The following is my foreword to Nurses Take Back Health Care One Employer at a Time, written by our colleague Jeanne Moore. I recommend it to everyone with an interest in “pry, poke and prod” workplace wellness and why it has fizzled.
As the Quizmeister-in-Chief of Quizzify, I write healthcare trivia questions for a living, so it seems appropriate to start this foreword with one: What is the country’s most trusted profession?
I’ll give you a hint: it’s not “workplace wellness vendor.” (In case anyone is keeping score at home, “workplace wellness” actually has the lowest Net Promoter Score ever recorded for an industry, according to WillisTowersWatson.)
The answer? Nursing. When was the last time you saw a nurse involved in a financial scandal? When was the last time a nurse jacked up his or her prices by 1000%? Do contracts for nurses include opaque rebates and volume incentives? Of course not.
And yet until now, no one has ever asked the question: “What do nurses think of the healthcare system?”
Not much, as it turns out. Over time, nurse/patient ratios have dramatically increased, while the number of hospital administrators, insurance executives, middlemen, healthcare trivia quiz writers, and, yes, wellness vendors, has skyrocketed. Ms. Moore describes what nursing care used to be like…and what it’s like today. Essentially everybody who has ever had any experience (their own or family members) with overnight hospital stays has a story…and many of those stories involve either the harms caused by inadequate staffing, or the heroics performed by a Florence Nightingale who turned around a situation that would have led to a bad outcome. Many such stories populate this book.
Yet despite the lack of nurses in many hospital settings, there is no shortage of white-coated healthcare techs waiting to descend upon healthy populations of employees to “pry, poke and prod” them because a wellness vendor snookered an employer into thinking this nonsense saves money. The idea that pry, poke and prod programs save money is so far from the truth that I myself offer a $3 million reward to anyone who can show that it breaks even.
And yet these programs are still popular. Ah, well, as Mark Twain said: “It is easier to fool people than to convince them they’ve been fooled.”
In this book, Jeanne recounts many examples of how we have all been fooled by suppliers who are supposed to be containing our costs and providing better care. In particular, she points out how the insurance companies have been feeding at the ACA trough for 9 years now, taking full advantage of its well-intentioned provision limiting profit margins to 15% or 20% of costs. Which of course means that the only way to increase profit is to increase costs.
I’d be lying, though, if I didn’t admit that my second-favorite part of the book is her smackdown of the wellness industry. Starting with the fraud that was Safeway (whose CEO eventually tired of wellness and moved on to his next bright shiny object, Theranos), which is credited with launching the ACA’s wellness provision despite not having a wellness program, she moves point by point through the fallacies, harms, cluelessness and lies which formulate the industry’s business model. (She is careful to exempt companies, like US Preventive Medicine and It Starts with Me, which have been validated by the Validation Institute.)
And, as one would expect after reading the other insights and stories in this book, Jeanne passes the ultimate IQ test: she recognized upon her first exposure to him that the leader of the wellness industry, Ron Goetzel, can’t produce even an iota of data to contradict my own exposés of the frauds and harms perpetrated by him and his cronies by screening the stuffing out of employees with callous disregard for established clinical guidelines.*
Further, despite the admitted trivial impact of their programs (Mr. Goetzel says it takes fully 2 to 3 years to reduce risk by a mere 1 to 2%), these vendors nonetheless create massive “savings” out of whole cloth. How? They have many ways to lie, but the most common way to “show savings” is to compare active motivated participants to inactive, unmotivated non-participants – even though it’s been proven repeatedly that no matter what you do (including doing nothing at all, including telling diabetics to eat more carbohydrates), participants will dramatically outperform non-participants simply due to being motivated to begin with.
So when Jeanne talks about nurses taking back healthcare, these are the perps she wants to take it back from – the immensely profitable insurance companies and wellness vendors who are sucking resources out of the healthcare system while actual health outcomes continue to stagnate or deteriorate in the US, even as lifespans in other countries continue to lengthen.
Join the movement. Get nurses back into healthcare. Employee experience and outcomes should improve because, let’s face it, they can’t get any worse.
*Mr. Goetzel, these are my own words, not Jeanne’s and not the publisher’s. So, as I’ve been urging you to do for years, sue me, not them. Please don’t make me beg.