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Bringing your dental benefit into the 21st Century

Time to bring your dental benefit into the 21st Century.  You may not look twice at it because it’s a small part of your spend, but it’s a big part of your employees‘ spend.

Further, unlike most of the stuff we cover in Quizzify, dental issues don’t go away on their own. Quite the opposite, they get worse in an exponential manner. An ignored 50% covered tooth issue can become a much larger 80%-covered medical issue.

Fortunately, there is plenty you can do about this at pretty much no cost. Read our article in Employee Benefit News, and then join the Linkedin conversation here (rather than comment below).

 

How to De-Crapify Vendor ROI Measurements

Are your vendors making claims that aren’t passing your sniff test?

Have you read my books but want a refresh?

Do you want to be the smartest person in the room (um, assuming I’m not also in it) when it comes to outcomes measurement?

I’ll be speaking on that exact topic, in more depth than usual, at The Healthcare Innovation Congress, taking place May 22-25, 2022, in Baltimore, MD.  Specifically, I’ll be leading two deep dive sessions for employer healthcare professionals and purchasers on Sunday, May 22.

Join this two-part workshop to gain expertise onaccurately measuring the outcomes and ROI on health benefits and wellness programs. (Successful completion of Part II qualifies attendees for the highest level of Critical Outcomes Report Analysis certification, CORA Pro.)

In addition to the usual hilarious examples of invalid measurement, presented via issue-spotters for you to find them, I’ll actually have several examples of – get ready – valid vendors. I mean there are thousands of vendors in this field so it shouldn’t be a surprise that just randomly a few get it right.


But wait…there’s more! Now how much would you pay?

Nothing, as it turns out. I have a limited number of complimentary VIP guest passes* for the Congress. Claim yours today by writing in AL2022 when you register.

I will also be speaking on the Employee Health & Well-being Track on Monday, May 23rd, 3:10 PM – 3:55 PM: “Do Your Employees Understand Healthcare?: Becoming Better Healthcare Consumers by Focusing on Health Literacy.”

Your guest pass gains you access to:

  • 150+ sessions
  • 12 comprehensive tracks
  • 17+ dedicated networking events
  • Pre-conference workshops
  • 4+ days of in-depth sessions, panels, and roundtables
  • 200+ speakers

Do not miss your chance to get a year’s worth of education in just four days. This is the most in-depth, comprehensive event you will attend all year!

Register today for The Healthcare Innovation Congress. I look forward to seeing you in Baltimore later this month.

Keep all your ER bills under $1000!

When was the last time you even saw an ER bill <$1000, all-in?

The Quizzify ER Prevent Sticker Shock Prevent Consent does exactly that.

Here is one of the two best-known authors in healthcare using it for his son.

Go to the post and see for yourself. Say goodbye to high ER bills for you, your family and your company.


And here are some more.


Here is a Level 5 (the most expensive ER visit code, with the bill:

You can subscribe individually by entering FriendofQuizzify in the promo code for a 20% discount at https://2go.quizzify.com/.

Or you can contact AL@quizzify.com to subscribe for your company.

J’Accuse! Naked Juice is sugar water

Occasionally we dual-post in Quizzify and They Said What, when we think an item is important to all of us. This is that situation.


Candy is bad for us. Your employees know that, so they don’t have to learn it in Quizzify. On the other hand, what seems to provide endless question fodder for our trivia quizzes is junk food marketed as health food. For example, we called out “Craisins” (dried cranberries) last month.

Everyone assumes that dried fruit is healthy. Well, dried fruit generally is healthy. Except when it isn’t. If, like cranberries, a fruit is so sour in its natural state that you have to smother it in sugar for it to taste good, well, that’s not healthy. Here is our question on it. Check out the nutrition label at the end:

1/4 dry cup, about 40 grams in total, has 29 grams of sugar, most of which is added. We were quite surprised to learn this (as I used to feed these things to my kids) and apparently so are your employees, as only about 20% get this question right.


We are shocked, shocked, to find that sugar is being added in here!

Just when we think we’ve seen everything, it turns out that one serving of the healthiest-sounding processed food on the planet, Naked Green Machine Juice (whose label touts “Goodness Inside”), supplies far more sugar (53 grams!) than we should be eating all day. (That latter figure would be, depending on who you believe, 35 grams for men and 25 grams for women.)

You can’t quite read it, but take our word for this: the label claims: “No added sugar.”  But here’s a piece of nutrition trivia. Naked Juice is sweetened with concentrated fruit juice, and concentrated fruit juice is an added sugar. Nevertheless, the Naked Juice people don’t have to list concentrated juice as added sugar because that’s what they are selling – juice. It’s like maple syrup. Maple syrup doesn’t list any added sugar on its own label because it is all sugar. But a processed food that includes maple syrup must count it as an added sugar.

Regradless, fruit juice concentrate is added sugar, period. If it were added to any non-juice product, it would be listed as an added sugar.  As far as your digestive system is concerned, there is no difference between fruit juice concentrate and sugar.

How much fruit-extracted sugar does Naked Juice concentrate into one serving? 2¼ apples worth, according to its own label. (Plus the sugary extracts of kiwis, bananas, pineapples, and pears.)

Naked Juice does supply lots of Vitamin A, B and C. But here’s the thing: for every American with a clinically significant deficiency of those vitamins, there are about 10,000 Americans with diabetes and another 20,000 on their way. Virtually every one of those 30,000, including many of your own employees, thinks they are doing their bodies a favor by drinking Naked Green Machine Juice.

Piling on, we’d also observe that the one nutrient we as a country are most deficient in is fiber. (Yes, that is also a Quizzify question.)  Fruits are a good source of fiber. Even Craisins can at least check the fiber box. Yet, somehow, Naked Juice has managed to process all the fiber out of these 2 ¼ apples and four other fruits, so the label above lists 0 grams.

Verdict: Naked Juice is not a healthy alternative to vegetables. Heck, it’s barely a healthy alternative to dessert.

Presenting Chris Deacon…Unplugged! (Webinar 01/06 1 PM EST)

Chris Deacon is going to give us the inside scoop on the successes and challenges in managing the highest-visibility health benefit in the country north of Bentonville (That would be the state of New Jersey and its 820,000 employees!)…and what she learned and we can learn from her experience.

Specifically, she will cover three initiatives that we all agree should reduce spend and likely improve outcomes, but which come with their own set of hurdles:

(1) Enabling advanced primary care
(2) PBMs
(3) Compiling your data in-house and knowing how to use it

Then she will discuss the challenges of each. Sometimes your TPA, broker, consultant or (in the case of public sector entities) politicians will be supportive. Other times they won’t be. A lot of money is changing hands and suffice it to say not all of it is transparent.

But as an attorney, she knows how to use ERISA (and now also the Consolidated Appropriations Act) to demand data, transparency and value. And in this webinar, Chris will share those secrets with you!

Register here. The webinar will be available afterwards to peopel who register ahead of time.

 

The Deplorables Award Winners of 2021 Give Stupidity a Bad Name

It’s a 3-way tie for the Deplorables Award this year, so I think we’re gonna need a bigger basket.


This race to the bottom was hotly contested this year, as we try to determine who, in the wellness industry’s epidemic of very stable geniuses, is Patient Einstein. These wellness vendors routinely violate rules of grammar, ethics, math and even wellness itself in their attempts to outstupid each other. Yes, I know that word is not in the dictionary but that’s only because Merriam-Webster uses a different wellness vendor. 

They also violate the rule that there are two sides to every story. In each case, this is their story, just annotated. In no case are we “challenging the data.” Quite the opposite. There is a saying that: “In wellness, you don’t have to challenge the data to invalidate it. You merely have to read the data. It will invalidate itself.”  

It’s a 3-way tie, in that three companies accomplished more in 2021 than most stupid people accomplish in a lifetime. It may seem impolite to call them “stupid,” but the alternative would be that they know their claims are false, so the alternative would be to call them liars.


Sprout

And sometimes, as in the case of one of our winners, we ourselves would be lying if we didn’t call them stupid. Here is the official catchphrase from the landing page of their website.  I would call this collection of wellness industry cliches a word salad, if only all of these were words.

Yes, Sprout At Work, the most obscure “industry-leading platform” in all of wellness, is a winner!

That’s because they’ve achieved the elusive quadruple aim of wellness: reducing employee costs, increasing employee productivity, raising employee engagne-ment, and poking employee cheeks.


Wellsteps

Needless to say, Wellsteps is back in the Deplorables Award winner’s circle, for the third time in six tries. I keep trying to retire from the business of exposing fraud in wellness. But just when I thought I was out, Wellsteps pulls me back in.

I’d like to propose that the Justice Department go after them. Not because they are lying, cheating and harming employees. Those are table stakes for wellness vendors profiled in these pages. Rather, they should be investigated by the Antitrust Division for trying to create a monopoly on stupidity. 

Yes, it seems like hardly a month goes by without the irresistible force of Wellsteps’ corporate IQ colliding with the immovable object of reality. They lit up the scorecard twice in 2021. First was Wellsteps Accomplished the Impossible: They Got Stupider.  The highlight was that they “updated their ROI calculator.”  But here are the three asterisks to that statement. Their “ROI Calculator”:

  1. is not updated.
  2. doesn’t show an ROI.
  3. doesn’t calculate.

Read the post, and then click through and try it yourself.

Not content with a single entry in this year’s contest, they entered a second time, with Dog Bites Man…and Wellsteps Fabricates Its Outcomes Again. At the risk of insulting the 76 million canines in this country, Wellsteps fabricating its outcomes is the “Dog Bites Man” headline of the wellness world. it really shouldn’t make the front page, especially in an industry segment as idiot-intensive as theirs. Yet transparently fabricating outcomes is their signature move, so I do like to make sure they get credit for it.

Wellsteps’ problem is that they aren’t remotely smart enough to lie without being caught. They may or may not be the most dishonest vendor, and they may or may not be the stupidest vendor, but they are certainly the stupidest dishonest vendor. 

They would also be a finailist for the Chiquita Award, by the CEO, Steve Aldana claiming that health can be improved with “even one more bite of a banana.”

I’ve always recommended to Mr. Aldana that if he is going to lie so much, he needs to hire a smart person.


Wellness360

Dumb-de-dumb-dumb.

Just when I thought wellness vendors couldn’t get any dumber than Wellsteps, I found this one. See Wellsteps: We’re the Stupidest Wellness Vendor. Wellness360: Hold My Beer.

The difference is that Wellness360 is not dishonest. They genuinely believe that we must drink 15 glasses of water a day – they aren’t just saying it to qualify for the pole position in our award competition. 

How do I know they genuinely believe we need “hydration wellbeing challenges” to meet this goal, even though the quoted study itself says “the vast majority of healthy people meet their hydration needs by letting thirst be their guide”?  They wrote to me to defend their findings, and also cited the massive savings reported in the 2010 Health Affairs article. I pointed out the slight problem that the authors of that study themselves retracted that conclusion when they did their own results, and found the opposite. Wellness360 replied: “Thousand’s [sic] of studies monthly give different results for sure,” which of course clears everything up.

They also posted a recipe for ginger snaps that sounded quite tasty…

…largely because it calls for a cup of sugar and 1/4 cup of molasses. I observed that perhaps it wasn’t exactly on-message for a wellness vendor to be advocating consumption of sugar by the cupful.  They posted back that, to offset the sugar, the ginger offers three attributes that I had apparently overlooked. Ginger:

  1. “Keeps your body warm,” 
  2. “Keeps your health in check,” and
  3. “Is a diaphoretic.”

It’s not just you. I had no clue what “diaphoretic” meant either. So I looked it up. Diaphoresis is a medical condition characterized by “excessive sweating for no apparent reason.” 

The good news is we’ve solved that medical mystery by finding that there is an “apparent reason” – those 15 glasses of water a day have to go somewhere.


Please put comments on the Linkedin post here.

Healthcare Heroes of 2021

Yes, I know.  You read TheySaidWhat for the same reason you rubberneck. You simply can’t look away.  You were hoping this week we would be publishing the annual Deplorables Awards. They are coming next week, when we will reveal which very stable genius is Vendor Zero in the wellness industry’s epidemic of cluelessness.

Today we are doing the opposite: giving credit to the people and corporations (they are people too, you know) who stood out in 2021 for advancing the causes of cost-effectiveness, quality, innovation, and health equity.

These are in alphabetical order and if you think I left someone out send me a linkedin note and I will add them if I agree they are worthy.

I would like to separately recognize my uncle, Dr. J. Michael Lane, who passed away fairly recently. He did more than anyone else to wipe out smallpox. First, he wrote the paper which provided the economic justification for investing in the eradication of smallpox, in lieu of vaccinating everyone in sight.

He observed that the vanishingly low smallpox incidence rate outside Africa was maintained by millions of vaccinations that created thousands of complications. And that the cost of going to Africa to eradicate the disease from its last strongholds was far less than the cost of said vaccines and complications. He then procured the budget from CDC and WHO, and led the team which went to Africa to teach the locals how to inoculate up to 10,000 people a day. The logistics of convincing local and tribal leaders, some of whom were Russian allies carrying AK-47s, to stick their friends and families with needles, were challenging, to put it mildly. 

It turns out he didn’t win a Nobel Prize in Medicine because prizewinners are required to invent or discover something. Whereas all he did was wipe out the biggest viral scourge in the history of mankind, albeit using a technology that had been around for centuries.


And now, the winners…

Marshall Allen’s Never Pay the First Bill almost hit the New York Times bestseller list. it is the first how-to book empowering patients/consumers to pay a fair price for services rendered. You shouldn’t need a book for that. I mean, no one has written a book to teach people how not to get snookered by, for example, laundromats. And yet we do. And yet he did.

His expose of broker compensation helped lead to the Comprehensive Appropriations Act, which requires full disclosure of all streams of payment between vendors/carrier/PBMs and middlepeople. This could change the industry, favoring honest vendors like Quizzify that don’t make under-the-table payments.

Jerry Ashton’s nonprofit, RIP Medical Debt, has paid off a total of $5 Billion of old medical debt, and as part of that, restored credit to the debtors, most of whom were otherwise essentially barred from procuring credit on favorable terms (if they can get credit at all), not to mentioned totally stressed. There is still tons more to go. Mind-blowing numbers of insured Americans carry mind-blowing amounts of medical debt. They accumulate this debt even as they’ve paid down their credit card debt in record amounts.

Dr. Bill Bestermann has developed an enormous national following among PCPs and cardiometablic clinicians by studiously mastering and integrating the genomic and metabolic evidence behind Optimal Medical Therapy and a unified theory of chronic disease. The health outcomes he achieved working with BCBS Louisiana, Ochsner, andea other groups are consistently far beyond conventional care, and he has been open and mission driven about sharing his model for the betterment of all humankind.

Katherine Baicker and Zirui Song, for publishing the definitive cluster randomization study on wellness, which naturally showed no impact at all. Special kudos for allowing themselves to be guided by the evidence. Yes, you shouldn’t get an award for that, but in this industry you do. Likewise, we reversed our opinion on these two. As Prof. Baicker demonstrated with her study on Oregon Medicaid’s natural experiment using a lottery control, she is the #1 researcher in this field. (The 2010 Health Affairs thing was well-intentioned, but wrong. I would add that I can’t talk — I didn’t figure out these vendors were scamming people until 2013. If you look hard at my 2012 textbook on outcomes measurement in disease management and patient-centered medical homes, you will see a brief but positive mention of wellness.) 

Leah Binder dramatically expanded the Leapfrog Group’s scope, forging ahead with ethical billing ratings (inspired in part by Marty Makary and one other guy…hmmm…wonder who that was?). Combined with Dr. Makary’s efforts, shining a light on these practices has without question had an impact on billing practices. 

Dr. Eric Bricker consistently produces the best short video exposes of anyone in the industry and nothing seems to escape his smackdowns. I learned from him, for example, why hospitals charge so much more for emergency care than for electives. I had always just assumed it was because you don’t really have a choice in an emergency. That would explain out-of-network price-gouging (which is ending a couple weeks after you read this), but Dr. Bricker explained the specific reason in-network rates are so high, summarized here.


Dave Chase, and other next-generation benefits advisors, showed it really is possible to reduce the overall cost of healthcare while increasing benefits. Maybe you could attribute the first few cases to good luck but after hundreds of similar outcomes, you have to think Health Rosetta’s special sauce works.

Christin Deacon became the highest-visibility benefits manager in the country, running the 4th largest health benefit in the country. The state of New Jersey had the good sense to combine all public-sector employees into one group, to increase purchasing power. Overcoming many hurdles from politicians and others, she made major changes that saved billions, to be shared with employees and taxpayers. Hear Chris tell her story in our January 6th webinar Presenting Chris Deacon…Unplugged.

Bryce Heinbaugh, who has been working tirelessly and successfully to make Direct Primary Care available for participants in the plans that he serves in rural areas of Ohio and West Virginia.  He has put in a couple of years of effort to find and recruit  DPC practices in underserved areas, and then drove a couple of thousand miles in a week to tell the participants about this great feature of their health plans.  And yet you’ve never heard of him. That’s what we’re here for. 

Brian Klepper devotes an absurd amount of time to curating a googlegroup in which like-minded (well, in the broadest sense of the word) disruptors can find common ground, share ideas and make connections. It is important for those of us on the “bleeding edge” to realize we are not alone in the universe, so this Healthcare Hackers Group performs an invaluable function. Curating it is way harder than it looks. Or as I sometimes say, it takes a lot of effort to make something look easy.

The advisors on the Hackers Group – Alera, Connect Health Collaboration, EPoweredBenefits, Higgenbotham, Mitigate Partners, Provinsure, and more – are all “next generation” advisors who have achieved excellent results and who welcome next month’s Consolidated Appropriations Act (CAA) instead of dreading its bright lights behind shined on their business practices. Indeed, asking two questions of your advisor or vendor will determine their ethics:

  1. What do you think of the CAA?
  2. What do you think of Al Lewis?

Dr. Marty Makary’s The Price We Pay also hit the bestseller list (in paperback). His quest to reduce or eliminate the number of lawsuits filed by hospitals against patients who unwittingly sign financial consents has shown clear results, as the number of such suits has plummeted. Only a small minority of hospitals were doing this, but they compensated for those small numbers with lots of lawsuits. (And some are still at it, of course.) Dr. Makary was also the inspiration for the “Prevent Consent,” which Quizzify literally guarantees will keep ER bills in the 3 figures, in the continental US.

Rosen Hotels is arguably the best employer health benefit in the country, per dollar spent. They get plenty of plaudits already, but we can pile on.

Gillian Pieper, Ashley Johnson, Amy Gilbert and colleagues at VEHI PATH have achieved a relationship with their constituents, the 19,000 Vermont teachers, that would be the envy of any organization anywhere. Quizzify is very engaging in most places, and yet somehow they are twice as engaging as the Quizzify average. It isn’t just Quizzify. Their combination of mutual trust, “champions” in every building, and an easily accessible and interesting set of offerings doesn’t just result in mind-blowing engagement levels, but does so with among the most modest incentives we’ve ever seen.

We should also give shout-outs to some of the leading Business Coalitions. It’s a tough thing to do because you have to rely on funding (at least partially) from exactly the organizations you are trying to negotiate with. But Jessica Brooks of PBGH, Chris Skisak of HBGH, and Bob Smith of CBGH deserve a special shout-out. (This is not to say some others don’t, but these three are willing to take bullets.)


The Vendors of 2021

Among vendors, we’d like to draw special attention to three which solve specific problems. This is no knock against some other vendors, but it’s very unusual for a vendor to make a bright-line change. Usually, with more or less success, the idea of vendors is to change employee behavior.

Quizzify also changes behavior, by teaching employees how to recognize and avoid useless and potentially harmful tests and procedures. Quizzify also tries to change eating behavior. For example, you probably think cranberries are a “superfruit,” if for no other reason than the package tells us so. 

Yet they are completely devoid of vitamins. That’s not even the bad part. The bad part is that in the form we usually eat them, “Craisins,” are literally 50% sugar, a proportion that could make Captain Horatio Crunch himself blush. You have to do the math on the label below, which needless to say Ocean Spray is not exactly forthcoming about. 1/4 Cup is 2 ounces. There are 29 grams in an ounce. Ergo…

See?  We just changed your eating behavior.

But the reason Quizzify is on the list of bright-line change is the Prevent Consent. As noted above, this was largely inspired by Dr. Makary. We simply took the next step from “Don’t sign their consent,” to “Sign your own instead.” So far this Consent has been accepted everywhere (treatment in the ER without affirmative objection constitutes acceptance–Contract Law 101), though occasionally the hospital seems to “forget” that they agreed to it and tries to send a conventional bill. Quizzify will take care of that.

It is now available in a mobile app, Quizzify2Go, which includes a “cheat sheet” to remind employees of their rights in the ER, and a support hotline if the ER intake person is being recalcitrant. It also has a full list of questions to ask during doctor visits for 100+ different topics.


The next is Sera Prognostics. They market a test called PreTRM, which dramatically increases an obstetrician’s ability to predict prematurity. If followed by an intensive prenatal health program, accurate prediction can substantially reduce, and has substantially reduced, the number of NICU days in a population. I’m not undertanding why employers who spend large sums to help employees get pregnant seem less interested in saving large sums by helping employees stay pregnant. But maybe that’s just me.

Employers who compare their NICU days/1000 to their primary-coded diabetes days per 1000 will see that with all the fuss about diabetes, reducing NICU days is a vastly more economically worthwhile activity. This is a list of the top 25 inpatient total spends by employers. Do you see a trend? The plurality are birth events. Diabetes doesn’t show up at all.

Not to mention that, unlike diabetes, your employees will love you for it and you won’t get reviews like Livongo’s.


Next is the Validation Institute, which really came into its own this year. Employers have finally figured out that vendors don’t retain actuaries to determine whether money was saved. They retain actuaries to “prove” that money was saved. Here is their master list of vendor sleight-of-hand techniques. 

In 2021, the Validation Institute (VI) drew a bright line between its own validations and actuarial number salad with its Credibility Guarantee. If you, as a customer of a validated entity, can show VI overstated a vendor claim, the VI will send you a multiple of the fee that the vendor paid to be validated.


And, finally, it is important to recognize that the wellness industry has some fine, upstanding citizens. As far as we know, this is the all-inclusive list but we are happy to add others if indeed they qualify. US Preventive Medicine leads the list because, uniquely in wellness, it has achieved validation by the Validation Institute for making a clear reduction in risk factors.  Aduro, Limeade, Sonic Boom, Wellable, and Wellright also make the cut.

 


Please put comments on Linkedin instead of here. I don’t moderate these posts for comments.

 

Six Things Employees Should Know about Nutritional Supplements

Continuing December’s guest posts of Quizzify’s greatest hits…

The vast majority of your employees take nutritional supplements, whose consumption just reached an all-time high. That increase means someone, somewhere – maybe even your very own wellness vendor – is telling them this is a good idea.

Or maybe they are thinking: “Hey, what harm can they do?”

Plenty, as it turns out.

Here are six things employee should know about nutritional supplements.


1. Virtually all the benefits of supplements with virtually none of the risk can be achieved by taking a regular multivitamin

There is plenty of evidence for the health benefits of virtually all vitamins and minerals and even a couple of supplements, so much evidence that we have room to highlight only a few.

Examples include fish oil for menopausal women with dry eye or possibly people at high risk of heart attack. Or folic acid for pregnant women and iron for pregnant women who are anemic. Or Vitamin D for people who have dark skin, live in cloudy climates, avoid all sun exposure and/or don’t each much dairy. And of course, Vitamin B12 for vegans. (Vitamin B12 is found only in animal products.)

Women likely benefit from small combined extra amounts of calcium and Vitamin D…but as noted below, don’t overdo it.
The 10% of the population who drink to excess really should be taking daily multivitamins. This is partly because alcohol interferes with absorption, and partly because they aren’t getting enough calories from real foods.

And as we noted in Six Things Employees Should Know about Antibiotics, probiotic supplements are a very wise idea for employees taking antibiotics. Ironically, pouring bacteria down your throat is (at least in that circumstance) more beneficial than any megavitamin or mineral.

With these exceptions, most people should be getting enough vitamins (and prebiotics, which feed probiotics) in a balanced diet, but a few cents a day of an “insurance” multivitamin pays for itself just in the psychological benefit of not worrying about that. However, the story changes when we talk about megavitamins, and especially when we talk about other supplements.


2. Almost every megavitamin which once showed “promise” in fighting cancer, heart disease, etc. doesn’t. Quite the opposite, they may cause harm.

Niacin, once thought to have magical properties against heart attacks, has been completely debunked. Vitamin E supplements could prevent cancer in some women but cause it in others, depending on genes. Men who are concerned about prostate cancer (meaning all of us) should specifically avoid Vitamin E supplements, which likely increase the odds of it. Vitamin D in large quantities is the latest to be debunked, just last month. Taking too much may cause osteoporosis, rather than prevent it.

And monitor your own wellness vendors. Interactive Health, for example, tests every employee for anemia. This is contrary to the advice of clinical guidelines, which oppose anemia screening except for pregnant women, where evidence is mixed. Employees who then take iron supplements risk stomach pain, nausea, vomiting and serious long-term complications.

The good news? It is possible large amounts of Vitamin C do offer modest benefits with respect to common colds, and that those possible benefits outweigh the possible harms. But just large amounts, like 200-400 mg., not massive amounts — and not so large that you need pills.


3. If you have to go to GNC to obtain a supplement, or order it through the mail, it has no value and may cause harm.

As a random example we picked because we like the name, consider horny goatweed, as a treatment for erectile dysfunction (ED). Along with the name, it also has a great back story, something about Mongolian herders observing goats getting aroused after grazing on it.

It is actually proven to work, and not just on goats. It also works on rats. For the rest of us, there is zero evidence. Plus, ED is one of those conditions, like obesity or baldness, where, if something really worked, we’d know about it by now.

At least the likelihood of harm is pretty low, other than to your wallet and self-confidence.


Continue here to the Quizzify blog.

 

 

 

SIx Things Employees Should Know about Heartburn (Part 2)

This is another installment in Quizzify’s “Six Things” Greatest Hits, which we are posting from now until Festivus.


The best and safest way to control your heartburn is through altering your diet and lifestyle, as outlined in the previous installment of Six Things Employees Should Know about Heartburn.

However, if you control your heartburn through regular use of Nexium, Prevacid, Prilosec or Protonix, be aware that these are very effective drugs specifically because they control stomach acid so well, with no obvious short-term side effects in most cases.

And yet they are probably the riskiest, most misunderstood and most overused drugs currently available without a prescription.

So this installment will take over where the previous one left off. The previous installment (covering the first three of the “Six Things”) covered heartburn prevention. This installment, starting with the fourth “thing,” covers the remedies – specifically the most popular remedy, the PPI. Of us who have experienced it (which is to say, virtually all of us), heartburn — otherwise known as indigestion or acid reflux — seems to be a part of the human condition. We would cite the massive numbers of people — probably a third of the American adult population — who experience this condition at least once a month, but we don’t have to because you, or at least most of the employees in your organization, are likely among them.

4. PPIs should be a last choice, not a first choice — and even then, only for the short term

Your doctor may not mention lifestyle changes or even the generic over-the-counter versions of safer but perhaps less effective remedies like Pepcid and Tums. The fact that PPIs are largely brand names and doctors get “detailed” on them by charismatic drug company salespeople may also influence their choice. Just a little…
 
As a result – and particularly if you yourself as a patient suggest the “purple pill” or something like it — your doctor might jump right to a prescription or recommendation for an over-the-counter PPI. Some doctors are confident the drug is going to relieve your symptoms posthaste.
 
With this in mind, you should:
  • Ask about effective non-drug or OTC drug options to control your heartburn.
  • Ask about the potential long-term harms of PPIs.
  • Ask about an end date: if you have simple heartburn and you are started on a PPI, it should never be for more than 8 weeks, after which you should be reassessed, or reduce the use of your PPI to an “as needed” intermittent basis.

 

Six Thing Employees Should Know about Heartburn (Part One–Lifestyle)

This is another in Quizzify’s Six Things Employees Should Know series, that They Said What? is offering this month. Heartburn is a two-part series.


To all of us who have experienced it (which is to say, virtually all of us), heartburn — otherwise known as indigestion or acid reflux — seems to be a part of the human condition. We would cite the massive numbers of people — probably a third of the American adult population — who experience this condition at least once a month, but we don’t have to because you, or at least many of the employees in your organization, are likely among them.

Rather than suffer through an episode or repeat episodes, many of us reach for a remedy. That remedy ranges from an occasional chewable Tums or Rolaids to daily dosages of Proton Pump Inhibitor (PPI) drugs, like Nexium, Prevacid or Prilosec. Most of these options reliably relieve most people’s symptoms without immediate side effects, so few people question either the need or the remedy.

And yet it turns out both the need and the remedy should be questioned. Simple lifestyle changes can reduce the need, and nobody should be taking any drug designed as a remedy every day. Most drugs intended to be taken intermittently or for short periods of time are not labeled, tested or, as we shall see in the next installment, safe for long-term use. (Our most recent Six Things post exposed another example: harmless-sounding OTC sleep aids.)


1. Some of the causes of heartburn can easily be addressed

Overeating, eating without an accompanying beverage, eating too fast, eating too late at night – all these things can cause indigestion. https://www.health.harvard.edu/staying-healthy/8-ways-to-quell-the-fire-of-heartburn Other less obvious physical causes include:

  • Eating while slouching,
  • Not loosening your belt while filling your stomach
  • Too much alcohol, caffeine, or even peppermint, carbonated beverages or chocolate
  • Fatty or greasy foods.
  • Exercising right after eating

Simply addressing these items – particularly in combination and particularly before bed — could go a long way towards relieving symptoms.


2. Three simple remedies are overlooked

First, try chewing sugarless gum after eating. This stimulates saliva production. You’ll often feel a satisfying burp as a result. (Or at least here at Quizzify we do. Yes, we know. TMI.) https://www.health.harvard.edu/staying-healthy/8-ways-to-quell-the-fire-of-heartburn

Next, probiotics found naturally in some yogurts (or kombucha) can solve many people’s indigestion if eaten regularly for two weeks or so.

There are hundreds of yogurts on the market, so how can you tell if a yogurt has probiotics? Rule of thumb: if you recognize the brand from your childhood, it doesn’t. There are also many types of probiotics. None fit everyone’s needs exactly, so varying your yogurt choices might be a good idea.

Caution: like every other nutritional supplement, probiotics should not become an obsession. Get them from natural sources rather than pills or other concentrated sources.

Finally, if you have nighttime indigestion, try elevating the head of your bed to create a slight downward plane. Not just adding pillows (see comment above about not scrunching your stomach), but rather inclining your entire bed — using books, or wedges available online or in any medical supply store. https://www.health.harvard.edu/diseases-and-conditions/gastroesophageal-reflux-disease While you’re sleeping, this small angle helps keep digestive juices out of your esophagus — which is specifically the body part that “acid reflux” irritates, as the next section describes.


To continue, click through to Quizzify.

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