Why I Dislike The Worried Well

So I've got a bit of a confession to make here. I really don't like the worried well. I just don't like it. What I mean by this, if you haven't come across this term before, the worried well is a term used to describe a patient who is basically okay, doesn't really have a problem, but is very, very worried about something. Like they have a minor strain, but they're catastrophizing and they're obsessing about it. They're getting all worked up about something that doesn't really matter. The implication being that they're kind of wasting your time by coming to see you. Or they think it's this really big thing, but actually just like a little bit of reassurance and don't worry like that scratch you've got is going to heal, it'll get better. Now, when I say I don't like the worried well, I'm not actually referring to those patients, I'm referring to the term. I really, really dislike this term. And the reason I was thinking of it today is because I'm actually going to go see a very big speaker in the pain science world and I'm going to see them do a seminar. And I've seen it before, I'm going back to see it again because the way they do things, the way they go about communicating with patients is in a lot of ways fantastic. But last time I saw them, they use this term, the worried well. They said, well, most manual therapy cases, most musculoskeletal cases in private practice are really just the worried well. They just need a little bit of assurance and off they go. They don't really need our care. And I take issue with that. I don't like that because to me, I don't see how you can say that and describe somebody as the worried well and come from a patient centered perspective. The reason for that is when you say worried well, what you're essentially doing is putting a value judgment on somebody else's suffering. You are saying the amount of suffering that you experience is not in proportion to what's going on. I think you're wrong to be suffering that. I think you just need to change your perspective. You're essentially saying, my perspective is better than yours and I want you to have mine because your perspective is wrong somehow. Now, are there patients who really just need a bit of reassurance sometimes and that goes a long way to helping them get better? Absolutely. Often patients are freaking out about something and we are in a really fortunate position as trusted healthcare practitioners to be able to reassure and go, actually, I know that your sister had this same kind of pain and it turned out to be bone cancer. But in your case, that doesn't fit because of da da da da. So we can rule that out. That's a real gift to be able to do that. But we have to acknowledge their perspective first. We have to take that on board. And describing somebody as the worried, well, to me, it dismisses that. And I think it's actually quite patronizing and condescending. It smacks of this idea that, like, well, your suffering really isn't that bad, and I'm gonna correct your wrong thinking and thank God I'm here. Because really, you don't need to be here. You're wasting my time. And trust me, you shouldn't be suffering that much. I don't really see how that's not Dr. Centered. I don't see how to use that term without it bringing a lot of that baggage with it. The other thing that I do see as well, that is often utilized by people who are using this term is it's used to kind of. I don't know if they're aware of this. I think it's probably subconscious, but it's to prop up this little bit of ego that's like, well, you know, those other people, they just treat the worried well, I'm dealing with real chronic, severe cases. You know, I'm actually treating the people who really. I'm taking all the difficult stuff, the complex stuff. I'm only treating the patients who need me. And I get that. And yes, certainly treating chronic cases, that is more of a challenge there. But to then dismiss a whole bunch of people as the worried, well, my reaction to that emotionally is to go, well, who are you to say this person doesn't deserve your care? Who are you to say this person doesn't need some care? Maybe even if they don't need as much as you think, maybe you can meet them where they're at. Maybe you can find out why it is they're suffering, what they're so afraid of, what they're so anxious about. Before we use this term and dismiss them as the worried, well, now, I don't know. In this person's case, I hope they're not using that as soon as they meet the person. I really hope they're not using it with the patient. But I think we need to have a discussion about the way that our language to each other then affects the way that we interact with patients as well. Because using that term, it seems to foster more of a doctor centered patronizing approach. It seems to come from a place often of being on a high horse. And I will condescend and come down to this poor patient to fix their wrong thinking because actually they don't have a problem and I think they shouldn't be suffering this much and I think they're out of proportion to it. Now, maybe I'm wrong. Maybe there are ways of using that term that are useful. Maybe it is possible to do both, to actually look at it and go, this patient is essentially worried about nothing. But I can correct that without having to condescend. I think that's possible. But. But I don't know if the term is really useful. But like I say, maybe I'm wrong. Maybe I'm missing something. Let me know. Do you use this term? Have you used it? Do you like it? Do you dislike it? Do you think there's other baggage associated with it? Do you think I'm making a mountain out of a molehill? And it's really not used that way a lot of the time. Have you never heard of it before? Whatever it is, let me know. Reply to this email or drop me a comment below because I'd love to have more of a conversation about this. You know, I'm just sharing my opinion. This is one person's opinion. Many of you are going to have different opinions of that. And I'd love to have a conversation because I think we can all learn more together. So pop that in the comments below and I'll see you soon for another video. Bye.