Can Wellness Programs be harmful?

By David Parekh

05/13/2014

That was the headline that caught my attention when it was published in Harvard Business Review on April 15, 2015. I was drawn to reading it, expecting to disagree with everything that was written. As a managing partner of a national provider of preventive health screenings, I have firsthand knowledge of the benefits of an effective wellness program. I know that thousands of lives have been positively affected by PicMed Wellness programs. In some cases, lives have been saved by our programs and our medical staff.

In his article, Andre’ Spicer states “Intense wellness initiatives were counterproductive”. The article goes on to say “there is an oppressive quality to wellness programs. It’s kind of a 1% phenomenon. Moral judgments are being made that aren’t really based on evidence. And access to wellness is skewed toward the healthy.” According to AndrĂ© Spicer, a professor at City University London, corporate wellness programs have potential to backfire entirely, causing some employees to be less productive, less healthy, and more anxious about their jobs.

The article goes on to declare that many wellness programs actually produce the opposite of their intended effect. They create guilt and anxiety in employees. Spicer provides an anecdotal statement, but fails to realize wellness programs are not solely responsible for creating guilt. That would be like blaming cameras, for people feeling bad about how they look in pictures. In fact, numerous studies have shown people who are unhealthy, feel bad in many areas of their life. Blaming wellness programs for the guilt of unhealthy employees seems to be a huge stretch and factually incorrect.

The article also states Spicer learned that people judged their coworkers negatively-“e.g. bad, lazy workers-if they were overweight.” This may be partially accurate but how are wellness programs to blame for this? This is more of a societal issue that has been around for decades, well before companies implemented wellness programs.

Unlike other wellness providers, I won’t discount everything that Spicer writes in his article even though I believe some of his assumptions are way off base. Where I somewhat agree with Spicer is that within some organizations, there is this ideology that effective leaders are all in excellent shape. We have worked with organizations that have wellness managers who are extremely healthy; marathoners, tri-athletes, and the like. Because of their knowledge and healthy lifestyle, they are placed in a position to inspire those who may not be the healthiest. Though these individuals may garner respect because of their focus on health and their athletic achievements, many lack the personal understanding of how to inspire those who are in the poorest of health. Many concentrate on creating a wellness program for currently health conscious employees rather than creating a program that promotes making small positive changes in the lifestyles of people totally different from themselves. These organizations spend hundreds of thousands of dollars sponsoring sporting events, wellness challenges, runs, activity trackers, and onsite gyms, only to have the healthiest of their population participate. Fitness is not the sole indicator of professional success and the more complicated and more intrusive the wellness program, the less effective it sometimes is in reaching the segment of the population that needs it the most.

Other research and our own experience have proven healthier places of work have reduced turnover, greater employee engagement, and increased productivity so wellness initiatives are a must. But as with all things, it should be taken in moderation to produce the best results. Effective wellness programs have measurable engagement that reaches the entire population and produces a quantifiable ROI.

Our simple advice to potential clients who believe they might not have the best wellness programs in place for all of their employees or who may be not obtaining a positive ROI: Ask yourselves, “Do we need all of the wellness programs that we currently utilize?” Is the ten tier wellness portal with a complex point system, wellness videos, brown bag lunch challenges, activity trackers, health challenges, and questionnaires regarding personal behavior right for your organization? If you are unsure of where to begin cutting or adding, determine through measurable means what programs reach all employees and what programs can affect modifiable health risks such as diabetes, cardiac risk, etc.

PicMed has developed and invested in making several of the services listed above available to our clients. But, we also know that dependent upon many factors, these services do not add true value to all wellness programs and thusly are not presented to the client. There are some vendors within our industry that utilize the “one size fits all” approach regardless of a company’s needs and push programs that don’t produce measurable results. By doing this, the only thing a vendor has improved is their bottom line rather than the health of the population they serve.

For some, we feel a simple program that includes a biometric screening for the most prevalent diseases, personalized coaching, and a simple five minute health risk assessment is sufficient to get individuals to at least think about their health. Additionally, this will allow the company to get baseline health measurements for their employee population so that they might enact effective programs where they are needed most. For other clients, we recommend the common sense solution of reaching out to those with the greatest number and severity of health risk factors. We utilize licensed medical staff (RN, LVN, APRN, MD) to inform them of the long term consequences of their biometric scores. This human interaction is all about encouraging them to take charge of their health and what’s at risk for them regarding their current state of health.
We want to encourage at risk employees to see their doctor or help them establish an ongoing relationship with a local medical provider. We believe that getting someone with high blood pressure or a diabetic condition to see a doctor is more effective in reaching at risk employees and reducing a company’s insurance costs than is providing a wellness portal that many don’t access or only small parts of it are utilized. Again, we don’t discount the need for many of the aforementioned products/services, but we feel that many of the bells and whistles that are incorporated into wellness services are not effective in garnering meaningful outcomes.

As a wellness provider we also set the expectation for our employers to be realistic about what they hope to achieve from programs. Your entire organization will not quit smoking or become marathon runners. However, we will help make small changes in a number of people that can positively affect their health. By making these small changes, health care cost are lowered, employee productivity is increased, and lives are changed. Our clients will see a positive ROI and will work with a wellness organization that cares about the lives reached just as much as it does the invoice sent. Measuring what percentage of your unhealthiest population visited their primary care physician for a wellness visit is more important than how many healthy employees participated in the wellness challenges and how many have reached the top of companies wellness pyramid.