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Final installment: 3 more stories of wellness shame and harms

Included in this concluding batch is yet another wellness program debacle regarding eating disorders. The irony is, this one takes place at an addiction facility.  I’m always maintained that, along with facts, integrity, math, data, employees and me, the wellness industry has no appreciation of irony. Examples:

This final set of case studies concludes with a statement from an actual named LCSW who specializes in the treatment of eating disorders.

Links to previous installments:

  • Part 1: Recovering executive with anorexia nervosa begs not to be weighed…DENIED
  • Part 2: Recovering technologist with bulimia told to “fit into his skinny jeans”
  • Part 3: Recovering employee with anorexia nervosa told “nothing tastes as good as skinny feels” and advised to eat only half her lunch.
  • Part 4: Recovering employee with bulimia and a severe grain allergy penalized for eating too many natural fats, as correctly prescribed by her dietitian…and begins purging again.

Joan

The school where I work recently instituted a wellness program.  In order for our insurance premiums to not increase, we had to go through a series of tests:  total cholesterol, blood pressure, BMI, LDL cholesterol and fasting glucose.  If we did not “pass” 4 out of 5 of these biometric screenings, we had to go through six weeks of phone therapy and then have the screenings done again after that time.

If, after the six weeks of phone therapy, the results did not change, our insurance would go up about $50.00/month.

The whole experience was a nightmare.  They conducted the screenings in the music room at school, with different tables and stations set up.  About 10 or 12 teachers and staff members were in the room at one time, so there was little privacy.

We moved from one station to the next as each of our results was written down and passed to the next person.

When we got to the end, a wellness “counselor” went over our results.  The lady saw my triglycerides number and immediately asked, “Does diabetes run in your family?”  “Is obesity an issue in your family?”  I asked why.  She said that a high level of triglycerides means that the body has “too many fat cells” and that I am at an “increased risk.”

To someone who has struggled with an eating disorder, as I have, this was tantamount to saying “Because of your high triglycerides, you are fat.  You are obese.”

Being weighed is always a humiliating and shameful experience for me, as it is for many people with eating disorders, and it can trigger exacerbations of my disorder (treating professionals familiar with eating disorders are well aware of this phenomenon and structure treatment accordingly).  To have to be weighed in front of my peers made that experience even worse.

This biometric screening triggered my disorder.  I was in tears by the time I got to the last “counselor” and had a very hard time controlling my feelings.  Right after this, I needed to get into my classroom and be with my kids.  I had to “suck it up,” until the end of the day.

It was horrible and it makes me wonder what is in our future in regard to all of this.


Katie

My workplace, an addiction treatment facility, has an employee “wellness” program.

If employees want to obtain the insurance “wellness rate” (the lower of two rates available to employees), we are required to start every year in January with a “health fair” and a “know your numbers screen” where they check weight, blood pressure, glucose levels and cholesterol.  Then we are “advised” by a registered nurse to exercise more and eat less (as if that had never occurred to anyone previously).

This year, the medical assistant drawing my blood engaged in numerous behaviors that would trigger most people with an eating disorder.  She informed me she “used to be as big as” I am until she “got bypass surgery.”  Despite mentioning several times that I see a nutritionist who recommends that I not weigh myself or know my weight, I was asked to guess my weight before I stepped on the scale.  I turned around when I stepped on the scale to avoid seeing my weight, but the assistant nonetheless chattered on about my weight.

I was reminded of embarrassing weigh-ins with school nurses and weight loss programs before I was exposed to eating disorder recovery.

This year we are also assigned to a “wellness team” where everyone is supposed to wear pedometers every day and log their steps weekly on a website.  Everyone can see everyone else’s steps on the site and a competitive spirit is encouraged.

I am especially saddened and concerned that we have this potentially damaging environment that encourages obsession with weight and numbers in a facility that treats addiction, where one would hope we would be steered away from, rather than toward, the process of addiction to disordered eating.


Rhonda Lee Benner, LCSW

I have worked with hundreds of patients over the 13 years during which I have worked with people with eating disorders.   In the past two years, I have seen a number of patients who were quite negatively impacted by the wellness programs at their place of work.

In one instance, a patient with binge eating disorder reported that she would be financially penalized if she didn’t set weight loss as a goal and make progress toward this goal. However, this was in direct conflict with her treatment goals to stabilize eating and set any goals for weight loss aside.  This patient could see how focusing on weight loss increased her binge eating; however, she felt shame and anxiety as a result of these pressures put on her by her employer.  She did not feel that as a larger-sized person she could speak up about this injustice.

In another instance, a patient reported that her employer required her to complete a health screening or be charged $600.00, and when she didn’t meet the health targets she was given an opportunity to still get the monetary “rewards” by meeting with a dietician three times.  She was also informed that she could get a “Healthy Weight Improvement Reward” by losing five pounds since her last health screening. Again, this is a patient with binge eating disorder whose condition is destabilized by focusing on weight loss. She too felt that as a larger-sized person she could not speak up about how this program could cause her harm.


What now?

Next week, and with the help of others, we will ask, what does this all mean? What can be done to prevent or discourage wellness vendors from harming employees?

And once again, kudos to the good guys, the vendors who are not implicated in this series at all, and indeed would never do such things to people:

American Institute of Preventive Medicine, Health Advocate, HealthCheck360, It Starts with Me, Limeade, Redbrick, SelfHelpWorks, Sterling, Sonic Boom, Sustainable Health Index, US Health Centers, US Preventive Medicine

Interactive Health doubles down on diagnoses (Part 1)

So much to say about Interactive Health, so little room on the internet. As a result this will be a two-part blog, at least.

Meanwhile, on the opposite end of the spectrum, we are going to be highlighting the most positively influential people and organizations in the field. Please go vote or submit additional nominations.


The following axiom proffered in Surviving Workplace Wellness used to be ironclad:

“In wellness, you don’t have to challenge the data to invalidate it. You merely have to read the data. It will invalidate itself.”

I thought this axiom applied to every vendor claiming huge savings. But, alas, Interactive Health is an exception. Yessiree, it turns out you can invalidate their data without reading the data.  It had been easy enough to invalidate their data by actually reading it — so much so that my original observations about them made it intp the Wall Street Journal .  They counterpunched by redacting all the raw statistics on risk reduction. (They didn’t realize I kept a screenshot, which will be the subject of Part II.)

Since risk reduction is what generates financial outcomes, taking risk reduction stats out of an financial outcomes report is like the movie theater in South Korea that decided The Sound of Music was too long, so they edited out the songs.

The Wall Street Journal debacle taught them half their lesson: they learned not to publish data, because data will obviously invalidate their savings claims. Last week they learned the other half of their lesson the hard way, which is that they shouldn’t publish anything, period. On Linkedin they bragged — without any data at all — about the gobs of money they saved by discovering all sorts of undiagnosed conditions and achieving trivial reductions in overall risk scores.

Of course it’s mathematically impossible to achieve massive savings by making asymptomatic employees anxious about diseases they almost certainly don’t have in any clinically meaningful sense, and/or slightly by reducing risk factors. With that in mind, I merely asked a question or two about the whereabouts of the data to support this mathematical impossibility…and <poof> their posting disappeared from Linkedin.

Even absent the data, it’s well-known that Interactive’s modus operandi is to do exactly that — attribute massive savings to trivial risk score reductions and “newly discovered conditions.”  Neither m.o. is unique to them. Indeed both are common enough to have names — the Wishful Thinking Multiplier and Hyperdiagnosis. Interactive’s brilliance is in marrying the two.


Interactive Health, the Wishful Thinking Multiplier and Hyperdiagnosis

The Wishful Thinking Multiplier is defined as:

total savings/total reduction in risk factors. 

The Multiplier originated with Staywell allegedly saving British Petroleum million of dollars when only a few hundred employees reduced a risk factor — which worked out to almost $20,000 for every risk factor reduced. As luck would have it, this Multiplier was about 100 times what Staywell themselves previously claimed was even possible, which in turn was about 100 times what is actually possible.  Yet, as we’ll see in the next installment, Interactive’s Wishful Thinking Multiplier leaves Staywell in the dust.

The practice of wellness vendors bragging about how many sick people they find is called “hyperdiagnosis.”  It originated when Health Fitness Corp breathlessly declared that about 1 in 10 screened Nebraska state employees had cancer.

Hyperdiagnosis differs from “overdiagnosis” in that doctors try to avoid overdiagnosis, because it results in expensive and potentially harmful overtreatment.

By contrast, hyperdiagnosis is something that vendors like Interactive embrace. Indeed, Interactive practically hyperventilates every time someone tests positive for something.  Since Interactive screens for everything under the sun — 38 panels, way more than most checkups and ten times what guidelines recommend — it’s tough to get out of one of their screenings without a false positive finding on something.

Here are examples of their hyperventilation in words and pictures, wisely not naming the client in their Linkedin post to avoid embarrassment:

[Their client] recently shared with their employees the successful outcomes they have achieved. First, hundreds of employees discovered new health conditions they were previously unaware of.

I’m sure the employees shared Interactive’s joy in finding out how sick they are! What employee wouldn’t be excited about such a “successful outcome” ? And not just a few employees, but rather almost half are now “at risk” with “newly discovered conditions.”

A vendor bragging that nearly half the employees are might lead you to think: “Where do these people get their ideas?”

Glad you asked. Interactive bases their “proven…amazing results” on a report by an outfit called Zoe Consulting. Let’s take a looksee at Zoe Consulting, to learn more about the people they are basing their entire financial value proposition on.


Hey, Butch, Who Are These Guys?

As you can see from this screenshot, Zoe Consulting is a “top-tier nationally recognized research firm.” (Source: Zoe Consulting.)  Here are the awards they’ve won (with Google’s commentary in parentheses):

  1. Two Koop Awards (they didn’t);
  2. The American Cancer Society Award for Program Excellence (they didn’t);
  3. The Ethel-somebody Leadership Award from UNC (they didn’t); and
  4. The Distinguished Leadership and Service Award from the Association for Workplace Health Promotion (they didn’t).

The last reminds me of a summer job selling Collier’s Encyclopedia door-to-door. Collier’s salespeople were instructed to say: “National Geographic won the Kodacolor Award 10 years in a row, but last year we copped the award from them.” One evening I ran into a Grolier’s salesman, who, as it turned out, used exactly the same line in his pitch, down to the exact same faux-cool-70’s-speak verb right out of The Deuce. I called Kodak to see who really won it, only to learn that no such award existed.

Likewise, one of the many reasons Zoe Consulting didn’t win an award from the Association for Workplace Health Promotion is that no such organization exists. So depending on how you count (and whether you count the Koop Awards as one lie or two), they lied six times in two bullet points, which may be a record even in the wellness industry. Seven if you count “top-tier nationally recognized research firm.” Eight if you count “top-tier” and “nationally recognized” separately. Nine for “unbiased.” To reach a round number, I’d say the tenth would be “research.”  That’s ten lies already.

In other words, Zoe Consulting is a perfect fit for Interactive Health.


Stay tuned for the next installment to learn why.

 

Wellness Vendors Dream the Impossible Dream

Alice laughed: “There’s no use trying,” she said. “One can’t believe impossible things.”

“I daresay you haven’t had much practice,” said the Queen. “When I was younger, I always did it for half an hour a day. Why, sometimes I’ve believed as many as six impossible things before breakfast.”


Six impossible things before breakfast?  The wellness industry would just be getting warmed up by believing six impossible things before breakfast. They believe enough impossible things all day long to support an entire restaurant chain:

Consider the article in the current issue of BenefitsPro — forwarded to me by many members of the Welligentsia — entitled: “Can the Wellness Industry Live Up to Its Promises?”  BenefitsPro rounded up some of the leaders of the wellness industry alt-stupid segment. Specifically, they interviewed US Corporate Wellness, Fitbit, Staywell, and HERO. Each is a perennial candidate for the Deplorables Awards — except US Corporate Wellness, which already secured its place in the Deplorables Hall of Fame (and Why Nobody Believes the Numbers) several years ago with these three paeans to the gods of impossibility.

In case you can’t read the key statistic — the first bullet point — it says: “Wellness program participants are 230% less likely to utilize EIB (extended illness benefit) than non-participants.”  Here is some news for the Einsteins at US Corporate Wellness:  You can’t be 230% less likely to do anything than anybody. For instance, even you, despite your best efforts in these three examples, can’t be 230% less likely to have a triple-digit IQ than the rest of us.  Here’s a rule of math for you: a number can only be reduced by 100%. Rules of math tend to be strictly enforced, even in wellness.  So the good news is, even in the worst-case scenario, you’re only 100% less likely to have a triple-digit IQ than the rest of us.

And yet, if it were possible to be 230% dumber than the rest of us, you might be. For instance, US Corporate Wellness also brought us this estimate of the massive annual savings that can be obtained just by, Seinfeld-style, doing nothing:

So assume I spent about $3500/year in healthcare 12 years ago, which is probably accurate. My modifiable risk factors were zero then and they are still zero — no increase. So my healthcare spending should have fallen by $350/year for 12 years, or $4200 since then. But that would be impossible, since I could only reduce my spending by $3500. Do you see how that works now?

To his credit, US Corporate Wellness’s CEO, Brad Cooper, is quoted in this article as saying: “Unfortunately some in the industry have exaggerated the savings numbers.” You think?

I’m pretty sure this next one is impossible too. I say “pretty sure” because I’ve never been able to quite decipher it, English being right up there with math as two subjects which apparently frustrated many a wellness vendor’s fifth grade teacher:

400% of what?  Is US Corporate Wellness saying that, as compared to employees with a chronic disease like hypertension, employees who take their blood pressure pills are 400% more productive?  Meaning that if they controlled their blood pressure, waiters could serve 400% more tables, doctors could see 400% more patients, pilots could fly planes 400% faster? Teachers could teach 400% more kids? Customer service recordings could tell us our calls are 400% more important to them?

Or maybe wellness vendors could make 400% more impossible claims. That would explain this BenefitsPro article.


Fitbit

We have been completely unable to get Fitbit to speak, but BenefitsPro couldn’t get them to shut up. Here is Fitbit’s Amy McDonough: “Measurement of a wellness program is an important part of the planning process.”   Indeed it is! It’s vitally important to plan on how to fabricate impossible outcomes to measure, when in reality your product may even lead to weight gain.  Here is one thing we know is impossible: you can’t achieve a 58% reduction in healthcare expenses through behavior change — especially if (as in the 133 patients they tracked in one of their studies) behavior didn’t actually change.

You can read about that gem, and others, in our recent Fitbit series here:


Health Enhancement Research Organization (HERO) and Staywell

I’ll consider these two outfits together because people seem to bounce back and forth between them. Jessica Grossmeier is one such person. Jessica became the Neil Armstrong of impossible wellness outcomes way back in 2013.  Not just any old impossible wellness outcomes — those have been around for decades. She and Staywell pioneered the concept of claiming outcomes they already knew were impossible.   While at Staywell, she and her co-conspirators told British Petroleum they had saved about $17,000 per risk factor reduced.  So, yes, according to Staywell, anyone who temporarily lost a little weight saved BP $17,000 — enough to clean up about 1000 gallons of oil spilled from Deepwater Horizon.

See British Petroleum’s Wellness Program Is Spewing Invalidity for the details.

Leave aside both the obvious impossibility of this claim, and also the mathematical impossibility of this claim given that employers only actually spend about $6000/person on healthcare.  Jessica’s breakthrough was to also ignore the fact that this $17,000/risk factor savings figure exceeds by 100 times what her very own article claims in savings. Not by 100 percent. By 100 times.

Fast-forward to her new role at HERO. In this article she says:

The conversation has thus shifted from a focus on ROI alone to a broader value proposition that includes both the tangible and intangible benefits of improved worker health and well-being.

Her memory may have failed her here too because HERO — in addition to admitting that wellness loses money (which explains its “shift” from the “focus on ROI alone”) — also listed the “broader value proposition” elements of their pry-poke-and-prod wellness programs. The problem is the elements of the broader value proposition of screening the stuffing out of employees aren’t “benefits.”  They’re costs, and lots of them:

When she says: “The conversation has shifted from a focus on ROI alone,” she means: “We all got caught making up ROIs so we need to make up a new metric.”  RAND’s Soeren Mattke predicted this new spin three years ago, observing that every time the wellness industry makes claims and they get debunked, they simply make a new set of claims, and then they get debunked, and then the whole process repeats with new claims, whack-a-mole fashion, ad infinitum.  Here is his specific quote:

“The industry went in with promises of 3 to 1 and 6 to 1 based on health care savings alone – then research came out that said that’s not true. Then they said: “OK, we are cost neutral.” Now, research says maybe not even cost neutral. So now they say: “But is really about productivity, which we can’t really measure but it’s an enormous return.”


Interactive Health

While other vendors, such as Wellsteps, harm plenty of employees, Interactive Health holds the distinction of being the only wellness vendor to actually harm me.  I went to a screening of theirs. In order to increase my productivity, they stretched out my calves.  Indeed, I could feel my productivity soaring — until one of them went into spasm. I doubt anyone has missed this story but in case anyone has

They also hold the distinction of being the first vendor (actually their consultant) to try to bribe me to stop pointing out how impossible their outcomes were. They were upset because I profiled them n the Wall Street Journal . The article is behind a paywall, so you probably can’t see it. Here’s the spoiler: they allegedly saved a whopping $53,000 for every risk factor reduced. In your face, Staywell!

Here is the BenefitsPro article’s quote from Interactive Health’s Jared Smith:

“There are many wellness vendors out there that claim to show ROI,” he says. “However, many of their models and methodologies are complex, based upon assumptions that do not provide sufficient quantitative evidence to substantiate their claims.”

You think?

Finally, here is a news flash for Interactive Health: sitting is not the new smoking.  If anything is the “new smoking,” it’s opioid addiction, which has reached epidemic proportions in the workforce while being totally, utterly, completely, negligently, mind-blowingly, Sergeant Shultz-ily, ignored by Interactive Health and the rest of the wellness industry.

There is nothing funny about opioid addiction and the wellness industry’s failure to address it, a topic for a future blog post. The only impossibility is that it is impossible to believe that an entire industry charged with what Jessica Grossmeier calls “worker health and well-being” could have allowed this to happen. Alas, happen it did.

And, as you can see from the time-stamp on this post, except at establishments favored by the Wellness Ignorati, breakfast hasn’t even been served yet.

And the Envelope Please. The Best Outcomes Evaluator in Wellness Is…*

*Among the subset of males not affiliated with They Said What.


Alert readers may recall that my New Year’s resolution was to balance my negative postings about the wellness industry with positive ones.  Like Diogenes searching for an honest man, I thought the finding the latter would be hard, but just as Romy Antoine also did earlier this month, The subject of this posting — to be named in Part Two — makes that easy.  Part One sets the stage for the review of his study.

By way of background, in preparation for bringing a possible lawsuit, I re-read the famous Chapter 2 of the equally famous HERO report. That was the chapter which inspired Ron Goetzel, Seth Serxner and Paul Terry (who was recently anointed as the American Journal of Health Promotion’s new Fabricator-in-Chief) to circulate their defamatory letter about me to the media, in a singularly self-immolating attempt to discourage them from publishing my material.  They insisted that Chapter 2 was pure fabricated nonsense, rather than a carefully analyzed report of real data.  Here is an excerpt from their actual letter, copies of which are available from me but which is summarized here:

A fabricated…absurd, mischievous and potentially harmful misrepresentation of our data.

Ron said it best in our Great Debate, minute 1:17 in the MP3 downloadable here:

Those numbers are wildly off…every number in that chapter has nothing to do with reality. 

However, the sun rises in the east, taxes are due April 15th, and Ron Goetzel is lying.  Quite the contrary, Chapter 2 turns out to be a carefully analyzed report of real data — almost certainly the best case study ever published.

How did I learn that Ron was fabricating a story that his guidebook had fabricated a story?

  1. This chapter says it’s a real report, on p. 22.
  2. Since this chapter’s analysis was so far above the pay grade of those three aforementioned HERO characters, I checked the acknowledgements in the HERO book. Sure enough, none of the HERO cabal wrote it. Someone else (to be named in the next posting) was the lead author, and I called to congratulate him on it. I also asked him some background questions, one of which proved very revealing. It turns out that…
  3. This real analysis of real data was — get ready — reviewed prior to publication by the exact same people who are disowning it now. Yes, among the people who peer-reviewed it prior to publication were the very same Ron Goetzel, Seth Serxner, and Paul Terry. (In addition to them doing the actual review, the lead author, very graciously sharing the credit, wanted to make sure that I indicate that he was only the “organizer and visible author of a team effort.”)

Yes, as is so often the case with these three, they lied about the lies that they lied about.  It’s quite ironic that their argument against my original praise of this analysis was to insist that because my source was their own lies, my own analysis was unreliable.  These lies above don’t include the actual lies I might sue them about, which were lies about me, which are totally separate from their lies about their previous lies. (Their lie about me was that I had a history of outrageously inaccurate statements, none of which they have ever been able to identify.)

These characters aren’t ordinary run-of-the mill alternative fact-type liars.  They’re way beyond that.

Their lies go to 11.

goetzel-on-fire


Coming soon, the reveal…

So many candidates for the Deplorables Award countdown, so few numbers between 1 and 10

Having covered the also-rans last week, here are the first runners-up, as we inch ever closer to the coveted top spot. (To read the original postings, click on the numbered headers.)

Today we are highlighting more people and organizations who’ve made the wellness industry what it is. Wednesday we will complete the listing of the Stars of Wellness, the people and organizations who are making the industry what it should be.


#5 Interactive Health

Interactive Health conducted what may be the head-scratchingest screen in wellness industry, a difficult feat given all the competition. For starters, they tested me for calf tightness. It turns out my calves are tight–and right on-site they loosened them. I could feel my productivity soaring…until the left one went into spasm that night and I couldn’t get back to sleep. Still, I can see their point — loose calves are a useful trait for many common jobs.

first-baseman

Next, Interactive Health shattered the record, previously shared by Total Wellness and Star Wellness, for most USPSTF non-recommended blood tests. I don’t know what half these things are, which means neither does Interactive Health.

interactivehealth

 


#4 Koop Award Committee

Where would a Deplorables Greatest Hits List be without the Koop Award Committee?

Every year, like clockwork, the industry’s biggest liars select the industry’s biggest lies.  2016 started with last year’s winning program, McKesson’s, being exposed as a joke in Employee Benefit News, and ended with this year’s winner, Wellsteps, being exposed as a joke in STATNews.

When bestowing this year’s award to their fellow Committee member, Wellsteps, they didn’t even pretend not to lie. And what lies they were! Not just regular-sized lies. Not even supersized lies. We’re talking lies that would make a thesaurus-writer blush.

To put their lies in perspective, I may not even know you, but if a Koop Committee member told me the sky was blue, and you told me the sky was green, I’d at least go look out the window.

PS  Not everyone on the Committee is a liar. One person is quite honest and can’t believe what goes on every year. I don’t want to name my source because in Koop-land, honesty is grounds for termination. As is getting validation. Or adopting the Code of Conduct. Basically ethical behavior is off-limits. An executive of one group, Altarum, published a blog critical of wellness and <poof> the Committee disappeared them.


#3 Michael O’Donnell

Michael O’Donnell seems to crave my attention. When he managed to go three whole months without being featured in a TSW posting, he came up with these irresistible nuggets:

  • “Wellness is indeed the best thing since sliced bread, up there with vaccines, sanitation and antibiotics.”
  • “[Wellness] can prevent 80% of all diseases.”
  • “The ROI from wellness is very strong.”
  • “Workplace health promotion may play a critical role in preserving civilization as we know it.”

If nothing else, Mr. O’Donnell presents the best argument for requiring educational standards, or at least a GED, in this field — by demonstrating his total lack of understanding not just of wellness, but also of vaccines, sanitation, antibiotics, percentages, diseases, ROIs, and preserving civilization as we know it.

Oh, yes, and multiplication as well. His article on how to increase productivity with wellness used an example demonstrating a productivity decrease. In 2016, he also went on an anti-employee jihad that should be read in its entirety. (Translation: some of my best work…)  Highlights:

  • Prospective new hires should be subjected to an intrusive physical exam, and hired only if they are in good shape.  OK, not every single prospective new hire — only those applying for “blue collar jobs or jobs that require excessive walking, standing, or even sitting.”   Hence he would waive the physical exam requirement for mattress-tester, prostitute, or Koop Committee member–because those jobs require only excessive lying.
  • He would “set the standard for BMI at the level where medical costs are lowest.”  Since people with very low BMIs incur higher costs than people with middling BMIs, Mr. O’Donnell would fine not only people who weigh more than his ideal, but also employees with anorexia.

If employees didn’t already have an eating disorder, what better way of giving them one — and hence extracting more penalties from them — than to levy fines based on their weight?  Employees above his ideal weight would pay per pound, sort of like if they were ordering lobster or mailing packages.


#2: Ron Goetzel, Seth Serxner, and Paul Terry (Health Enhancement Research Organization)

These three characters — naturally also on the Koop Committee — managed to pile more lies, sardine-like, into a single page than anyone else in this industry, in the “poison pen” about me they circulated to the media.

A good starting question would be, why on earth would anyone think that they can send a “confidential” letter to the media?  The media are in the business of disseminating information. You see, that’s why they call them “the media.”  Am I going too fast for you, Mr. Goetzel?

The funny thing about these Einsteins? Their defense to my observation that their very own numbers show wellness loses money was that their very own numbers were made up. Imagine being so dishonest that the way you defend yourselves is by claiming you fabricated your own report.

That’s not even the punchline.  It turns out that this allegedly fabricated report is in truth an actual non-fabricated report. So, in the immortal words of the great philosopher LL Cool J, they lied about the lies that they lied about.

How did I learn this? That will be the subject of a post early year.


Watch this space…soon we will be naming the industry’s #1 Deplorable of 2016.

The Great Debate, Part 5: Ron Goetzel “endorses” me…by mistake.

We are now in Ron’s wheelhouse, which is publishing peer-reviewed articles in third-tier wellness trade journals. Let’s see how he does.

For those who are new to this thread, Part 4 is here, and links to earlier installments. The recording is here. Time stamps roughly synch up.


53:30

Ron says he is a researcher, and publishes in peer-reviewed journals.  He “applauds” me again for giving them the “opportunity” to correct their many errors, and says the comments I make are often “right on the money.”

It is indeed a creative use of the word “opportunity,” as in: “Last year the IRS gave me the opportunity to be subject to an audit.”

He says “that’s what the scientific method is all about, having peer reviewers critique your work and find problems.” And yet, I’ve never, ever been asked to peer review anything that he and his cronies have ever published. Go figure.

He would like “us” (meaning him and his cronies) to be able to review my work, even though I’m not allowed to peer-review theirs.  He says he has “never seen an article by Al Lewis…to review.”

Hmmm…perhaps his internet is down?

Since all my work is right on this site (including links to other work, in “In the News” to Health Affairs, Harvard Business Review etc.) he is free to review it anytime, and we publish all comments.  There isn’t really any need to for him to look at our material because mostly it’s his own and his cronies’ material. And you know the mantra from Surviving Workplace Wellness: “In wellness, you don’t have to challenge the data to invalidate it. You merely have to read the data. It will invalidate itself.”

As in his opening remarks and in his “secret” letter to the media, he once again criticizes my stuff as being “out there…outlandish,” but gives zero examples.


55:30

Ron, in the process of saying something he knows not to be true for a change, accidentally endorses me.

“Ron, would you say I am the most qualified person in peer review in terms of finding the most mistakes?”

“No.”

“Well, who has found more mistakes than I have?”

[Silence and nervous laughter from the audience.]

I point out that — despite his tacit endorsement just now that I am the best peer reviewer — none of his friends’ wellness trade journals have ever asked me to peer review anything.

And he still refuses to say why he hasn’t claimed the million-dollar reward.


57:00

Peer reviewed or not, numbers need to add up, and Ron’s don’t.  In one award-winning example, Eastman Chemical, $900/person in savings was shown — with risk factors changing by only 0.17 per person, excluding dropouts.

Ron did not rebut this. Eastman was one of the two Koop Award applications he had doctored when it turned out the applicant had accidentally told the truth but no one on the award committee noticed.


58:30

Ron has already run away from most of the industry’s claims, as earlier installments of this debate have observed. Now is he running away from Wellsteps’ Steve Aldana, whom he has co-presented and co-authored with and who naturally is on his Koop Award committee. Aldana recently wrote that I was “sick” because a colleague posted my Harvard Business Review article on his linkedin group and asked what people thought of it.

[2016 Update: Ron is now embracing Steve Aldana and Wellsteps, the first company to admit to harming employees.]


59:00

Ron is turning his blacklisting of me into my “plea” to do peer review in his trade journals. I have never “pled” to do peer review in his trade journals, which are mostly useful as punchlines. I merely observe that I’ve never been asked. “You’re very good at calling out mistakes, but you’re not very good at publishing your own research studies.”

He then cites the Johnson & Johnson study (that’s the same Johnson & Johnson that just proposed the Fat Tax). That is the only study he’s ever done that I’ve not been able to invalidate on its face, so he gets his first point of this round here. Not because the study is valid.  There wasn’t enough data in it for me to automatically prove that it was invalid, which is a very high standard, but that’s my standard–“face invalidity.”

So there you have it: one company in the entire universe that might possibly have saved money on wellness. And as coincidence would have it, they also sell wellness services. No publication bias there…


November 4, 2016 Update: I just found this J&J study. It is even worse than the others.  Employees lying on HRAs, trivial risk reductions…and of course massive savings. It appears that all they did was increase the deductible and then give employees $500 to do wellness, thus shifting the money out of the healthspend into the incentives account, which is not included in the “savings.”


1:00:00

I point out that even though I’m apparently not qualified enough to peer review for his friends who run low-impact journals, I do get called upon to peer review for Health Affairs and other high-impact journals. And most importantly, while I’ve done only two peer-reviewed articles, one led to the dismantling of the North Carolina Medicaid medical home. The other was #1 for 2015 in the American Journal of Managed Care and continues to be cited widely.  My award-winning book was peer-reviewed by some of healthcare’s leading figures: Stuart Altman, James Prochaska, Tom Scully, Leah Binder, Bob Galvin, Regina Herzlinger, and Nortin Hadler (the same Nortin Hadler who apologized for poor peer review by one of Ron’s favorite trade journals).

Most importantly, speaking of peer review, Quizzify is the only population health company that may publicly say “our content is reviewed by doctors at Harvard Medical School.”


1:02

Ron — whose entire industry loses money and can’t even guarantee not losing money — is now lecturing me on Quizzify’s guarantee of savings and how it needs to be peer-reviewed.  I was not expecting to be attacked for offering an incredible, unique, value proposition, so I didn’t have a good answer. Only in wellness is saving money for customers considered a bad idea.


1:02:30

He continues to harp on peer review by his friends-and-relations, but I won the round with one simple observation: “We are not here today because of Ron’s peer-reviewed articles. We are here today because of my non-peer-reviewed articles.”



I could fill a blog with all the nonsense that Ron’s friends who run so-called “peer-reviewed journals” have published. Come to think of it, I have. Examples:

AJHP’s proposal to tie insurance premiums to weight, like ordering lobster or mailing packages

AJHP’s proposal to use wellness to dramatically reduce productivity

JOEM’s Aetna debacle

JOEM’s failure to understand how to do stock price analysis

AJHP’sRandomized control trials show negative ROIs.” (I didn’t have to post anything here–this spoke for itself.)

JOEM’s fabricated evidence of savings

 

 

Dog Bites Man: Yet Another HR Publication Slams Wellness…in a Cover Story

It simply isn’t news any more when a publication aimed at the human resources market publishes an article slamming wellness.  It just means a reporter (Bruce Shutan in this case) is actually reporting the facts, rather than assuming a “false equivalence” between wellness critics and wellness apologists. While reporters “take sides” frequently these days in wellness, it’s a rarity when writing on other topics. Normally, reporters use “he said-she said” because a good rule of thumb is that most but not all debates do indeed have two sides. The exceptions to that rule are wellness,* evolution, and Trump University.

Below are the article’s highlights.


Our $1-million reward has gone unclaimed.

Obviously, if the Wellness Ignorati–and we are reviving that phrase by popular demand (for the uninitiated, it means wellness apologists who knowingly ignore facts in order to snooker) — really thought that “pry, poke and prod” programs work, they would have claimed it by now.


Wellness vendors deliberately flout guidelines to make more money

If they were to adhere to US Preventive Services Task Force guidelines, they would be screening appropriately–but make much less money. Optum’s Seth Serxner stood up on camera to blame employers for making Optum flout the guidelines, while HealthMine takes great pride in their ignorance of them. Either way, employees and employers lose.


Ron Goetzel is still flogging weight loss as the answer to an employer’s health cost problems

We aren’t listing everything wrong with Mr. Goetzel’s position, in order to leave space on the internet for other things, such as Google and Amazon.

In a nutshell, according to:

…employee weight loss programs don’t work.

He is also still calling McKesson a best practice in wellness, even though their employees gained weight (as noted below), their glucose increased (ditto) and their analytics consultant speaks in tongues.

mckesson bmi and glucose

Additionally, according to his own company’s data compiled for the federal government, even if these crash-dieting contests did work, they would have a trivial effect on health spending, which is mostly unrelated to an employee’s weight in any event. Ron has also backed off his 3-to-1 ROI claims and is now down to 1-to-1 as a goal.


HERO is caught telling the truth

HERO (the Health Enhancement Research Organization — truly the belly of the wellness beast, led by Paul Terry, Ron Goetzel and Seth Serxner) said wellness loses money.  Being the one instance in which a wellness organization has told the truth, naturally they tried to walk it back.  First, they said, with a straight face, they fabricated their data.  They said we should substitute real data for this admittedly fabricated data.  We did–and the losses skyrocketed. Then they circulated a “poison pen” letter to the media in which they blamed me for reading their report carefully.

In any event, their argument was undone when the state of Connecticut admitted they lost more than a dollar for every dollar they spent on the program.


And make sure to read to the end–Quizzify is presented as part of the solution.

A bit of a “correction” is in order here, because the article is slightly inaccurate. Please see the Quizzify landing page for the very specific language vis-a-vis Quizzify and Harvard Medical School.  Harvard Medical School doesn’t “partner” with vendors. We are the only population health company that is even allowed to use their shield at all.



*Maybe I can’t judge wellness fairly. The Wellness Ignorati would accuse me of bias due to my heritage–my parents were smart.

 

 

 

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