Wellness Reimagined: Dr. Turner Osler Of QOR360.com On 5 Things That Should Be Done To Improve and Reform The Health & Wellness Industry

An Interview With Maria Angelova

Prioritize problems that are having large impacts on our health. Clear skin is nice to have, but type 2 diabetes shortens lives and is a leading cause of blindness and amputation. Surely the Health and Wellness industry should find a way to prioritize diseases with grave consequences over those that are better described as “concerns of the well”.

In our world of constant change, and with life moving faster than ever, topics such as mental health, self-care, and prevention have become popular buzzwords. But there are misconceptions about the meaning of self-care and exercise. Many opt for quick solutions — surgery, pills — to dull the problem without adequately addressing the underlying cause. Meanwhile, many parts of the industry are unregulated and oversaturated. People with years of training are competing with people with weekend training. Many providers are overworked, overwhelmed, and underpaid. The general public is not educated about asking the right questions when selecting a wellness provider. In the face of all this, what can be done to correct the status quo? In this interview series, we are seeking to hear from a variety of leaders in the health and wellness industries who agree that the wellness Industry is in need of an overhaul and offer suggestions about what can be done moving forward. As a part of this series, I had the distinct pleasure of interviewing Dr. Turner Osler.

The founder of Vermont-based, QOR360, Dr. Osler is a retired academic trauma surgeon and researcher, and has over 300 peer-reviewed papers on his CV. But after receiving a master’s degree in biostatistics and a grant from the National Institute of Health in 2005 he traded the OR for full-time outcomes research. He became interested in the health problems created by our passive, hair centric lifestyle, and has spent the last few years studying “sitting disease” and ways to combat it.

Thank you so much for doing this interview. It is an honor. Our readers would love to learn more about you and your personal background. Can you please share your personal backstory? What has brought you to this point in your life?

I have the usual academic trauma surgeon back story: BA Neurobiology (Princeton), MD (Medical College of Virginia), surgical residency (Columbia, Harvard), fellowship (University of New Mexico) and then 20 years an academic trauma surgeon (University of Vermont) with over 300 peer reviewed papers and book chapters. But then I went off script, got a masters in Biostatistics and an NIH grant and abandoned the operating room to study trauma epidemiology. Somewhere in the last decade I became obsessed with the problems that come from sitting too much, and especially sitting badly. Now an Emeritus Professor at the University of Vermont, I split my time between my family, my epidemiological research, and running a little startup with some friends that aims to improve the way we all sit.

What is your “why” behind the work that you do? What fuels you?

I’m driven by a delight in solving problems. The experience is made sweeter by solving problems that are worth solving, and by working with a team of similarly committed people. For me the most important solutions are those that directly help people live better and healthier lives. I’ve been fortunate that each of my careers has indulged this need. First as a trauma surgeon, solving one patient’s problem at a time in the operating room, and later as an epidemiologist, an enterprise where solving a problem can help millions of people at a single go. And now as an entrepreneur, working to solve the problem of “sitting disease”, a constellation of health problems brought on by our addiction to passive sitting that affects hundreds of millions of people.

What are some of the most interesting or exciting new projects you are working on now?

I’m currently working with a team of engineering students and programmers to create an app that will allow people to keep track of how many calories they aren’t burning while sitting slumped at their computers. Importantly, this app also has a “movement snack” game to get people seated at a keyboard to move more, and burn more calories. The great thing about this app is that it uses the accelerometers in any smartphone to monitor movement; because no hardware is required, we’ll be able to give away this app, which we hope will inspire millions of people to move more, and stay healthier while sitting. It’s an epidemiologist’s dream app.

Speaking of epidemiology: An epidemiologic problem I’m currently working with a team of researchers and mathematicians here at the University of Vermont and Norwich University is trying to bring the power of artificial intelligence to bear on understanding the consequences of gun violence in America. This is “geek squeak” stuff, but I find it exciting, because if we can better understand gun violence, we may be able to reduce the carnage in the United States where every year 117,000 people are shot, of whom 41,000 go on to die. So, a big and important problem.

It has been said that our mistakes can be our greatest teachers. Can you share a story about the funniest mistake you made when you were first starting? Can you tell us what lesson you learned from that?

This may be funny only to surgeons, but many years ago I was called in the middle of the night to see a patient who had been hospitalized with a duodenal ulcer. As sometimes can happen, his ulcer had suddenly begun to bleed, and bleed a lot. By the time I was called he had lost half his blood and was well on his way to dying. But when I told him we needed to go to the operating room immediately he declined; he was an engineer and was used to solving his own problems and surgery sounded scary. I was far enough along in my career that I though I was pretty good at talking to patients, but the guy wouldn’t budge, and time was running out. At that moment I was rescued by one of my much younger colleagues, still very early in his training. He pulled me aside and said “You just go get the OR set up; I’ve got this”. I had the good sense to listen to the kid, and sure enough he wheeled the patient into the waiting OR just a few minutes later, and handed me the signed consent form. Hours later with our patient patched up and safely in the ICU, I asked my young colleague: “How on earth did you do that?” To which he replied: “Easy. I called his wife.” I think I learned two things from this: First, you never know who you next teacher might be; it could be your erstwhile “student”. And secondly, if you need to talk some sense into a patient, sometimes it’s a good idea to outsource it to the spouse.

OK, thank you for all of that. Let’s now shift to the core focus of our interview. From where you stand, why are you passionate about the topic of Reimagining The Health and Wellness industries? Can you explain what you mean with a story or an example?

The health and wellness industry has great potential, but is rife with missed opportunities. As a work-a-day physician I often knew what patients needed, but sometimes had a hard time persuading them to follow through on my recommendations. The Health and Wellness industry is gifted by having a very motivated community, but too often the recommendations that are made by Health and Wellness influencers are driven more by the search for profit than by the health of their clients. If the Health and Wellness industry can be persuaded to put people at the center of the project rather than profits, well, MDs like me might largely be put out of business. It is this great potential, but missed opportunities, that gets my blood pumping. The big question is: how can we realigned the priorities of the Health and Wellness industry to create real value for their community?

Standing desks are a good example of the “profits over people” problem. Epidemiologists now understand that sedentary sitting is an immense public health problem, reducing our lifespans by as much as two years. In response to this discovery an entire standing desk industry arose almost overnight growing to sales of billions of dollars is a just a few years. But here’s the thing: there is no evidence that standing desks improve health or wellness. The NY Times observed in 2018: “Standing desks are overrated: They’re not cures for anything, and standing is not exercise”. I’m advocating for a Health and Wellness industry where the research precedes the product. As an aside: It turns out the answer to bad, sedentary chair designs is actually chair designs that promote movement while sitting. But that’s a story for another day.

When I talk about Reimagining the Wellness industry, I am talking about reimagining it from the perspective of the providers as well as from the perspective of the recipients and patients. Can you share a few reasons why the status quo is not working for both providers and patients?

Patients and recipients face a daunting landscape when they venture onto the web for information, because on the web it seems authority is always up for grabs. Who’s telling the truth, and who’s running a cash grab? It can be very difficult for those seeking Health and Wellness information to winnow the helpful from the irrelevant or even harmful. New Yorker cartoonist Peter Steiner put it brilliantly 30 years ago: “On the internet no one knows you’re a dog.”

The problem with assigning authority is a difficult one. Here’s a story. I recently read a piece on Medium that touted the necessity of drinking 8 glasses of water each day. This misinformation has been repeated many times, but I messaged the author and explained carefully that he was mistaken on every point in his discussion. I was gratified, but saddened, by his response: He confessed that he had simply recapitulated an article that he had found on the web, and, because this “reference” had over a million reads the poor guy simply assumed that this “reference” must be true. On the web, popularity is taken as a surrogate for truth, not because it gets the right answer, but because it is convenient to calculate. Unfortunately, this shortcut results in popular things becoming more “true”, regardless of their accuracy. This is not to say that the basic algorithm that makes web searches possible (Popularity = Authority) cannot work; it is, after all what makes any web search possible, and it is used successfully in many other contexts. For example, the authority of medical journals (“impact score”) is computed by simply looking at how often articles published in a given journal are cited by other authors. But relying solely upon popularity as a measure of validity can result in feedback loops that promote misinformation. At this point it seems at least some human oversight is unavoidable, but in the longer run AI may provide important support.

This dynamic is also a problem for providers. How can an experienced neurologist with decades of experience treating patients with, say, Parkinson’s disease hope to compete with a 20-year-old TikTok influencer with a million followers who woke up that morning with an idea for treating Parkinson’s disease with garlic? It’s hard for reliable advice to be heard over the din that is the internet. The web provides access to reliable information too, of course, such as scientific journals, but such articles are often placed behind very tall pay walls ($48 for one article!), and in any case reading these necessarily technical articles usually requires a specialized vocabulary. To their credit, most medical journals removed their paywalls for articles concerning COVID during the pandemic, but COVID is a tiny fraction of the questions people have about how to make healthy choices generally.

We all hope, of course, that the marketplace and Google’s search algorithms will make good decisions and lead us toward reliable Health and Wellness resources, but it can be quite a gamble. While crystal therapy is unlikely to harm anyone, dietary supplements are unregulated and may contain harmful substances that have been responsible for thousands of untoward reactions and have contributed to some deaths. Geller et al. reported in the New England Journal of Medicine in 2015 that each year dietary supplements send over 23,000 people to the ER, and this is certainly an undercount.

Why do you think there is a good opportunity now to improve and reform the health and wellness industry?

Now is the most promising time in a long time to start improving our health and wellness industry for at least two reasons. First, we’re coming to understand how crowdsourcing can be harnessed to increase the reliability of a data source; Wikipedia is the preeminent example. Also, artificial intelligence is coming of age, and can scale even more easily than crowdsourcing. While free speech issues won’t allow the exclusion of voices from the internet, content that has been vetted by reliable algorithms could be marked with some sort of “seal of approval”. Informed by artificial intelligence, consumers would be better able to make safe and effective choices for themselves and their families.

Can you please share your “5 Things That Should Be Done To Improve and Reform The Health & Wellness Industry”? Please share an example or story for each if you can.

1. Better science behind claims. Unproven claims, even untrue claims, to health benefits of implausible therapies are far too common. The Health & Wellness industry can do a much better job of requiring better science before health solutions are widely recommended.

2. More exposure for proven approaches (e.g., chat-bots for mental health care). Therapies are evolving so fast that it’s hard to keep up with all the innovations as they appear. As a result, therapies that have great potential are underutilized simply because they haven’t risen to the top of Google’s search algorithm.

3. More time spent debunking clearly ineffectual treatments. You won’t make may friends debunking treasured treatments, but careful review of what doesn’t work is extremely important to a well-functioning marketplace of ideas. Think of debunking as a sort of “immune system” for the Health & Wellness body of information.

4. More realistic recommendations that people are actually likely to follow: It’s difficult enough to get patients to follow good advice, but it’s impossible to get patients to follow recommendations that are simply beyond their abilities or commitment. So, recommendations should be offered on a “sliding scale”: rather than recommending training for a marathon to everyone, it’s important to realize that a 4K is just as big a triumph, and will bring similar benefits, for many people. And, simply because it is attainable, the 4K will benefit many more people and result in a broader public health impact.

5. Prioritize problems that are having large impacts on our health. Clear skin is nice to have, but type 2 diabetes shortens lives and is a leading cause of blindness and amputation. Surely the Health and Wellness industry should find a way to prioritize diseases with grave consequences over those that are better described as “concerns of the well”.

From the recipient and patient side of the industry, can you please share a few ways that patients and recipients should reimagine what the wellness and healthcare industry should provide?

I think prioritizing activities over stuff would be a great place to start: Tibetan salt lamps not so much; how about a Tai Chi class instead? Belly fat burning abdominal belts not so much; how about meditation apps? If it sounds too good to be true, well, probably it is too good to be true.

What do you think are the biggest roadblocks to reforming the industry? What can be done to address those hurdles?

It will be difficult for the Health and Wellness industry to reform itself, because jettisoning treatments and therapies that are of no value or are harmful will necessarily mean lower profits. Indeed, many in the industry will discover that they offer no value and will need to reevaluate their entire approach. Upton Sinclair observed, “It is difficult to get a man to understand something when his salary depends upon his not understanding it.”, so this is an immense hurdle. But I don’t believe this is an insuperable problem: Wikipedia has shown that it is possible for a community to be self-regulating so long as the ground rules are clear and enforceable. “Ivermectin COVID” turns up 10 million times in a Google search, but Wikipedia dispenses with the issue in a single sentence and two references: “During the COVID-19 pandemic, ivermectin was researched for possible utility in preventing and treating COVID-19, but no good evidence of benefit was found.”

I’m very passionate about the topic of proactive versus reactive self-care and healthcare. What do you think can be done to shift the industries towards a proactive healthcare approach? How can we shift the self-care mindset for consumers and providers alike?

It’s common for healthy behaviors to be ignored or avoided until health deteriorates to a point that something must be done. But as Ben Franklin observed “An ounce of prevention is worth a pound of cure”. Franklin was advocating for funding fire stations, but the principle is general: heading off a problem before it gets out of hand is far preferable to dealing with an advanced problem. So, the question is how to tip the Health and Wellness enterprise more toward prevention rather than its current focus on treatment? I’m afraid I don’t have a good answer, to this seemingly universal problem.

But here are a couple of examples from my surgical career: My first career was spent in the operating room taking care of the carnage that resulted from gunshot wounds and car wrecks, just the sort of problems that simply require immediate intervention. But really there are two lessons in this experience. It turns out that over the course of my career car crash deaths dramatically decreased as a result of changes to our infrastructure: better car design, divided highways, seatbelts, and airbags in concert served to reduced auto deaths several fold over my surgical career. On the other hand, deaths from gunshot wounds, continue to increase despite advances in surgical care: surgeons seemingly can’t keep up with the growing problem of gun violence. So, I think the lesson is clear: progress can only be made if we address the root cause of a problem, in this case gun violence, rather than simply playing catchup in the OR.

Thank you for all that great insight! Let’s start wrapping up. Can you share your favorite “Life Lesson Quote”? Why does that resonate with you so much?

As a teacher teaching teachers, I can’t share this insight often enough: “Teaching is listening, learning is talking.” That is, our charge as teachers is really to get our students to be able think for themselves. The internet has rendered the old teach model of conveying information obsolete; anyone can now google anything. The remaining role for teachers, the real role, is to help their students evaluate, understand, and use information.

And speaking of listening, here’s a bonus quote I recently encountered which has been a big help to me each day: “We usually listen in order to respond but we should be listening to understand.”

We are very blessed that some of the biggest names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world or in the US whom you would love to have a private breakfast or lunch with, and why? He or she might just see this, especially if we both tag them :-)

I’d like to get every medical journal editor in a room and pitch to them the idea of getting rid of their pay walls. If they’re really interested in helping their patients, well, a good place to start is providing their patients with the best available information. Besides, federal money pays for most research, so charging our citizens for access to the research that they already paid for seems like double billing. I’m lookin’ at you, Kirsten (JAMA) and you, Jeffery (New England Journal of Medicine), and all the rest of you guys: let’s put patients over profits, shall we?

I appreciate your time and valuable contribution. One last question, how can people reach or follow you?

I can be reached through my University of Vermont email: tosler@uvm.edu. I also occasionally write for the Vermont paper of record, VT Digger (vtdigger.org), and even more occasionally on Medium (https://turneroslermd.medium.com/); I also write a monthly blog (https://qor360.com/blog/).

This was very inspiring. Thank you so much for the time you spent on this. We wish you only continued success.

About The Interviewer: Maria Angelova, MBA is a disruptor, author, motivational speaker, body-mind expert, Pilates teacher, and founder and CEO of Rebellious Intl. As a disruptor, Maria is on a mission to change the face of the wellness industry by shifting the self-care mindset for consumers and providers alike. As a mind-body coach, Maria’s superpower is alignment which helps clients create a strong body and a calm mind so they can live a life of freedom, happiness, and fulfillment. Prior to founding Rebellious Intl, Maria was a Finance Director and a professional with 17+ years of progressive corporate experience in the Telecommunications, Finance, and Insurance industries. Born in Bulgaria, Maria moved to the United States in 1992. She graduated summa cum laude from both Georgia State University (MBA, Finance) and the University of Georgia (BBA, Finance). Maria’s favorite job is being a mom. Maria enjoys learning, coaching, creating authentic connections, working out, Latin dancing, traveling, and spending time with her tribe. To contact Maria, email her at angelova@rebellious-intl.com. To schedule a free consultation, click here.