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A perfect example of doing wellness FOR employees and not TO them

I just posted a “financial wellness” opportunity that will reduce employee stress and increase their appreciation of their employer, doesn’t even require a budget and might actually be cash flow-positive for the employer.

It’ll be interesting to see if anyone actually does it.

Comments appreciated–might as well add them right on the posting so that someone sees them other than the usual suspects.

The Bad News about the 2016 MBGH Annual Conference

The bad news is this: you’ll never want to sponsor, exhibit at, or even attend another conference after this one.  The Midwest Business Group on Health just set the standard so high that any other show would be a letdown.

The regional business coalition shows–lately I’ve done Philly, Northeast, Pittsburgh, and South Carolina–have all featured excellent speakers and diverse attendees.

It turns out there is a specific reason for this: the regional coalition charters typically require that actual employers comprise the majority of the boards and attendees.  Consequently, their conference agendas are not exclusively devoted to vendors breathlessly pitching their outcomes fantasies, punctuated by genuflections to the “Harvard Study” and its 3.27-to-1 ROI.

Instead, the speakers are edgy and controversial. (“Controversial” means “agree with me.”)  I would even concede that one of them — Todd Bisping of Caterpillar — was more entertaining than I was.  I made a mental note never to present directly after him.

The conference organizers, Larry Boress and Cheryl Larson and Mindy McBee, selected a great venue on the 80th floor of a Chicago skyscraper, designed the layout so that vendors would be in proximity to attendees but not in their faces, and provided some relaxation/meeting space as well.  All the food offerings were delicious and, yes, healthy.  (Plus, Zipongo was giving out goji berries.) There was just the right ratio of people to space, so that it felt energized but not crowded, and there was none of that feeling you get in large conference venues of endless walking in cavernous marble vestibules.

The whole thing ran very smoothly.  It usually takes a lot of work to make something look easy, and I’m sure this was no exception.

And, yes, I know it’s not always about me but my presentation was very well-received. MBGH conducted one of those electronic polls, both before and after my slides, to see what people thought of wellness economics. Because this was a sophisticated audience, even the “before” picture showed that only 20% of attendees were pleased with their wellness program’s outcomes.  45 minutes later — same question–only 10% were.

Following my keynote was an expert reaction panel, featuring Bruce ShermanTom Ciccotti, Sandra Morris and Kim Dwyer. As a “reaction panel,” they were supposed to give me hell but really they only gave me heck, meaning mostly in agreement but bringing up a few issues I had overlooked or understated. Tom quite justifiably called me out on making sure I drew a bright line between “pry, poke and prod” programs vs. “wellness for employees,” a category that includes a lot of emerging programs that he has industry-leading expertise with.  Bruce brought up the importance of stress and financial well-being programs, which I hadn’t mentioned but which are increasingly important, prevalent and, needless to say, preferred by employees over pry, poke and prod.

I had urged screening according to guidelines. Sandra pointed out that the USPSTF guidelines give skin cancer screening an “I”, meaning not enough information. Skin cancer would be one place where a company might recommend and fully cover screens above and beyond USPSTF, since USPSTF seems timid on this score.  Skin cancer would seem to fit the bill for screening, as it is very common and the consequences of “false positives” are quite minimal.

As an aside, I have always maintained a company shouldn’t be wedded to the USPSTF–but if they deviate, they need a very good reason. “The employers make us do it,” the excuse offered by Optum’s Seth Serxner for overscreening, would be an example of a reason that does not fit that description. This is especially true when Optum’s PR person — after accusing me of making Optum “look bad” by quoting Mr. Serxner verbatim — was subsequently unable to identify a single employer willing to state: “Yes, we decided to overscreen employees despite Optum’s objections.”

Kim Dwyer disagreed with my overall assessment of wellness economics. She stated that her organization’s wellness program will pay off in reduced wellness-sensitive medical events in 2018-2020.  I wish her the best in achieving that goal and as of this posting am now offering to measure those outcomes gratis.

The conference also featured a free vendor wellness screening that included checking the tightness of employees’ calves. Loosening employee calves is the key to reducing healthcare costs and increasing productivity, For example, suppose your wellness programs recommends drinking eight glasses of water a day.

If you get up from your desk too quickly because you really really really have to pee but your calves are tight, you could tear your Achilles heel.

Fortunately that won’t happen to me. This vendor stretched my calves out quite a bit. And they stayed loose, probably looser than they’ve ever been–until I was asleep, when the left one went into spasm.


Does Today’s NY Times Spell the End of Corporate Weight Loss Programs?

They say: “Vivaldi didn’t write 400 violin concertos. He wrote 1 violin concerto 400 times.”

Whether you agree with that assessment or not (or whether, like us, you could care less because your idea of “classical music” is Meet the Beatles), the same is true of They Said What: the 200 seemingly different posts on this blog are really the same post 200 times, in that we always say the same thing, albeit a bit differently.

Actually ours are five different posts, an average of about 40 times each because we say five different things:

  1. Wellness is a waste of time and money that is now proven to make spending increase;
  2. Wellness can harm employees;
  3. Wellness vendors lie;
  4. You cannot pay, bribe, shame, fine, coax, cajole, threaten, browbeat or embarrass employees into losing weight;
  5. Even if you could, it won’t save you any money.

Today’s theme is #4. Obesity is a complex biochemical phenomenon that is poorly understood both by the finest minds and also by wellness vendors.  The only thing the former agree on is that you can’t cure obese patients by with finances, so naturally that’s what the latter advocate, because, like Willie Sutton said about robbing banks, get-thin-quick contests are where the money is.

We have already called out ShapeUp, Wellness Corporate Solutions and HealthyWage for these worthless and hazardous programs. They all know better but in wellness, filthy lucre trumps integrity.

Still, these companies couldn’t sell this nonsense if you didn’t buy it, and now there is a terrific study in the New York Times (a preview of a study coming out in Obesity) on why you shouldn’t buy it. The study tracks what happens to “Biggest Loser” contestants after the show ends. It turns out [Warning: SPOILER ALERT] that…

…are you ready for this?…

These contestants have already gained most of their weight back.

Usually we point out that because corporate get-thin-quick contests count only active motivated willing participants and don’t count non-participants or dropouts, self-selection accounts for a large chunk of the alleged favorable outcomes. However, who could be more motivated and self-selected than a participant on a reality show, one that requires multiple rounds of auditions and that, for winners and runners-up, brings the promise of at least temporary wealth and fame?  You can’t ask for more motivation than that.

And yet…

These contestants have already gained most of their weight back.

Are you noticing a theme here?  We recommend reading the article in its entirety. It turns out that your body “fights very hard to gain the weight back,” as the article says. Contestants’ metabolisms consistently and significantly slowed following the initial weight loss, meaning that 13 of the 14 contestants are actually worse off than if they hadn’t been on the show in the first place. The measured change in metabolisms isn’t trivial — it’s many hundreds of calories a day.

The beauty of this study was how carefully these folks were tracked, and how motivated they were to stay thin. Biochemistry trumps motivation.

And of course, we are happy to help you get out of your contracts with these vendors and demand your money back. Then maybe you can spend that money on something with a higher benefit-to-cost ratio than get-thin-quick programs — like, as Dee Edington said a decade ago, flushing it down the toilet.

Or Quizzify.  The effect of increasing one’s knowledge of the healthcare system does not “wear off” after the contest ends, and at the very least, employee metabolisms won’t slow down.

Update, May 3: It was pointed out that this study was only for morbidly obese people and they might have a malfunctioning metabolism to begin with. And it is uncontrolled. Both are of course true…and if this were a standalone study reaching a dramatically different result from others, those criticisms would carry weight. However, all this study does is confirm what other studies have already shown:  for many reasons it is very hard to lose weight. The difference is that these subjects were highly motivated and totally self-selected to be successful at it…and yet…

Harvard Business Review: Wellness Vendors Make Employees Worse

As our more alert readers may possibly have noticed just a little bit, there is a battle taking place between advocates of doing wellness to employees (wellness vendors) vs. advocates of doing wellness for employees (the rest of the inhabited solar system).  There are also those who want to do both, what my colleague Jon Robison calls “paradigm straddling”.  This latter group consists of vendors who want to check off the culture-of-wellness box so they sound relevant and supportive and au courant, while continuing to charge employers large sums to screen the stuffing out of their employees. The most hilarious example of the last is Total Wellness. If you haven’t already read their “profile,” it’s well worth the wear and tear on your keypad to click through.

Now, along comes Stanford University’s Emma Seppala, writing “Good Bosses Create More Wellness than Wellness Plans Do” in Harvard Business Review, to draw a bright-line distinction between the two approaches.

Her first paragraph:

In the name of employee wellness, and in response to insurance company demands, corporations are offering well-being initiatives with financial incentives. Complete this cholesterol screening, say, and you’ll get $100 added to your paycheck; participate in some number of wellness programs, and you’ll receive another bonus. In this quest to increase employee wellness, however, organizations are often unwittingly making things worse. Is it any surprise that initial studies on wellness programs are showing they don’t lead to any visible results?

As an aside, even our less alert readers may recall that I got in a lot of trouble with the HERO crowd (Ron Goetzel, Staywell, and Seth Serxner) just for the crime of noticing that their own numbers in their own guidebook showed wellness loses money. Apparently, Ms. Seppala noticed the same thing, because the link in her article in support of the “wellness programs don’t lead to any visible results” comment goes directly to their report. I guess she’s going to be placed on their Enemies List as well, and she can probably also expect them to circulate a “poison pen” letter about her as well, perhaps using the one they wrote about me as a template. Congratulations, Emma!  You’ve arrived.

These programs “can actually cause more stress,” she writes. And she notes that those employees who do take time off for the corporate yoga class etc. get dirty looks from colleagues who need to pick up their slack.

What to Do Instead

It won’t surprise even our least alert readers that Ms. Seppala advocates a Dee Edington-type “culture of wellness,” starting with the work environment itself:

A workplace characterized by humanity. An organizational culture characterized by forgiveness, kindness, trust, respect, and inspiration… Leaders set the tone for their organization, and their behavior determines whether interactions in their organization are characterized by trust, forgiveness, understanding, empathy, generosity, and respect.

I’ll leave the rest for you to read.

Where Does This Leave the Wellness Industry?

You’ll see a lot more paradigm-straddling. Once again, the wellness industry comes through with the quintessential example:  a Pulse post from a wellness vendor called Dacadoo. (There are so many wellness vendors that I guess all the other names have been taken.)

Talking about all the “fun things” that a wellness culture can provide, Dacadoo writes:

[Health fairs] are professionally run events that are designed to provide education and basic medical screening at usually little cost or no cost for the employees. At these fairs employees can undertake some screening tests such as blood pressure, glucose cholesterol, height and weight, anemia, etc.

Speaking of the solar system, anyone from another planet would interpret this passage as employees thinking: “Wow, my employer can weigh me and test me for both ‘glucose cholesterol’ and anemia!  At little or no cost to me? How cool is that?”

And I bet if employees are willing to pay them just a tiny bit more, Dacadoo will also allow them to paint their fence.



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