Jay Seifert is the co-founder of LoneStart Wellness. He is a pioneer in applying established principles of social neuroscience and behavioral economics to individual and organizational “wellness.” His strategy is specifically designed to improve the health and well-being of those individuals most at risk for preventable chronic illness but least likely to participate in traditional “diet and exercise” programs. He is a monthly wellness guest columnist and you can see his columns in the first NCHN e-News of the month or right here on the blog.

Leadership and Organizational Health:
Why “Nuts and Bolts” beats “Bells and Whistles” Every Time.

Way back around 1980, employee healthcare costs were consuming around 7 percent of corporate profits and trending upwards.  “Corporate America” responded to this issue in a way that was utterly logical—they outsourced the issue to the “experts.”  Large employers began contracting with places like Johns Hopkins and the Mayo Clinic to develop strategies to reverse this trend—and the “workplace wellness” movement was born.

The strategy was to focus on knowledge and skill-acquisition.  So they brought in dietitians, physical therapists and trainers to tell employees what they needed to know in order to get healthier.  “Do this, don’t do that.  Eat this, don’t eat that.”  This “diet and exercise” model quickly became standard workplace wellness strategy.

How well has this model performed in these last 30-some years?  Not well.  By 2006, over 50 percent of corporate profits went to employee healthcare and today about 86 percent of all full-time employees are obese and/or have at least one chronic illness.  By any standards, the “diet and exercise” model has failed to either improve the health status of employees or contain employee healthcare costs.

As Employee Benefit News put it in 2006:

“There’s a lot of ignorance out there in terms of what works and what does not,
and a lot of what doesn’t is being put in place by employers.”

Unfortunately, this is truer today than when it was written. According to the most recent Rand report on wellness, employers are now spending an average of $1,000 per employee on wellness programs and incentives while the health status of their employees continues to decline. 

There are several reasons why this is true, but one critical factor is that today’s $6 billion workplace wellness industry is profitable because it is designed more for scalability than effectiveness.  As a result, their programs tend to be:

• More passive than active
• More “top-down” than “bottom-up”
• More on-line than in-person
• More “bells & whistles” than “nuts & bolts”

Let’s look at two specific offerings that are promoted not because they are effective, but because they are profitable:

Health Risk Assessments

While they have a legitimate role in disease management, HRA’s are an unnecessary,  expensive and often counter-productive component of most traditional wellness initiatives.

• Several studies have shown that not only are HRA’s unnecessary, they can actually be dangerous by giving a completely false sense of health status, both on an individual and on an aggregate level.
• The problem is that common “white lies” become the “new truth” when committed to paper or online during a HRA. People leave the experience believing they’re healthier than they are, and that although they could stand to improve a few things, there’s not that much to worry about.
• HRAs keep us preoccupied with health risks, or health failures, when we should really be focused on those aspects of health that directly improve our productivity and lower our health care costs.

Health Coaching

This is a little trickier, because the right kind of health coaching can be very effective, especially when it invites and encourages the active participation of the individual being coached.  Unfortunately, because of the provider’s emphasis on scalability and profitability, health coaching is often:

• Intrusive, one-directional and confrontational   
• Intended more to check on participant compliance than to respond to their specific needs at that moment in time 
• The cause of resentment and suspicion and reinforces the notion that this program is “being done to me, not for me.”

Here’s where the “Nuts & Bolts” come in.  Most people want to be healthy and most will respond positively to a message that is:

• Simple
• Positive
• Concrete
• Credible

The good news is that this can be accomplished simply by inviting your employees to be a part of a new conversation about health and wellness and keeping that conversation renewed and refreshed.  The better news is that it costs very little money to accomplish this.  That’s good for you and your organization, but not so good for traditional wellness providers.

You have to wonder just whose bottom line is really benefiting from all those “Bells and Whistles,” theirs or yours?

If you have questions or issues you would like us to address in this column, contact: Jay Seifert at 512-894-3440 or jseifert@lonestartnow.com.