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A Festivus Special: The Year’s Funniest Vendors — Keas, Star, and Vivify

In the spirit of Festivus, we reprise four of the funniest vendors we’ve highlighted in 2015 that you might have overlooked. In more ways than one, these vendors didn’t get as many hits as they deserved:

and just to be fair and balanced…


Seasons Greetings from all (both) of us here at They Said What?

festivus

Should the Wellness Vendor Oath Be: “First, Do Harm” ?

Quizzify Q in B and W

The Quizzify oath: First, do help.

When Thomas Edison said: “We don’t know a millionth of 1% about anything,” he wasn’t talking about the wellness industry, because wellness vendors aren’t that knowledgeable.  And much of what they “know” is harmful.

Smoking and exercise aside, taking wellness vendors’ advice 10 years ago — during the time wellness was somehow allegedly racking up its famously fictitious 3.27-to-1 ROI by making employees healthier– would have been a very bad idea.  PSA tests, annual mammograms for younger women, colonoscopies at 5-year intervals, and EKGs were perfect examples of must-to-avoid screens, even if it meant leaving incentives on the table.

And yet even though most wellness vendors (Star Wellness, Bravo Wellness Total Wellness, HealthFair Services and Aetna being notable exceptions) won’t harm employees as much as they did 10 years ago, a lot of mythology still causes a lot of harm today, albeit more subtly.

Myth: “We need to ‘do wellness’ because 75% of our healthcare cost is due to preventable chronic disease.” (Ron Goetzel, in our recent debate, boosted this figure to 80% for reasons unknown.)

Fact:  Have ya looked at your high utilizers and other expenses? We-can-prevent-75%-of-cost-due-to-chronic-disease is the biggest urban legend in healthcare. We’ve done multiple articles on it — there are too many fallacies to squeeze in here.  Though it’s just arithmetic, this is the most harmful fallacy of all, because by causing employers to obsess with overprevention, it spins off all the other fallacies below.

Myth: “Reducing our employees’ BMIs will save money.”

Fact: The actual science is far more nuanced.  Some people have high BMIs because they are healthy.  And belly fat — even at “normal” weights — is riskier than all but the highest BMIs.  Further, attaching money to weight loss between weigh-ins creates a binge/crash-diet cycle that is decidedly unhealthy.

Myth: “Corporate weight loss programs save money.”

Fact: No corporate weight loss program has ever saved money. They don’t reduce BMIs, BMIs are the wrong measure (see above), and the link between reducing BMIs and saving money is nonexistent.

Myth: “Screening our employees will be good for their health.”

Fact: Annual screenings are a bad idea for the majority of employees. The head of Optum’s wellness operations, Seth Serxner, just acknowledged this inconvenient truth last week.  (He somehow shifted the blame to employers, for stupidly spending too much money on Optum and other vendors. That’s a topic for another post.)  The US Preventive Services Task Force has a schedule of screenings that essentially no wellness vendor follows. Because so few biometric screens are recommended for working-age adults by the card-carrying grownups who comprise the USPSTF, following USPSTF guidelines would bankrupt the industry.

Myth: “Screening guidelines balance costs and benefits so at worst we’ll break even.”

Fact:  Screening guidelines balance harms and benefits, not costs and benefits.  The subtlety of the distinction would be lost on most wellness vendors, but it is important.  (1) Unless screens are provided free, an employer will lose money even on a screening program done according to guidelines; (2) you are not doing your employees any favors by providing screening “greater than” guidelines, like the Health Fitness Corporation/Nebraska program did.  You are simply raising the likelihood of harm.

nebraska screening guidelines

Myth: “Annual checkups will keep our employees healthy.”

Fact:  For wellness vendors, the annual checkup has almost mystical power. Bravo’s CEO Jim Pshock loudly credits checkups with preventing cancer.  Wellness vendor bloviating aside, the science is quite settled: employees are more likely to be harmed than benefited by annual checkups.

Myth:  “Our employees need to eat healthier.”

Fact:  OK, there is a, uh, grain of truth here.  Many people have bad diets–fried food, sugar etc. But beyond eating less fried food and sugar, the science remains unsettled.  Salt, saturated fat, complex carbohydrates…all in the realm of not completely settled. What is true and remarkably overlooked is the epidemiological rule of thumb that if an impact is major, it shows up in small samples. 86 cases were needed to link lung cancer to smoking. And a famous study of 523 veterans proved very high blood pressure causes strokes. Yet after tons of controlled and observational studies — even comparing countries to one another — we still haven’t found “the answer.” That means “the answer,” whatever it is, won’t matter much in the workplace.  So you’re wasting your time trying to get employees to “eat right.”

We could keep going — antioxidants are more likely to cause cancer than prevent it. Sitting is not the new smoking.   And drinking eight glasses of water a day is good for you only in that you’ll get more exercise going to and from the restroom.

The biggest myth of all?  Wellness vendors actually do anything of value, other than make up savings figures to show your CFO so you look good.  Or as my colleague Vik Khanna says: “Love your employees.  Fire your wellness vendor.”

 

Hey, How Come Wellness Needs an ROI But Real Healthcare Doesn’t?

Now that the myth that there is any ROI in wellness is thoroughly both debunked and also even acknowledged by the wellness industry, vendors often fall back on the “argument” that nothing else in healthcare needs an ROI.  Why should workplace wellness be singled out?  The editor of the American Journal of Health Promotion, Michael O’Donnell, even asked: “Who cares about an ROI anyway?”

The answer to Michael’s question?  Everyone should care. And everyone should insist on an ROI from wellness, for three distinct reasons.  Each reason is sufficient on its own.  So even if there were a fallacy in two of the reasons (and there isn’t), the remaining reason would still be definitive.

First, consider an employee with appendicitis. You don’t calculate an ROI. You call an ambulance. But suppose a vendor says to you: “If an employee’s appendix bursts, the cost could be $100,000.  So we propose taking out everyone’s appendix preventively.”

You’d ask:  “What’s the rate of burst appendixes and how much do appendectomies cost?”  While that’s an extreme example (and we didn’t mean to give these people any ideas), this is basically the calculation you should make when vendors propose screens. Here’s how to do the calculation. You’ll be shocked at how much it costs to avoid even one event by screening everyone.

Second, wellness is the only thing in healthcare that employees are forced to do, subject to a financial forfeiture of penalties or lost incentives.  Other activities which people are penalized for not doing include: wearing helmets/life jackets/seat belts and getting kids vaccinated.  In each case, the clinical evidence/science overwhelms considerations of personal choice.  (Even then, in some states personal choice still rules.)

By contrast, the only thing that’s overwhelming about wellness evidence/science is how overwhelmingly the evidence eviscerates wellness, which of course is what this site is all about.  Unfortunately, wellness vendors don’t understand evidence — or for that matter healthcare itself. Many vendors have no knowledge of basics like clinical guidelines, or even arithmetic.  One wonders how they can do their jobs as wellness vendors without understanding healthcare. And that brings us to the third reason that wellness (unlike healthcare) needs an ROI, which is…

Wellness isn’t healthcare.  Quite literally every other provider of physical healthcare–from heart surgeons to  acupuncturists–needs to train, pass a test, get a license, take continuing education, and be subject to review by an oversight board.  Not wellness vendors.  You can become a wellness vendor for $67,000. “Up to” eight days of classroom and on-the-job-training are also included in that $67,000.  (To put that in perspective, Four Seasons housekeepers get ten days of training.) The vendor that offers these franchises, Star Wellness, brags about how no healthcare background is needed to be a wellness vendor. A background in “sales or municipal administration” is perfectly sufficient.

So if you’re wondering why wellness vendors know so little about wellness, there’s your answer:  they aren’t required to know anything about wellness. Knowing just a little exceeds the minimum requirement.

Quizzify Q in B and W

Quizzify does have an ROI…and it’s guaranteed.

To conclude, here is our advice to workplace wellness vendors trying to justify what popular healthcare blogger Paul Levy calls the “wellness tax“: shut up and just be happy you still get to collect it, and that the authorities haven’t shut you down. (A doctor doing all this overscreening and billing for it would have been shut down.)

Don’t try to justify your hyperdiagnostic jihad on the basis of ROI or any other purpose other than enriching your bank accounts. Every time you try, you provide yet another reason why whatever college gave you a degree in anything other than advanced idiocy should lose its accreditation.

You Too Can Become a Wellness Vendor…in Just 5 Days

Anyone care to become a wellness vendor?  Good news:  you can buy a wellness franchise from Star Wellness without knowing a single thing about healthcare…

star wellness franchise questions --medical background

…as long as you have your checkbook handy.

star wellness franchise investment

They do, however, recommend a background in sales, finance, or municipal administration.

The other good news — for you salespeople, financiers, or city managers — is that Star Wellness will teach you everything you need to know about wellness:

star wellness five days

Yes, in five days you too can learn everything that Star Wellness knows, like how to ignore USPSTF guidelines, which is one category in which Star leads the industry.  (One place they lag is reading comprehension, since we have already pointed out that most of what they propose is more likely to harm employees than benefit them…and yet they continue to advertise these hazardous screens.)

In addition to “up to” 5 days in the classroom, franchisees also get 3 days of on-the job training.  So in case anyone is keeping score at home:

  • Training required to get a job as a wellness vendor:  8 days
  • Training required to get a job as a housekeeper at the Four Seasons:  10 days

This intensive training has captured the attention of WELCOA, which has named Star a Premier Provider:

star wellness --WELCOA

WELCOA has very high standards, as we have noted on They Said What.  One thing they excel at is spelling the name of their founder, assuming their founder invented the all-you-can-eat self-service restaurant.

welcoa warren buffet

A commitment to excellence, like that displayed by Star Wellness and WELCOA, might explain why employers have gone all-in on the notion that teaching employees, for example, to drink eight glasses of water a day will reduce healthcare costs, and also increase productivity, at least between trips to the water coolers and the rest rooms.

You’d learn far more than the typical wellness vendor knows about wellness simply by taking the Quizzify quiz.  You’d learn more just by taking the demo quiz on the landing page.

Heck, you’d learn more just by reading the Quizzify landing page itself.

 

 

 

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