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In the wellness industry’s epidemic of very stable geniusitis, Healthywage is Patient Einstein.
Somehow they recruited Russian trolls to convince Schlumberger that the best thing they could do to reverse their four-year stock price decline…
…would be to: encourage their employees to binge and then crash-diet. So far Schlumberger is halfway through its 8-week crash-dieting contest. In case you’re keeping score at home following our initial posting, here are the standings:
Pound Town has lost 10% of its weight in 4 weeks. Figure — as a conservative estimate — the average participant weighed 200 pounds at weigh-in. A 9.86% loss of body weight equates to more than 19 pounds, almost 5 pounds a week. The Centers for Disease Control (CDC) recommends 1-2 pounds/week.
The better CDC recommendations include not crash-dieting at all, but rather improving your health and fitness, at your current weight, because rapid weight loss likely leads to rapid weight regain, and possibly even slows metabolism so that one could regain more than one loses.
However, the CDC recommendations didn’t take into account that weight regain is a big part of what makes this contest work. Employees can win the $10,000 in 2018 — and then regain the weight in order to enter again in 2019. Is this a great country or what?
Health has nothing to do with it, of course. It’s about making Schlumberger shareholders proud again.
There is a lot more to this study than meets the eye.
Some tourist attractions feature an “A” tour for newbies and then a “behind-the-scenes” tour for those of us who truly need lives. For instance, I confess to having taken Disney’s Magic Kingdom underground tour, exploring, among other things, the tunnels through which employees travel so as not to be seen out of costume in the wrong “Land.”
Likewise, there have been many reviews of the recent wellness study conducted by the National Bureau of Economic Research (NBER), the first-ever randomized control study of a wellness program. This, however, is the first review to go beyond the “A” tour of the headlines.
By way of background, the headline is that the mainstream wellness program the investigators examined at the University of Illinois did not noticeably move the needle on employee health. They didn’t address return-on-investment (ROI), because there obviously was none. Achieving a positive ROI would require moving the health risk needle—not just by a little, but rather by enough to significantly improve the health of many employees. Then, since wellness-related events, such as heart attacks, would not otherwise have befallen these employees immediately, this improvement would have to be sustained over several years before there was a statistical chance of some events being avoided.
Finally, the magnitude of this improvement would have to be great enough to violate the rules of arithmetic, because it is not mathematically possible to avoid enough medical events to break even on wellness. For instance, it actually costs about $1 million to avoid a heart attack through a screening program.
This finding, therefore, represents an existential threat to conventional wellness programs.
It all boils down to: why would an associate professor (Damon Jones) publicly humiliate his own dean (Katherine Baicker — yes, the very same Katherine Baicker who always seems to be on the wrong side of every wellness debate) …unless he is absolutely sure he is right?
She can’t fire him now because that would get picked up by the lay media. Perhaps she should have paid him $130,000 not to disclose the results.
I cannot make this stuff up. While there were other issues too, here is the article. Scroll down towards the end and you’ll see that getting rid of the wellness program ranked right up there with a pay raise in worker demands, becoming the key issue for them even after the pay raise was agreed upon:
It wasn’t so clear any longer that a pay raise could resolve them. Quite quickly, it was apparent that the union’s membership…would reject the deal. “I live paycheck to paycheck,” Katie Endicott, a thirty-one-year-old high-school teacher from Gilbert, told the Times. Then she recounted the program, mandated by the state’s new health-insurance program, that required teachers to download an app that would check how many steps they took each day.
“If I don’t earn enough points, and if I choose not to use the app, then I’m penalized $500 at the end of the year,” she said. “People felt that was very invasive.”
The irony, of course, is that this is far from the most invasive wellness program we’ve ever seen. It wouldn’t even be subject to the forthcoming rules reflecting the AARP v. EEOC decision. Plus, taking some extra steps is a good idea in general, and especially in the state with the country’s second-highest obesity rate.
Still, the fact that an activity tracking program was considered repugnant enough extend a strike over is Exhibit A that WillisTowersWatson is right: employees hate wellness. Not all wellness, of course, but rather forced voluntary wellness programs just like this one.
A bunch of months back I published a comprehensive, richly sourced, linked and footnoted review of the three greatest failures of the workplace wellness industry’s leading vendors, consultants and promoters. Those three greatest failures, of course, would be: outcomes, economics and ethics. Hence the title.
The paper is quite uncharacteristically, rather dry, as befits publication in the country’s leading law-medicine journal. However, I’d encourage everyone to download it and at least skim it.
To get you started, Tom Emerick just now reviewed it in Insurance Thought Leadership, so that might be a good place to start. If that catches your attention, then you can link through to the main event. (And, yes, there is a juicy tidbit in there.)
PS The journal issue includes four other articles on wellness too, including one by The Incidental Economist. They couldn’t find anyone unconnected with the wellness industry to defend it, so the entire issue is an evisceration of its shortcomings.
Dear Welligentsia Nation,
For some reason there seems to be a ton of interest in the podcast that Josh Luke just did with me. I’m a bit embarrassed because most podcasts are audio and hence I didn’t really gussy myself up in anticipation of video, but nonetheless worth a looksee. Even in the best of circumstances I do look like I just fell off a mountain bike — and that’s after making an effort to look presentable, as in these shots from a couple of trivia contests.
This podcast covers everything you want to know about how wellness got to the state it’s in, how I stumbled into figuring out that it wasn’t working, and how Quizzify arose from its ashes.
Even more than blowing the whistle on the very stable geniuses in the wellness industry, I love catching people doing something right, partly because it is so rare. This is one of those moments.
Two books that would seem to have little in common are Unaccountable: What Hospitals Won’t Tell You and How Transparency Can Revolutionize Healthcare, by Marty Makery and rEvolution: Turn Crisis into Clarity and Ignite Growth, by Tim Leman, CEO of Gibson, northern Indiana’s largest insurance brokerage. Dr. Makery has never set foot inside an insurance brokerage while Mr. Leman has never set foot inside an OR. (He may or may not have been wheeled in at one point or another but I don’t know. If I did know, HIPAA rules are quite clear: if I told ya, I’d have to kill ya.) And yet these books have share a common thread.
Coincidentally, and why I am writing today about both books, Unaccountable is back in the news because Fox made a very watchable drama out of it, called The Resident. And rEvolution is in the news — my news, at least, because I have been blown away by what I have seen of Gibson’s competence and professionalism.
First, a brief word on The Resident. It is a highly watchable medical drama that got a notch-less-than-great reviews only because, unlike in every other medical drama, reviewers didn’t appreciate that the characters are based on real people. There really was a surgeon at Dr. Makery’s hospital known as “Dr. Death” because of his high failure rate, and yet patients loved him because of his bedside manner. And admittedly the show goes over the top:
- While hospitals upcode all the time, vendors of these coding tools don’t distribute brochures titled The Art of Upcoding.
- Revenue-maximization consultants don’t watch patients get MRIs.
- Hospital CEOs don’t have conference calls like baseball’s winter meetings where they propose swapping patients with each other.
- No federal ICE agent has ever dragged an undocumented immigrant out of an intensive care unit. (Not that I want to put ideas in their head.)
Once again, they are ignoring every iota of research that says crash-dieting is a complete waste of time. It may also harm you. Once again, they are offering a whopping $10,000 prize to the winning team.
The relevant language from the Wellness Code of Conduct
Here is the relevant language from the Employee Health and Wellness Program Code of Conduct. The language that the group agreed upon — “may have negative effects on their health” — was intended to be as acceptable as possible to what has become an delightfully large Ethical Wellness group:
Research shows that the vast majority of people who participate in weight loss programs will eventually gain their weight back after the program ends. Many will also gain back more than they lose. The weight cycling that occurs with repeated participation in weight loss programs may have negative effects on their health.
It’s also slightly possible that offering a $10,000 prize (for a team of five) could exacerbate the harms of weight-cycling just a tiny bit by encouraging employees to binge, bloat, salt and constipate themselves before the first weigh-in. But no team would ever do that, right? After all, it’s not worth sacrificing your ethics or harming yourself in order to win a measly $2000/team member.
Haha, good one, Al.
The relevant language from Here’s How to Win a Corporate Biggest Loser Contest
On the weigh-in day, avoid the bathroom before weigh-in if you can, and minimize your activity, another big glass of whole milk with your breakfast that contains some salty options will help you retain more water. If you are also going to get your waist measured, drink about half a can of root beer. Sounds gross, but the carbonation and salt will give you are really good belly bloat…If they are measuring your waist, wear some pants that are snug around the waist, or add a tight belt that hits below your belly button, this will create some fluid buildup in your belly area. At this point you should be a big bloated sloshing mess that needs to go to the bathroom really bad. This is the perfect time to get weighed and measured. If you are getting measured, poor posture can get you another inch and a half, so go for it.
To their credit, even the group that gives this advice has a more adult sense of responsibility than Schlumberger and HealthyWage, as they preface a few pages of advice with:
It’s getting to be New Year’s resolution time and many companies will try and “encourage” weight loss with a “Biggest Loser” type contest. Frankly, this is really a bad idea, as it can create all kinds of bad habits and damaging activities by the participants, as they starve, dehydrate and supplement themselves in an effort to win.
The relevant language from Schlumberger’s vendor, HealthyWage
Let’s look at the marketing pitch from HealthyWage, the outfit that runs this contest and epitomizes everything that makes the wellness industry what it is today:
That equates to over 50 pounds per person, in their 12-week contests — more than 4 pounds a week.* This means one of five things:
- Employees are indeed binging, bloating, salting and constipating themselves before the contest to maximize their odds of winning, since losing 50 pounds in 12 weeks would be a Herculean task without a bunch of extra weight that will be as easy to take off as it was to put on, thanks in part to websites that show you how to gain weight rapidly in preparation for corporate crash-dieting contests;
- Healthywage is unfamiliar with the CDC guidelines that recommend steady weight loss at 1-2 pounds per week;
- Healthywage is betting that employers don’t know that the odds of keeping weight off are 1 in 200 for males and 1 in 100 for females;
- Heathywage is counting repeat contestants more than once, meaning that the same employees binge, crash-diet, regain the weight and then do it all over again;
- Heathywage is lying.
Of course, this being the wellness industry, it may be all five.
*How does a 50-pound weight loss compare to other companies? Pfizer won a Koop Award because its participating employees were able to lose — get ready — four ounces. Six if you measure against the two ounces gained by non-participants. In all fairness, Pfizer’s program was not exactly intensive. “Participate” was defined as “open an email with a message in it.” The good news is that opening an email isn’t going to harm anyone.
Plus you never know what a message will contain. Open this link to see an example.