concept of health assets is fairly new but the use and application of the same has increased in the past few years. Health assets are basically certain potentials that an individual possesses which if banked upon and enhanced well can act as a starting point in the journey towards achieving and maintaining positive health. Every individual possesses certain health assets. They just need to be identified and nurtured so as to incorporate them in his/her day to day life. Health assets support health and well-being. They basically comprise of the core of an individual. These are the central attributes and the traits of an individual and they can further be classified as external and internal. The internal strengths include motivation, relationships and their derivatives, volitional strengths, expectations from self and protective while the external strengths include physical elements, environment, support system and expectations from others. There are also certain precursors to health assets like the genetic factors, hereditary factors, value system, belief system and general experiences in life. These are the antecedents to positive health. Health assets are at their core the factors that motivate a person to make change and embrace it.

A few examples of health assets include biological factors like high HDL levels (good cholesterol), optimal cardio-respiratory function, and good variability in heart rate etc. Then there are certain factors related to self or subjective factors like self-belief, introspection, positive emotions and their balance with negative emotions, hope, optimism, sense of fulfilment and a purpose or meaning to life. A branch of subjective health assets are functional health assets which include your relationships with friends and family members, your work life, social life and the ability to balance all these. Biological health assets can be measured and analyzed by another and hence they are objective. They can be measured via investigations and examinations. Functional health assets are those that can be observed by those around an individual including the family, friends, relatives and colleagues. Functional health assets can be assessed based on observations by self and other around you. Subjective health assets are mostly related to positive state of mind, emotions and feelings. And hence, these are felt by the individual himself / herself and can be reported directly by a person.

Whether or not these health assets are related to each other and in what manner is still under study. But their individual effects on a person’s life are well researched and proven.

Positive health is a consequence of the optimal use of these health assets in the right direction. When these traits and behaviours are used in the manner that we use other assets in life, health will be the end result. Continuing to bank on these health assets will ultimately lead to improved health outcomes and gaining mastery over health and wellness. It will also help a person in the journey towards achieving self-realization and self-actualization.

Health assets help improve the longevity and the quality of life ultimately. Positive health is basically a method which helps one through promoting the coping mechanisms and self-esteem of individuals. It is just a way of helping people identify the positive traits they have and motivating them to work on these so as to strengthen health and ward off diseases. Health assets are mere stepping stones that help people to focus on their strengths and abilities rather than focussing on their weaknesses and deficits. Working on positive health is a journey full of optimism and self-belief. Health assets help one to lay a strong foundation on which a positive future can be built. They help people in overcoming their faults, weaknesses as well as the challenges they face.

Health assets are not just helpful to an individual but they are also helpful to the community at large. By banking on the health assets of a person, that person is set on the path of positive health and by setting multiple people on this path towards positive health we aim to make the community move towards positive health as a whole.

Positive health can be very well correlated with other approaches to a good state of health. These include health promotion, disease prevention and wellness. All these approaches are similar to each other and are correlated in the application and results of things that promote a good state of health.

Health promotion is related to lifestyle changes so as to attain optimal health. This is brought about by awareness, motivation for promotion of positive health practices, developing skill-sets and enhancing positive environment. The common thread between positive health and health promotion is the goal that they both set out to achieve: good health. Positive health and health promotion differ in two aspects; first is that positive health is also correlated to disease prevention as well as the prognosis of a disease once it has occurred and the second aspect is the empiricism of positive health assets.

Disease prevention is mainly carried out by various measures that have been developed over a period of time. With the advent of disease preventive measures, life expectancy has increased. Although there is no direct or indirect correlation between positive health and fatal illnesses, they are definitely dependent on each other. They are not independent. Positive health is basically an antecedent; a necessary precursor to prevention of disease. Positive health and prevention are similar in the fact that they both use methods for prevention of disease and these methods are used early on i.e. much before the occurrence of disease. While they are different from each other in the sense that positive health focuses on health directly while disease prevention has health as an indirect focus and positive health is concerned with health assets while disease prevention is concerned with avoidance of risk factors that might predispose one to disease.

Wellness is a state of optimal physical and mental health and it helps people by making them aware of the factors that can help them in achieving good health and warding off diseases. Wellness is hence very close to positive health. They both are consistent with their ultimate goal being complete well-being of an individual. They are both wholistic concepts. While they are both very similar to each other they are distinct in the fact that positive health is more scientific in its search for optimal health with determining health assets and basing the final goal on building relevant strategies for finding and maintaining these health assets. On the other hand, wellness is more ideological than scientific.

In conclusion, it can be said that positive health is related to all the three factors i.e. wellness, disease prevention and promotion of health.

Let’s talk about disease. What is disease? Disease, simply put, is not being at ease. Earlier it was thought that just like health comprised only of absence of disease at the physical level, similarly disease comprised of just being physically unwell or out of sorts. The other aspects of an individual’s life were never considered to be of any importance in the achievement of health or the treatment of disease. It is with time and development that it was realized that the mind and body are one entity. That they are interconnected and each does have an influence on the other, whether positive or negative. Once this was realized, man could be viewed as a single cohesive unit made up of the soul, mind and the body. To achieve health a balance between the soul, mind and the body needs to be attained. We must also remember that as human beings we are social animals. That is the quality which separates us and sets us apart from all the other animals. We build societies, live in them, interact with other human beings and depend on each other for our growth, development and for our fulfilment. And therefore, the social aspect of life needs to be taken care of as well.

Once balance between all these is achieved, it is then that we can say a person is healthy. A lot of work goes into achieving this state. And this is our motto at Eternesse Medical Centre: to help you not only to achieve this state we call health but, also to maintain it.

This concept of health is very close to wellness. Wellness is not just a state of life; it is a mode of living. Wellness is state of being in optimal physical and mental health. The balance that we have been talking about all along leads to a state of well-being or wellness. Wellness is a relatively newer concept. It involves taking proactive steps towards one’s own well-being. Wellness is more of a conscious choice and a decision to do things that are beneficial to one self. Wellness is a chosen responsibility to lead a healthy lifestyle. It does not come easy and it is like an inculcated value. It is a dynamic process of making informed choices towards a fulfilling and healthy life by being aware and taking determined steps towards the same. To achieve wellness and avoid illness is also a point of focus at Eternesse Medical Centre. Like mentioned several times earlier, we promote “wellness and not illness.”

In order to achieve wellness one must know the risk factors that act as a hindrance on the path that leads to wellness. Risk factors are different types of actions or conditions that increase a person’s chances of illness or injury. A majority of factors that pose a risk to wellness are similar to the causative factors for lifestyle disorders or diseases. Wellness is therefore a subset of a healthy lifestyle.

There are certain dimensions to wellness and all of these are important in order to understand, achieve and maintain wellness. The ability to function optimally in each dimension is wellness. All these dimensions are interconnected with each other and achieving a balance amongst them is the only path that will lead to wellness. In general, there are 5 dimensions of life, so to speak. These include physical, emotional, intellectual, spiritual and social. But wellness can be dissected into a few more by creating demarcations within these five levels depending on the conditions surrounding us and the times that we are living in. With passing years, the things that define a human being also include his occupation and finances apart from all the things that are mentioned above. The role of the environment a person lives in can also not be discounted. And hence, wellness has eight dimensions. All these dimensions are intersecting i.e. they are all correlated to each other and one definitely affects the other. They are like the sides of a cube, where the entity is single but can be seen from different perspectives and each face has something different to tell although, all the faces are connected and together form the whole. Without taking care of the parts, the whole will never be taken care of and vice versa. To achieve wellness is to create and maintain an optimum balance between all these dimensions.

What we have been doing over the years however, is compartmentalizing and dealing with illnesses at the superficial level that they present at. Symptoms are treated as the whole disease and once the superficial set of symptoms disappears, it is thought that the disease is cured. However, multi-factorial cascade of causes or multi-factorial involvement at the various dimensions is rarely taken into consideration. We have been treating human beings like a mechanic would repair a car. But a human being is far more complex and has various dimensions to him, and all these are interrelated. There is no dissociation between the various facets of wellness. In the world of mind-body wellness, there are no disconnected parts. Each part will definitely have an effect on the other.

For e.g.: stress as a physiological response affects every single organ of the body; it induces the fight or flight response and every single organ of the body will react to this in its own manner to overcome this stress or to deal optimally with it. Another example that is relevant in our times and most of us will be able to easily relate to is that of depression. At its core, depression is a disorder of the mind. But it is not devoid of physical effects. And a recent study has shown that exercise provides the same amount of relief in cases of depression as anti-depressant medications do. Also, when one is depressed, would the person want to be social and meet other people and engage in conversations? No! So, the social aspect of wellness is also affected by what seemed to be at face-value a disorder at the level of the emotion or the mind. This should be enough for anyone to understand how the mind, body and the soul are all interconnected and that balance is what needs to be sought and achieved in order to lead a life in harmony and peace. It is of great essence, in fact it is imperative that we understand and apply this concept in our fitness, health or wellness programmes as well as use it in the treatment of diseases.

Achieving this kind of harmony and making wellness a priority is what is aimed for at Eternesse Medical Centre. With the introduction of concierge medical practice, we aim to bring to life this idea with great force and conviction. We hope to translate our beliefs from dreams to reality and make people a part of this wellness revolution. As a stepping stone to this, let’s talk about the dimensions of wellness and what is the role of each dimension in achieving wellness.

Physical wellness is the first dimension of wellness and it is important because the body is our vessel and in order to take care of day to day activities being physically fit is a pre-requisite. The physical dimension of wellness is the dimension where detecting an imbalance is the easiest. This can be done by clinical examinations, investigations and some other evaluative measures, all of which are in abundance. Therefore, being unwell at the physical level is easily seen and more often than not taken care of as opposed to the other dimensions of wellness. The physical dimension is the one that is the most focussed on and being physically fit is a goal that most of us have today. This can be done via exercise, eating healthy food, practising safe sex, avoiding dangerous activities etc. Physical fitness and physical wellness are directly correlated. Physical wellness is enhanced by physical fitness. A physically well person is not easily fatigued by day-to-day activities, has a good amount of sleep, gives time for the body to rejuvenate and recuperate and understands the value of fitness. Being physically well and fit helps one to take care of themselves and others optimally. This is especially important in times of danger and need. This physical fitness is also a sign that one is capable of warding off diseases and can avoid falling ill to a great extent.

Intellectual dimension is the second dimension of wellness. Developing intellectual wellness includes promoting critical thinking, learning new things, reading, staying up to date with the new developments, being curious and asking questions, being open to being questioned, analysis and evaluation of different situations etc. All these help the intellectual faculties to flourish and it helps an individual to do well not only at school or work but also in life. Intellectual wellness is necessary to deal with tricky situations and handle stress optimally in life. It is also seen that intellectually well developed individuals are less likely to suffer from mental health issues. Various mental health issues can be staved off by people who challenge their minds and are up for learning new things regularly. And hence, intellectual wellness is an important part of the entire wellness programme. It is also usually a neglected aspect as most people are not aware of its importance. At Eternesse Medical Centre we not only understand and appreciate its value, but also incorporate it in our wellness programme so that complete wellness is achieved by all our patrons and members. We not only promote being creative, pursuing a hobby and being someone who keeps learning throughout life but also promote participation in cultural, community and scholastic activities.

Emotional wellness is the third dimension of wellness which is much broader as compared to the others. An emotionally well person can cope with emotional turmoil and rationally deal with situations that are emotionally taxing. Confidence, a stable self esteem, understanding the feelings of others, the ability to build and maintain trust and being able to deal with the emotional situations of another individual are indicators of emotional wellness. In a healthy person emotional enrichment leads to sensitivity regarding the situations of the people around them and awareness about their own emotions. Such an emotionally aware and well person is capable of dealing with emotional situations optimally. This dealing is not forced and is usually adequate. Emotional wellness is tough to achieve especially in our current times as people are constantly trying to portray a certain image in society. They are afraid of facing their own emotions and run away from situations that demand the display of emotions in any manner. This constant race of trying to show that one is happy and fulfilled while suffering on the inside is the reason most of the individuals today are suffering from various mental health issues; the frontrunner being depression. It is a pressing issue and apart from awareness, it is necessary to build a sound support system for people dealing with mental health issues. Eternesse Medical Centre has a team dedicated specially to emotional wellness so that complete wellness can be achieved and facing emotional issues is easier and smoother. Self-care, stress reduction, relaxation and development of inner resources are the area of focus and this is the way in which we aim to achieve emotional wellness at Eternesse medical centre.

Interpersonal dimension of wellness comes next. This can be correlated with the social aspect in the definition of health. This dimension of wellness rests on two pillars namely, a reliable support system and a sense that they belong. It is of great significance for a human being to have someone they can rely upon. To have someone that can be trusted, with whom you can share things, have a bond, meet and feel relaxed is a blessing. Regularly making new social connections, exchanging thoughts and ideas, sharing of feelings, seeking advice from people who belong to your peer group and with whom you share healthy friendships are all a part and parcel of social/interpersonal wellness. It helps one grow as an individual while being in touch with society. Eternesse Medical Centre will help you accomplish this by having not only a great and friendly support staff but also by have primary care physicians who are interested in your wellness and growth just as any family member or well meaning friend would be. At Eternesse medical centre, you can have a home away from home.

The environmental dimension of wellness although discussed less, is of chief importance in a country like India. Environment does not just mean nature. It encompasses all your surroundings. One must find an environment that makes you feel positive and encourages good physical and mental health. It should be a place where one can feel safe and at ease. There is a certain calming effect that a positive environment creates. This aspect of wellness is inspirational in terms of helping one lead a life that is respectful of his/her surroundings and full of awareness regarding them.

The next dimension comprises of financial wellness. What exactly is financial wellness? It is a state where an individual is capable of being at peace with and handling his financial situations well. Everyone must make it a point to understand their finances well. Money plays a critical role in our bias and not having enough ahs adverse effects on our physical, mental and social wellness. Having a financial deficit not only effects health but also the academic performance, job performance, strains interpersonal relations and acts as a constant stress. There is a growing necessity for people to establish their financial havens and plan well in advance for the future. The upcoming generation is more focussed at instant gratification and they therefore face financial crunches in the future. Making our youth aware of the significance of well managed finances and savings is now more imperative than ever. This will help us to collectively achieve wellness as a society. For this awareness, we have at Eternesse Medical Centre certain experts who can guide you and help you with issues you might be facing.

Occupational wellness is the next dimension in line. Occupation is generally defined as something you do to earn a living. Most people however concentrate on the money aspect of work and are hence involved in an occupation that they do not enjoy or a completely impassionate about. When you are unhappy with your occupation you will not be as dedicated towards it as you would be to something you loved doing. Work then becomes tedious, boring and a burden. Such a situation leads to undue stresses in life that make wellness and health a distant dream. Constant struggle with what you are doing vs. what you’d rather be doing leads to an unwanted inner tussle and causes stress. This kind of stress is the cause for a variety of illnesses. Find satisfaction in things that make you fell passionate about them. This could be a part of work, school, volunteering or anything else. Find ways to participate in occupational endeavours and feel the appreciation and validation everyone needs to be content in life. There is nothing wrong with seeking appreciation and validation for what you do. It is however incorrect to depend on these to lead a life and to evaluate self based on just these. We help you achieve this at Eternesse Medical Centre with our wellness training program.

The last and final dimension of wellness is spiritual. This is the least understood aspect of wellness and health. The concept of spirituality is very ambiguous and confusing for most people. Spirituality is immeasurable. Most people confuse spirituality with religion. Both are however two very different things and a clear distinction between them should be made. Spirituality is connected to mindfulness. Your spirit is your essence. It is as important as your mind and body, if not more. Enhance your connections to self, others and nature so as to bring peace and balance to life. Disconnecting from distractions and being mindful is another way of connecting with your inner spirituality and soul. Discover the values and beliefs that are most important to you and make you a better person. When you are spiritually awake, the things surrounding you affect you little and dealing with stress and changes becomes easier. An inner connection with yourself keeps you disconnected from distractions and negativity. It thus helps you maintain a peaceful, stable, healthy lifestyle and brings you closer to wellness.

Striving to maintain or make small changes to the eight dimensions of wellness is the key to your overall health. And we at Eternesse Medical Centre fully understand and appreciate this. If we constantly pursue dynamic growth and balance in all the eight dimensions of wellness, we will automatically be able to achieve a better quality of life. Ultimately, a better quality of life leads to avoidance of lifestyle disorders and other diseases, helps in maintaining health and preventing diseases and makes life worth it. We are aware of the significance of a good quality of life and hence continue to emphasize on how important it is and how we are willing to help you achieve and maintain it.

Most diseases can be taken care of by a mere modification in our lifestyle. Prevention is often better than cure. This age old adage that we have been listening to all along is the key to health and wellness. It is an important aspect in the attainment of wellness. Prevention is not given the due it deserves. Most diseases are preventable and it is only a matter of awareness as to how they can be prevented. In the past couple of decades, the focus of healthcare has shifted to prevention of diseases and wellness. The application of preventive measures however is at a much slower rate in comparison with what it should be. The primary reason for this is the carefree attitude of the people, the basic lack of education and awareness. The day we understand the power of prevention truly, is the day when we will experience a paradigm shift in our lives. Let’s understand what exactly is prevention and why is it necessary to emphasize on it. Prevention is basically the act of stopping something from occurring or hindering the occurrence of an event or a thing. Preventive Medicine or Preventive healthcare is a branch of medicine that deals with prevention of disease rather than the treatment of disease. In this branch of medicine, the doctors are taught certain measures that are useful in hindering or avoiding the occurrence of a disease. Just like health and wellness, diseases are also affected by the presence of certain factors like genetic predisposition, environment, and disease causing agents like bacteria, viruses, parasites and most importantly, lifestyle. We have covered most of these aspects in detail in relation to health, wellness and lifestyle disorders. In relation to diseases, their role is slightly modified. They act as the things that can be avoided in order to stay away from disease and keep in good health to eventually attain wellness. Just like health and wellness, diseases too are dynamic in nature. They are underlying processes which manifest themselves much before we can identify how and why they are occurring. However, with years of research, certain factors have been identified which can be hindered in order to prevent diseases. These are actions that are carried out in the anticipation of stopping the occurrence of a disease in a person.

Preventive measures are important in a variety of diseases right from infective to lifestyle disorders. Vector borne diseases like malaria, bacterial diseases like cholera, lifestyle disorders like hypertension and diabetes can all be prevented. The best example of preventive measures causing complete eradication of a disease is smallpox. Smallpox was completely eradicated by the use of vaccination and ever since, various vaccines have been developed that act as great preventives against a variety of diseases. Preventive measures can be classified as primordial, primary, secondary and tertiary. This classification depends on the stage at which they are used in the prevention cascade of a disease.

There is an important role played by the preventive healthcare services in decreasing the morbidity and mortality in the entire society. They reduce the occurrence of chronic diseases, suffering, disabilities and deaths. They then help not only in expanding the life span of an individual, but help in doing so with an improved quality of life.

Your primary healthcare physician plays a very important role in the prevention of diseases. He/ She is responsible for suggesting the necessary preventive measures one must take in cases of outbreaks of various diseases. They can suggest such measures based on evaluating your health status, your family and past history and your lifestyle etc. At Eternesse Medical Centre we are well aware of this responsibility and make it a point to create awareness regarding various endemic and epidemic diseases, to help you know the risk factors for a particular illness you might be predisposed to based on your history, to help you follow the vaccination schedules for your children and to exchange tips for a balanced and healthy lifestyle. One must have a good relationship with his/her primary health care physician so as to be aware of the preventive measures for various diseases. It has been observed that a majority of the preventable diseases occur due to a lack of communication between the patient and his/her doctor. It is our duty at Eternesse Medical Centre to bridge this communication gap and we take our responsibility towards you and towards your health and wellness very seriously. We accomplish this with regular health screening, awareness, education regarding lifestyle measures, wellness clinics and other basic primordial and primary preventive steps. It is via this method that we aim to nip illnesses in the bud and help you attain wellness.

Our screening programmes include monthly health check-ups, hypertension screening, regular blood tests for blood glucose levels, calcium and vitamin D levels, lipid profiles for cholesterol levels, thyroid function tests, bone density evaluation and other tests as per your individual health status and needs. Apart from these basic tests we also provide custom-made screening routines for you based on your age, sex, occupation, lifestyle and the stresses you encounter on a daily basis. We also provide special screening routines like mammography, Pap smear, screening for various types of cancers, HIV and STD’s. Genetic Screens, genetic testing and counselling are also made available for your benefit at Eternesse Medical Centre. And we do all of this at an affordable cost to ensure full comfort and value for money that you spend. These are a part of our wellness profiles.

Wellness profiles are basically a group of health screens and investigations that we carry out at stipulated intervals in order to screen you for the predisposition to certain diseases and prevent their occurrence. Wellness profiles range from basic to premium based on the package that you avail of and upgrades are always available. These profiles are one of the key steps in prevention of diseases and attainment of wellness.

There is a bone health profile which includes tests like serum calcium levels, vitamin D3 levels, alkaline phosphatise levels and bone densitometry; obesity prevention profile which includes BMI screen, lipid profile, thyroid function tests, liver function test and serum cortisol levels. Anaemia profiles include tests like CBC, ESR, Thyroid function tests, Lipid Profile, Serum electrolytes, Liver function tests, Renal function tests, Iron studies, Vitamin B12 and Vitamin D3 levels. Infertility profiles, tumour scans, arthritis profiles, immunological disorder screen, cardiac health profiles, cardiac risk markers, children nutrition profiles, blood disorders profile, fever profile, new born screens, ANC profile, pregnancy profile, women health at 40 profile and many others are also available. In addition to these, custom-made profiles according to your case history, genetics and predispositions can be made.

Wellness profiles are again a relatively new concept that we are introducing via Eternesse Medical Centre. Wellness is introduced right since conception to the patrons of Eternesse Medical Centre. This is initiated via the ANC profile screens that we have. The health of the mother is primary for the health of the child. The only way in which a child is connected to the outer world is via the mother. And it is hence important that the mother be in optimal health both mentally and physically so that the child born is healthy. For this the ANC profile is done. This includes regular health check-ups, investigations, ultrasound scans, anomaly scans, weight monitoring graphs etc. Along with the ANC profile there is also an ANC clinic where lectures for awareness, exercises during pregnancy, birthing lessons, sessions for answering questions related to pregnancy and childbirth, diet and nutrition advice, garbhasanskar and many other such activities are carried out for your benefit. These sessions are conducted in groups followed by one-to-one interactions. Thus, wellness is focussed on right since the conception of the baby in the womb. Age appropriate measures are then taken based on these wellness profiles for promoting health, preventing disease and attaining we

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