Q&A with Dr. Bill Hettler, MD, the father of American wellness

Over a series of discussions, I had the chance to talk with Bill Hettler, MD (retired), a wellness pioneer and the author of the Six Dimensions of Wellness model. Our conversation touches upon why wellness matters, wellness models, and programs, among other topics. Here are some excerpts from our conversation:

Adam Rozan: How do you define wellness?

Dr. Bill Hettler: Wellness is an active process through which people become aware of and make choices toward a more successful existence. And we encourage people to look at multiple dimensions in their life, not to become focused on any one component, but all aspects of their life, and importantly how they spend their time.

Q: Okay, let’s talk about wellness and how you came to create the six-dimension wellness model in 1976? Which is the original diagram that explores fitness through multiple categories, such as physical, emotional, and intellectual wellness, to name a few.

BH: You know, one of the simplest ways to understand wellness as a concept is the old YMCA triangle, that of the body, mind, and spirit.

I looked at how people spend their time, and that's how I came up with that six-dimensional model and the dimensions that I ended up using.

I created an assessment tool/instrument for college students to use as a health screening tool, and it was initially called the Lifestyle Assessment Questionnaire. That’s what led me to this work, and in working with students, I realized I needed to have a tool to use.

Q: That’s interesting, so the Lifestyle Assessment Questionnaire was based on the six dimensions wellness model. For readers unfamiliar with the Six Dimensions Model, please explain what it is and why it’s necessary to have this diagram?

BH: The goal is to find things that people would be interested in to see what was needed to heal themselves and improve their lives. The six dimensions are social, occupational, spiritual, physical, intellectual, and emotional. And those were areas of people's lives that they often would spend the most time.

We were trying to develop a program that students would be interested in. We saw that if we got them interested in one of those dimensions, then, we might be able to do some cross-referencing while we have their attention on one dimension, then we could have them consider other dimensions where they may have been neglectful at their development at that point in their lives.

Q: So, the six dimensions model is a tool for users to reflect on the various elements of their life, where they have control over, and where they spend their time?

BH: The tool’s purpose was to create a teachable moment to get people to pay attention to the most important thing: their own life.

Q: Why did wellness become such an important topic, a national, international topic of conversation?

BH: What has happened is that medical care costs have continued to rise exponentially. And many people now are beginning to recognize how important it is not to wait for things to go wrong and then try to correct it, but to try and live in such a way that you are moving towards a more successful existence like in the [wellness] definition.

Q: You’re now retired; when you did work, what did you do?

BH: In the 40 plus years that I worked, I had many jobs in my life. At one time, I even worked for the post office. I worked at a summer camp as a waterfront director, a lifeguard, and even a counselor for kids. I also spent two years in the Air Force, where I mostly did pediatrics and primary care for soldiers. I was an ER physician for several years early in my career.

And, for 40 years, I worked at a university health service [University of Wisconsin Stevens Point], where I taught and practiced medicine, and, starting in 1977, I became the director. Hence, I had some responsibilities for administration too, but I always worked at least 50% clinical or practicing medicine. The other 50% of my time was spent being an administrator, managing, setting up position descriptions, hiring people, and so on.

And, and the other third of my life, the third 50% of my work (laughs, I know that means I worked 150% of time possible), also started in 1977, when I started the National Wellness Institute with friends of mine. That took me on the road quite a bit, traveling worldwide, running the Institute with two of my friends, and I did that for 30 years.

Q: Your program at Stevens Point, where you worked students, would that be considered the first or at least one of the first wellness programs? 

BH: Yes, that's right, and UW-Stevens Point was featured on Good Morning America as one of the most progressive wellness programs in a university setting.

Q: So fast forward, wellness programs are now commonplace, as are wellness models. They’re different from your original model, with the number of dimensions changing, along with the definitions. What are your thoughts on how the wellness dimensions evolved?

BH: You know I'm glad you asked that question because, over the years, you know other models were discussed and shared by other leaders in the field, and these discussions did routinely come up. One of my favorites came from an expert named Robert Allen, and I'll share his quote with you. He said the best model is the one that you use. People want to argue theoretical models; they could spend their whole life doing just that. But if you're serious about living a better life for yourself, then you got to start doing it.

Sure, it has to do with behavior. The wellness assessments that I developed over the years had to do with personal choices that people made; it’s not what you say you'd like to do; or how many friends you've got; or; how many likes you got on Facebook or Instagram or something like that. It's what you do with the hours you have each day.

Q: Yes, that makes sense. For readers using the dimension model for the first time, any pointers?

BH: You first must start with some assessment. In other words, you got to know where you are, a starting point. And we developed over the years many instruments that would help people measure how well they were doing and what they could do to improve how well they were doing. The next thing you would try is to create a teachable moment. You say, all right, well, look, you only scored 75 on that dimension of wellness. Do you want to know what you could do to improve your score? Most people would say, “Yes, I am interested.”

And by the way, most people do want to improve their scores. Very few people say, “no,” I want to be worse, or I'm interested in getting worse than I am right now.

Q: Let’s talk about Wellness programs; why are these programs important to businesses, universities, employees, and students?

BH: Wellness programs are helpful in that they're going to save the organizations or companies money in the long run by having a healthier workforce; right, and there other reasons why organizations want this.

If people are feeling better about themselves, they're going to be happier, and they're going to be more productive employees. So, it has to do with retention, Adam; the retention of employees, you know, it's a costly process.

During times of high turnover, you have to replace people and go through the selection and hiring process, then on-the-job training or orientation, and so on. That's a costly process, with all that's happening in the staff hiring and retention area. The companies that have wellness programs are more likely to be concerned about the wellness of their employees, their families, customers, and so on, and that’s a good thing.

Q: Today, wellness and happiness are mainstream topics that are routinely discussed, written about, and as such, are everywhere. And yet, loneliness and other societal issues have risen to epidemic levels. If everyone is talking about being happier and improving overall wellness, why are we lonelier and more isolated as individuals and across our society?

BH: You know what is happening in the world today, including the global pandemic. Plus the polarization that's occurred in many countries, with some very aggressive conservative thinkers is leading to many dysfunctions, and people aren’t happy. Add the restrictions to everyday routines, the average daily activities that they can’t do, and the constant changes that occur, that’s enough not to be satisfied with their lives right now.

As individuals, we’re constantly wondering how other people are spending their time each day, right, when they could be thinking about the changes that need to happen in their own life.

Q: What do you think is the future of wellness as well?

BH: You have to be optimistic about it [wellness] because it's such a positive force. As I said, there's nobody interested in pushing the worst in this way of life. The wellness way of life leads to that happiness you talked about earlier.

And if you check the places in the world where people are the happiest, you're going to find many wellness activities going on.

Q: That is a beautiful way to end it. Thank you.