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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

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.

More Media Coverage Slamming New Genetic-Screening Wellness Bill

This afternoon STATNews followed up with more criticism of HR 1313, the Preserving Employee Wellness Programs Act.  As measured by comments to their previous article and the Washington Post’s article, public opinion is running about 999-to-1 against it.  That’s a lot even for wellness.

Ryan Picarella, of WELCOA, jumped on this and got way ahead of HERO, which is not opposing it.  They can’t. Aetna is a major dues-paying supporter, and Aetna loves genetically screening employees for defects. Naturally they fabricate their outcomes.  This time we mean it literally when we say: “Lying is part of wellness vendor DNA.” Aetna even invested in a company to further their dystopian vision, a company ironically named Newtopia.

By contrast, this is the kind of leadership we’ve come to expect from WELCOA, filling the ethical vacuum created by HERO.

But, more importantly, this article is the first media mention of Ethical Wellness, our new website dedicated to putting the wellness back in wellness. You might recall the original Workplace Wellness Code of Conduct.  Ethical Wellness has updated it.  You can sign on to the website, join and endorse, all at no cost.  You can also contribute, separately, and be highlighted as a contributor. Scott Life and Dan Keith have both pitched in $500, as compared by to my $10 (to test the donating mechanism — that’s my story and I’m sticking to it). I’ll be putting in the other $490 shortly. Really.  There is also a linkedin group.  No mass postings — a true discussion group.

We’ll be talking more about Ethical Wellness in the coming days.  for now, it’s about not fining employees for refusing to have their children genetically screened for defects.

 

 

Breaking News: Is Ron Goetzel about to admit wellness loses money?

This article is now mooted — the Health Affairs piece did come out…and it’s much much worse (meaning, better) than I thought. Skip to it now.

Rumor has it that within the next couple of days Health Affairs is going to release a paper in which Ron Goetzel admits that — even with his finger on the scale as it always is (along with the other nine and all his toes) — wellness loses money.  This is total vindication for the years in which he has preferred to simply fabricate large savings, based on trivial risk impact, and then accuse me of “outrageous inaccuracies” and other such fanciful tales for observing — accurately, as it turns out — that all his savings are made up.

Yes, I know I’ve said he has admitted wellness loses money several times before, like in his HERO Guidebook, or in STATNews, or in the Chicago Tribune.  But those were all gaffes. (A gaffe is defined as “accidentally telling the truth.”)  The difference is, this time it’s deliberate.

And, no, he hasn’t sworn off lying.  Lying is a thing these days.  He was way ahead of the curve on that. Mind you, I have not seen the article, and I wasn’t allowed to peer review it. (Health Affairs allows authors to rule out certain peer reviewers, so he ruled me out — despite admitting not too long ago that I am the best peer reviewer in the field.)  However, I anticipated that, given his level of integrity, he would use the completely invalid participants-vs-non-participants methodology, and so I invalidated it for him ahead of time, not that he didn’t already know.

Despite admitting losses, he still holds to the fiction that somehow risk factors decline, a claim which I intend to examine once I see the article.  I suspect he didn’t plausibility-test the outcomes (even though his HERO guidebook says to do that) and/or he didn’t count dropouts and non-participants.  But we’ll know soon enough.

However, by admitting wellness loses money even if risk factors improve, he just invalidated every single Koop Award he has ever bestowed on any of his buddies.  The reason is that in those award-winning situations, risk factors either only improve a trifle (Staywell, 2014 and Nebraska, 2012), don’t decline at all (McKesson, 2015), or increase (Wellsteps and Boise, 2016).  None of these non-improvements acknowledges dropouts, of course.

Stay tuned…


PS  Remember my $2-million reward for showing wellness saves money?  Let’s make it $3-million.

 

 

 

 

And the envelope please. The best outcomes evaluator in wellness is…

The best outcomes evaluator in the wellness field is Dr. Iver Juster.*

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

Why Dr. Juster’s Case Study Is the Best Case Study Ever Done in This Field

Chapter 2 of the HERO Guide is a great study and deserves high praise. But before we get into the salient points of what makes this absolutely the best case study analysis ever done in this field, be aware the provenance is not a coincidence.  Dr. Juster is very skilled at evaluation. Indeed he was the first person to receive Critical Outcomes Report Analysis (CORA) certification from the Disease Management Purchasing Consortium. (Dr. Juster very graciously shares the credit, and as described in his comments below would like to be listed as “the organizer and visible author of a team effort.”)

Note: the CORA course and certification are now licensed for use by the Validation Institute, which has conferred honorary lifetime certification on Iver gratis, to recognize his decades of contribution to this field. (Aside from the licensure, the Validation Institute is a completely independent organization from DMPC, from They Said What, and from me. It is owned by Care Innovations, an subsidiary of Intel.  If you would like to take the CORA Certification course live, it is being offered next in Philadelphia on March 27.  You can take it online as well.)

Early in the chapter, Iver lists and illustrates multiple ways to measure outcomes. He dutifully lists the drawbacks and benefits of each, but, most importantly, notes that they all need to be plausibility checked with an event-rate analysis, which he provides a detailed example of–using data from his own work. In an event rate analysis, wellness-sensitive medical events are tracked over the period of time in question.

Wellness has never been shown to have a positive impact on anything other than wellness-sensitive events. Consequently, there is no biostatistical basis for crediting, for example, “a few more bites of a banana” with, to use our favorite example, a claimed reduction in cost for hemophilia, von Willibrand’s Disease and cat-scratch fever.

ted-nugent

By contrast, real researchers, such as Iver, link outcomes with inputs using a concept called attribution, meaning there has to be a reason logically attributable to the intervention to explain the outcome. it can’t just a coincidence, like cat scratch fever. As a result, he is willing to attribute only changes in wellness-sensitive medical events to wellness.

Event-Rate Plausibility Analysis

Event rates (referred to below as “PPH” or “potentially preventable hospitalizations”) are laid out by disease on page 22 of the HERO Report.  Note the finding that PPH are a small fraction of “all-cause hospitalizations.”  Though the relative triviality of the magnitude of PPH might come as a surprise to people who have been told by their vendors that wellness will solve all their problems, Iver’s hospitalization data sample is representative of the US as a whole for the <65 population, in which chronic disease events are rare in the <65 population.

hero page 23 total

Gross savings total $0.99 per employee per month.  This figure counts all events suffered by all members, rather than excluding events suffered by non-participants and dropouts. Hence it marks the first time that anyone in the wellness industry had included those people’s results in the total outcomes tally — or even implicitly acknowledged the existence of dropouts and non-participants. He also says, on p. 17:

For example, sometimes savings due to lifestyle risk reduction is calculated on the 20% of the population that supplied appropriate data. It’s assumed that the other 80% didn’t change but if some of the people who didn’t supply risk factor data worsened, and people who got worse were less likely to report their data, that model would overestimate savings.

Note that the PPH declined only in cardiac (“IVD”) and asthma.  Besides the event rates themselves being representative of the employed population in the US as a whole as a snapshot, the observed declines in those event rates are almost exactly consistent with declines nationally over that same period. This decline can be attributed to improvements in usual care, improvements that are achieved whether or not a wellness program was in place.  The existence and magnitudes of the declines, coupled with the slight increase in CHF, diabetes and COPD combined (likewise very consistent with national trends), also confirm that Iver’s analysis was done correctly. (Along with attribution, in biostatistics one looks for independent confirmation outside the realm of what can be influenced by the investigator.)

It is ironic that Ron Goetzel says: “Those numbers are wildly off…every number in that chapter has nothing to do with reality” when I have never, ever seen a case study whose tallies — for either total events or event reduction, let alone both — hewed closer to reality (as measured by HCUP) than this one.

Another factor that conveniently gets overlooked in most wellness analyses is that costs other than PPHs rise.  By contrast, Iver is the first person to acknowledge that:

HERO other costs increase

The implication, of course, is that increases in these costs could exceed the usual care-driven reductions in wellness-sensitive medical events. Indeed, Iver’s acknowledgement proved prescient when Connecticut announced that its wellness program made costs go up.

The $0.99 gross savings, and Connecticut’s healthcare spending increase, exclude the cost of the wellness program itself, of course. Factor in Ron Goetzel’s recommendation of spending $150/year for a wellness program and you get some pretty massive losses.


The old Al Lewis would close by making some reference to the dishonesty and cluelessness of the Health Enhancement Research Organization’s board. The new Al Lewis will do just the opposite. In addition to congratulating Iver Juster (and his co-author, Ben Hamlin) on putting this chapter together, I would like to congratulate the Health Enhancement Research Organization, for what Iver describes as the “team effort” in publishing it — HERO’s first flirtation, however fleeting and inadvertent, with integrity and competence.



Iver Juster Comments on the article

Iver reviewed this article and would like to add several points. I am only adding a couple of my own points, noted in indented italics:

  • It’s important to credit the work to a larger group than just myself. I was the ‘lead author’ on the financial outcomes chapter of the HERO/PHA measurement guide, but the work entailed substantial planning and review in collaboration with the chapter’s coauthor (Ben Hamlin from NCQA) and members of the group dedicated to the chapter (as well as the HERO/PHA authoring group as a whole).
    • Yes, I am more than happy to credit the entire group with this study, especially Ron Goetzel, Seth Serxner and Paul Terry.
  • Nonetheless the work does reflect my perspective and approach on the topic – the important points being (a) select metrics that are impactible by the intervention or program; (b) be transparent about the metric definitions and methodology used to measure and compare the; (c) assiduously seek out potential sources of both bias and noise (in other words, exert the discipline of being curious, which is greatly aided by listening to others’ points of view); (d) understand and speak to the perspective of the study—payer, employee/dependents, clinician/healthcare system, society.
  • Be particularly sensitive to the biologically-plausible timeframes in which your outcomes ought to occur, given the nature of the program. Even if optimally implemented with optimal uptake and adherence, we might expect ‘leading indicators’ like initial behavior changes to improve quickly; program-sensitive biometrics (lipids, A1C, blood pressure, BMI) and medication adherence to change in a matter of months; and a few program-sensitive ER/inpatient visits (like worsening heart failure or asthma/COPD exacerbations) to improve within several months (again, assuming the program is designed to address the causes of these events). Longer-term events like kidney failure, heart attack and stroke and retinopathy take much longer to prevent partly because they require sustained healthy behavior, and partly due to the underlying biology.
    • This is one excellent reason that the measured event rate decline mirrored the secular decline in the US as a whole over the period, meaning the program itself produced no decline over that period.  Possibly they might decline in future years if Iver is correct. Ron Goetzel would take issue with Iver’s assertion — Ron says risk factors decline only 1-2% in 2-3 years.
  • Event rate measurement in any but the largest Commercially-insured populations is subject to considerable noise. Though a challenge, estimating ‘ confidence intervals should at least shed light on the statistical noisiness of your findings. 
    • No need this time because your results hewed so closely to secular trend, reflecting the quality of the analysis.
  • It is very likely that the program used in the illustration did affect more than the events shown because it was a fairly comprehensive population health improvement initiative. For example, ER visits were not counted; and collateral effects of ‘activation’ – a very key component of wellness – were not included in this analysis. Assuming the 99 cents is an accurate reflection of the program’s effect on the events in the chart, I’d be willing to increase the actual claims impact by 50 to 75%.
    • If your speculation is accurate, that would increase gross savings to $1.49 to $1.73/month–before counting preventive care increases indicated on Page 22.
  • Nonetheless, to get effect from an effective program you have to increase both the breadth (number of at-risk people) and depth (sustained behavior change including activation) – but at a cost that is less than a 1:1 tradeoff to the benefit. In other words, you must increase value = outcomes per dollar. This cannot be done through incentives alone – as many researchers have shown, if it can be done at all, it must be the result of very sustained, authentic (no lip service!) company culture.
  • We are beginning to pay attention to other potential benefits of well-designed, authentic employee / workplace wellness programs (of which EHM is a part) on absenteeism, presenteeism, employee turnover and retention – and, importantly, company performance (which is after all what the company is in business to do). It’s early days but it’s possible research will show that companies that are great places to work and great places to have in our society will find financial returns that far outstrip claims savings. The jury’s still out on this important topic but let’s help them deliberate transparently and with genuine curiosity.
  • Did Ron really say you have to spend $150 per year PER MEMBER on a wellness program? I’d be thinking a few dollars (unless he’s including participation incentives)

 

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.

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