Health and wellness is becoming increasingly interested in data and technology. We’re looking for innovative ways to tweak our health through the proverbial ‘push of a button.’ The idea itself is deeply rooted in our cultural Zeitgeist. Lead by Silicon Valley, twenty-first century America is constantly looking to step into a new and promising future where everything, including we humans, are optimized through the help of our inventions. But when you peel back the glitz and glam you realize that technology doesn’t capture the full picture of human thriving, which makes the question of whether or not it will be able to deliver what it promises a very big, and very open one. If we’re looking for a hint though, the health and wellness scene is a good place to start.
The Promise Of Tech
Future historians looking to gain an insight into the ethos of our time could do worse than to look at the mission statements of some of our largest companies. Uber’s, for example, reads, “We ignite opportunity by setting the world in motion.” Facebook declares that they exist to, “give people the power to build community and bring the world closer together.” Microsoft hopes to “empower every person and every organization on the planet to achieve more.” What’s notable about these mission statements, and many others like them, is that they are about something bigger than their product. It’s not just making and selling, it’s providing opportunity, bringing people together, helping people create—messages both aspirational and far-reaching. When we take a step back though, we can see how these statements might be a bit of a stretch. They’re a stretch because the products themselves do not actually shape people; people shape the product. Facebook decides what to show you based on what you already look at. Microsoft allows you to express whatever is most important to you, especially when it lends itself to spreadsheet form. Even Uber is simply offering you another convenient way to get where you’ve already decided you want to go.
The fact that these products and services mostly aid us in what we are already up to is, arguably, one of the main reasons we are becoming disillusioned with them. They promise to help lead us toward a better future, then reinforce the habits, decisions, and opinions we’ve already made. Why the disconnect? How come our data and technology doesn’t seem to be bringing out the best in us?
Tech-Up Your Fitness
That question is certainly a large one, and could be approached from many different angles. However, one great place to look is actually athletics and health and fitness. Human beings, from pro-level athletes to regular exercising Joes and Janes have a vested interest in maximizing their physical performance. Athletes want to kick ass in their sports, regular people want to kick ass in life. Thanks to the sheer amount of capital involved in both industries, there has been plenty of research, data collection, and technology development to service those ends. We know a great deal about training the human body. We know the principles of optimal recovery, optimal nutrition, optimal training design, optimal injury management and mitigation and so on. And, true to our time, all of this knowledge is being converted into technology. We’ve got fitness trackers, nutrition trackers, and sleep trackers; genetic testing, microbiome sequencing, and blood analysis—all of of which are becoming more and more accessible to the general public. Resistance, it seems, is futile. But has any of this tech actually produce the results in the health and wellness scene? Does it make us better athletes, more fit citizens, more productive humans?
The available research is less than overwhelming. Studies on activity trackers tend to show that people drop off from using their devices pretty quickly after the initial novelty wears off.1 2 Worse still, even when people are using their devices, they do not tend to be big drivers of actual behavior change.3 The results of genetic testing are equally lack-luster. Studies looking at associations between genotype and diet success have so far not been able to show any significant connections between the two.4 Geneticists are also generally cautious at this time. While they may have high hopes for the future possibilities of genetic testing, they acknowledge that as of this moment, the research is simply not there.5
Why are the results so ambiguous? One plausible answer is that knowledge is only power when you know what to do with it.
Put me In Coach
If you google ‘best coaching advice’ you will not find a list of training protocols to follow, of wearable devices to purchase, genetic tests to take, supplements to add to your diet, or superfoods to add to your grocery list. You won’t find any famous coaches talking about the research studies they conducted or the spreadsheets they developed. What you will find are hundreds of quotes that say something like “be open-minded,” “see the best in everyone,” “coach the person, not the athlete,” “listen,” “inspire,” and so on. This is because coaches understand that helping a person to achieve their maximum potential is not about simply knowing the most efficient, scientific method for stimulating a result. It is about dealing with the human being. The best coaches know the science, but they also know their players. They know which of their athletes handle pressure well, and which don’t. They know who responds to tough love and who to encouragement. They know who can practice just as hard on poor sleep and no breakfast, and who will fall apart and get hurt. They know when the moment is right to push for a top performance and when to wait. They know when a smile or an inside joke is the way to get a person’s head back in the game. These are the things that science and technology don’t do particularly well.
These less tangible skills—the soft, interpersonal ones—are what can get a person to perform a task, whether that task is making the final shot or rejecting the extra dessert. What happens when you trade good coaching in for some type of technological solution?
We’ve got one good example in twentieth century American healthcare. In the 1960s, fifty percent of medical graduates studied and then went into primary care. In 2015, that number had shrunk to thirty-three percent. 6 A recent article in the Atlantic shows one way in which this trend can have disastrous consequences, and it comes down to coaching. The piece profiles one Dr. Lou Ortenzio, a primary care physician in a small West Virginia town. Ortenzio was a primary care physician whose story is a model for the general trend we’ve observed in the second half of the twentieth century. In the beginning of his career, Ortenzio was the kind of small town doctor who provided personal, intimate care to his patients. So the Atlantic:
His patients called him “Doc O.” He made time to listen to them as they poured out the details of their lives. “To me, he wasn’t like a doctor; he was more like a big brother, somebody I could talk to when I couldn’t talk to anybody else,” says Phyllis Mills, whose family was among Ortenzio’s first patients.
Ms. Mills is describing Ortenzio as the kind of doctor who would come to know his patients well, their families well; their very lives well. The deep and personal relationships that he built gave him insight into how to best promote their health. This Dr. Ortenzio was, in short, a kind of coach. His personal touch made him very popular, and he became a very successful, and very busy, doctor. Unfortunately, his success was a double-edged sword. Like many doctors during the 1980s and 1990s, as insurance reimbursements for run of the mill visits to the doctor’s office declined, he found himself seeing ever more patients, with less and less time for each, just to continue earning the same money. Moreover, with fewer young primary care practitioners coming out of medical school, small towns like his were slowly losing doctors. When someone retired, there was no one to replace them.
Caught in the middle of the trends, Ortenzio found himself getting squeezed. He was holding long hours for less money and it was having a negative impact on his personal life and health. At the same time, drug companies were telling the public through television adds—a gift of deregulation from our Congress—that great drugs were available for what ailed them.7 Those same companies would visit doctors and let them know that there was a quick fix for the patients that were coming to them with serious pain problems. The companies had reassuring data and studies showing that this was safe, efficient, and effective. Doctors could spend a shorter amount of time with each person and then solve their problem with the stroke of a pen. Everyone, it seemed, benefited. Twenty-some years later, we all know where this would finally lead. It became the formula by which Doctors slowly stopped giving their patients the kind of personalized, hands-on care that could make a real difference in their health and instead began giving them the quickest and easiest solution to their problems. The market, and their patients, were demanding it. The final result was the demise of Ortenzio’s small-town touch and the rise of the pharmaceutical solution. The trajectory eventually funneled him and his patients into the opioid crisis.
So Far, Personal Still Trumps Technical
The lesson we can learn from stories like Dr. Ortenzio’s is that often, when it comes to people and their health, the quick fix is too good to be true because people just aren’t that simple. With human performance, the key is still figuring out how to change a person’s behavior, and that requires more than data or tech. That requires deeper, personal work. Good coaches do this kind of work, which is why good coaches create results in whatever their chosen field is, be it sports, personal fitness, medicine, psychology, or whatever can be positively influenced by getting at a person’s behavior.
Knowing this, we should be wary about how much faith we put in the technological solutions that are coming out every day. Fitness trackers show people how many steps they take, but that doesn’t necessarily make them walk more. Genetic testing might show you some interesting probabilities, but it’s not likely to make you any better at resisting a second glass of wine. Supplements, cleanses, and superfoods deliver certain nutrients, but that doesn’t make you a healthy eater. To be sure, data and technology can be a tool to help gather and organize information, which could in turn help a person see what needs to be changed, but that change will still have to come from inside because in the end, the real catalyst for change always comes from within. The technology—from apps, to drugs, to tests—won’t do that part for you.
References:
- Harvard Health Publishing – Activity Trackers: Can They Really Help You Get Fit?
- Gartner – Gartner Survey Shows Wearable Devices Need To Be More Useful
- JAMA- Wearable Devices As Facilitators, Not Drivers, Of Health Behavior Change
- Effect Of Low-Fat Vs Low-Carbohydrate Diet In 12 Month Weight Loss In Overweight Adults And The Association With Genotype Pattern Or Insulin Secretion
- Wired – You Don’t Need A Personal Genetics Test To Take Charge Of Your Health
- American Journal Of Medicine – Where Have The Generalists Gone?
- Direct To Consumer Pharmaceutical Advertising