Here’s something you don’t see every day: a book slamming wellness written by someone in charge of wellness at their organization.
In this case, it’s Dr. Richard Safeer, who is the Chief Medical Director, Employee Health and Well-Being for Johns Hopkins Medicine and its 60,000+ (formerly) soda-loving employees.
Eschewing and verily even dissing (“it’s a band-aid”) the old “pry, poke and prod” wellness model breathlessly promoted by fellow Hopkins employee Ron Goetzel before his own heart attack slowed him down, Dr. Safeer writes of his continuing and generally successful quest to create not just a culture of health at Johns Hopkins, but actually a healthy culture. The latter includes the former but goes much farther. You can have the healthiest employees in the country but if your culture is unhealthy, that won’t do you any good. And a poisonous culture will also impact the actual health of even the healthiest employees. (That happened to me three times in my earlier days.)
I would strongly recommend this book to anyone who wants to know what it’s like in the trenches, trying to nudge a (very) large organization into healthier habits. It’s not remotely as easy as all those smiling faces on wellness vendor websites would have you believe. As the person in charge of wellness, you have to do your job almost totally by the strength of your ideas and persuasion, since less than 0.1% of those employees report to you, and in any event you can’t force people to be healthy. (Although there is a saying: “Wellness programs will make employees happy whether they like it or not.”)
As with most of these books although more so due to his first-hand experience and observations, the strength is in the storytelling. Starting with his first week on the job, when he noticed a big red fire truck outside the ER. Only it wasn’t a fire truck. It was a soda truck, doing quite the robust business. (He also noticed that on campus, soda cost less than water. Reversing that was an early success.) And, later, there was a fundraiser for the American Diabetes Association – in the form of a bake sale.
It’s not just about the broccoli: It’s the “building blocks.”
Those are examples of nudging Hopkins towards healthier eating, building awareness of the perils of added sugar among people who should know better already. But two-thirds of the book is about the far more important task of creating a healthy culture through building blocks. This is a dramatically different approach than the typical flavor-of-the-month “challenges,” like who can crash-diet the fastest or drink the most water.
Quite the opposite, there is some behavior change science that when applied intentionally and methodically – and slowly enough to avoid pushback while building consensus – will be far more impactful in the long run. Pursuing wellbeing in the workplace is less about what an individual is doing for themselves (“challenges”) and more about what the organization, leaders and co-workers are doing together so that everyone feels supported and everyone benefits. Many of the stories and lessons in these chapters are about cultures, “sub-cultures,” peer cultures and “culture-killers.”
Some of the stories in these chapters are very relatable, at least for me, particularly the last. Three times I’ve fired people who were “culture killers,” as Dr. Safeer calls them – and three times the output from the remaining staff increased immediately. One of those people was so poisonous that when I prepared to fire him over the phone, I bought one of those recording apps and drove to Rhode Island, since I thought he might threaten me over the phone, and recording calls is illegal in Massachusetts. It took half a day to make a five-minute call. (On the other hand, the surf was up, so the other half-day was well-spent.)
His reaction was the opposite – that he was expecting the call. And that brings me to my own observation about culture and hiring and firing. HIring is like a civil trial–the weight of the evidence. Firing is like a criminal trial–beyond a reasonable doubt. We often wait too long to fire people who are disrupting the culture.
The overall message of A Cure for the Common Company: If we were each able to improve our own habits and maintain a positive outlook on our own, we would have done that by now. Yet it’s 2023 and our workplaces are still taking the same approach of telling the employee this is your problem because you weigh too much etc. A diametically different approach is needed, particular in an era when employees have so many choices of where to work…and that’s what’s laid out in these pages.
Al, Since I lived to be able to do so, thought I’d pass this long. I guess I need to eat more broccoli:)
On Monday, January 16 I went to my local CrossFit gym. Theworkout was hard but not exceptionally so and lasted twenty minutes. Nothing Ihaven’t done before in the 10+ years I’ve been doing similar routines.
After the workout as I drove home, I felt sore in my chest,and the soreness grew somewhat as I got home. I chalked it off to my recentless-regular gym attendance, thinking it likely was just muscle strain andfatigue. All of the soreness and symptoms dissipated by the next day, though Iwas more tired than usual for a similar workout. I ascribed it to generalfatigue.
Fast-forward to Friday, January 20. Back to my CrossFit gymand we are just beginning the warm-up portion of the day’s workout. Nothing strenuoushadn’t even begun to perspire or breathe hard. Easy-peazy. Immediately, thesymptoms I felt Monday begin to come on again, but sharper and more pronouncedand painful. This is not normal and has never happened before. I immediatelystop, put away my equipment, and quietly leave class and drive home.
My girlfriend is surprised when I walk in the door – I neverleave the gym early. I tell her I don’t feel well, and can see the look of fearon her face. She tells me I look pale, chalky. She said “Do not take off yourshoes. We are going to the ER.” I said OK. I remind myself that for the last four weeks or so she’s said that Iseem tired, not as energetic as usual. We immediately drive to the hospital.
ER admits me right away and begins an EKG, which they tell meindicates I have not had a heart attack. They also do a blood test for troponinlevels (look it up, it is a you-have-had-a-heart-attack indicator) and theinitial test is slightly elevated. Not a major concern, but they need to do anadditional test to see if the levels go down (good) or up. Mine go up. So theydo another EKG, and yet another blood test.
The results aren’t good. The troponin levels are going up toa not-good level and my blood pressure was elevated. They call my girlfriend inand advise her that I need to be transferred to a hospital with a cardiologist.They are trying to find one with availability, and also looking to securetransportation as there are limited ambulances in our area. Finally, theylocate a room but it is not available until the morning. Spent the night in theER of the local hospital. The nurses on duty check in with me every 15 to 20minutes, asking if I am in pain. I am closely monitored all night.
The next morning, I am transferred at 8:30, fortunately mybirthday ride is only 20-minutes. I am admitted, and the hospitalist and nursesadvise that the cardiologist feels that because I had pain upon exertion thatwent away when the exertion stopped, the best course of action is to perform anangiogram.
After about three hours I am taken to the angiogramoperating theatre. In a hey what-a-way-to-spend-your-birthday, they do the prepthat I hope you’ve never been through. Blood draws, lots of them….I’ll leave itat that.
Once the prep is done, the cardiologist tells my girlfriendthat he will be out in 1 to 1-1/2 hours.
After 2 ½ hours, he comes out to see her. A surgery thatruns long is generally not good.
He comes out waving a piece of paper saying, “Maam, that guygot one heck of a birthday present.”
So what happened? I had 95%, 80%, and 75% blockages on theartery on the left side of my heart. The doctor said that had I not come in,death was certain. He complimented me, as ignoring the symptoms is tragicallycommon.
My birthday gift is two stents that I get to keep forever.
I was discharged late morning on January 22.
I am doing fine. No pain or soreness, a little fatigue. Veryslight loss of function in one small part of my heart that will almostcertainly recover fully. After a few days, I can resume my normal activitiesincluding the gym.
Happy Birthday to me.