“WELLNESS OR ELSE!” The Beginning of The End — Part 2

Note: This article has an accompanying video — watch now.

In our new book, “How To Build a Thriving Culture a Work, Featuring The 7 Points of Transformation,” Dr. Rosie Ward and I explain in detail why the overwhelming trend in the workplace wellness industry — what we refer to as “Wellness or Else” — is detrimental to the health of employees and the organizations in which they work, and in fact threatens the very survival of our profession. This approach basically comes down to turning the workplace into a doctor’s office, forcing people to participate in behavior-change programs and punishing them if they don’t.

We and a few others in and outside of our field are dedicated to reversing this trend and eliminating this abomination. Of course, we understand that the people promoting these approaches find our suggestions offensive and scary, perhaps in a similar way that people in the beginning of the 17th century found Galileo’s proclamations that the earth was NOT the center of the solar system so disturbing.

In Part One of this series, Selling Workplace Wellness: Rhetoric vs. Reality (view article * view video), we describe why the “wellness or else” approach is unethical, ineffective, financially irresponsible and highly unpopular. Typically when we do this folks respond with “Well, what do you think we should do instead?” This is a great question, as just complaining about an outdated paradigm without suggesting an alternative one is not very helpful. Of course, Galileo actually proved his contentions were correct by inventing the telescope, yet was still placed under house arrest for the remainder of his life.

Nevertheless, in our new book we provide a detailed blueprint for doing things differently. Here, in Part 2, we offer just a glimpse into that blueprint by contrasting some of the most common current assumptions and approaches with our updated, science-based alternatives for ushering organizational and employee wellbeing into the 21st century.

  1. First, let’s look at the meaning of a “Healthy” Organizational Culture

    Instead of this: Traditional workplace wellness conceptualizes a “healthy organization” or a “culture of health” as primarily a place where employees can take an aerobics class, obtain a pedometer, get money toward a gym membership, have access to fruits and vegetables in the cafeteria, and perhaps take a stress management class. In fact, however, this bears little resemblance to how experts in the organizational development world understand this concept. For them:

    Consider this: A “ healthy organization” is one in which there are minimal politics and confusion, high morale and productivity, and low turnover. As such, the foundation of a “culture of health” ultimately rests on the quality of the relationships among its people rather than on what they eat, how much they exercise, and whether they practice stress management techniques.

    Rationale: Although traditional approaches to creating a healthy culture may provide some positive benefits, they do not address the underlying (nor the most important) aspects of employee wellbeing. From an organizational perspective, the potential benefits from such initiatives pale in comparison to the benefits of creating an environment where relationships and open communication are cherished, and employees are intrinsically motivated to come to work and be involved in something larger than themselves; something that contributes meaning and purpose to their lives. Consequently, an organization can have a traditionally defined “culture of health/wellness” but still be completely dysfunctional in terms of true organizational health. Unfortunately for many workplaces, this is the consistent and unpleasant reality. Clearly, the likelihood of any change initiative being sustainable in such a culture is minimal at best.

  2. Next, we turn our attention to the role of Leadership 

    Instead of this: Almost everyone agrees that quality leaders are a necessary pre-requisite for employee and organizational health. Traditional approaches to worksite wellness stress the critical importance of having leaders actively and visibly participating in wellness initiatives while encouraging employees to do so as well. Again, this flies in the face of the extensive literature on leadership, which tells us that instead…

    Consider this: Great leaders create the conditions to support employees in clarifying their purpose and finding meaning in their work. THIS will provide the maximum benefit for employee wellbeing, much more so than whether your leaders visibly participate in wellness programs and/or support healthy lifestyles.

    Rationale: If this does not sound intuitively evident, we invite you to entertain the following questions: Who cares if leaders model “healthy behaviors” if they treat their employees like mindless machines or small children? Who cares if leaders help communicate messages about wellness programs if employees don’t trust them? Who cares if a workplace has healthy food and a fitness center, if employees are stressed because of their manager from hell? Who cares about employee wellness when your boss and your work are essentially making you sick?

  3. Perhaps nothing in our field is more contentious and controversial than the issue of  Motivation

    Instead of this: As a result of historically low participation in workplace wellness programs, companies first resorted to using rewards and are now increasingly using punishments to coerce participation. The underlying assumption is that employees won’t do the right things unless they are rewarded for doing them and/or punished if they don’t.

    Consider this: Over and over and over again, we hear wellness and business leaders alike saying, “How can I get my employees to work harder, be safer, participate, and be healthier?” Unfortunately, these are actually the wrong questions to be asking. Instead, the correct question is: “How can we create the conditions within which people can find the motivation to_____?”  Creating these conditions requires thinking differently about people and change.

    Rationale: Decades of definitive evidence demonstrate that extrinsic motivation does not result in sustainable change. In fact, rewards and punishments reduce performance and creativity, foster short-term thinking, cheating, lying and taking shortcuts, and diminish intrinsic motivation.

    The key lies in helping people to enhance intrinsic motivation — and this simply cannot be accomplished through pressure, coercion, rewards or punishments, but only  by nurturing autonomy, mastery and purpose, and helping people strengthen their intrinsic thinking. As internationally renowned economist, financial journalist, and technology innovator JP Rangaswami put it:

    “Why would you want to hire a really smart person and then tell them what to do? It’s kind of stupid.”

  4. Next we turn our attention to the Medicalization of The Workplace.

    This has become one of the mainstays of “wellness or else” approaches. A growing body of literature over the past few years has addressed the inconsistencies, pitfalls, and outright dangers of trying to turn the workplace into a doctor’s office. In response we suggest that…

    Instead of these: Biometric screenings and Health Risk Assessments

    Consider these: Healthcare consumerism, The Chronic Disease Self-Management Program, Company Sponsored Centers of Excellence, Leapfrog Safety Scores, and The Coordinated Care Model. We have discussed these in our book and recommend Tom Emerick’s seminal work, which goes into more detail in easy to understand and implement terms.

    Rationale: There is no evidence that screenings and health risk assessments save money or improve health, and growing evidence that they may lead to overdiagnosis and overtreatment and cost shifting to the most vulnerable employees. However, learning to make better healthcare decisions not only reduces unnecessary visits to physicians and emergency rooms, it also decreases healthcare costs, improves quality of care, improves satisfaction with patient care, and increases patient empowerment.

  5. Another mainstay of “wellness or else” approaches is Programming — particularly around Health Ed/Behavior Change. And of course, nutrition and exercise related programs are some of the most common. Unfortunately these programs are often delivered in ways that are not helpful and potentially harmful. With that in mind we recommend…

    Instead of these: Weight loss programs, prescriptive eating and exercise initiatives

    Consider these: Health for Every Body®, intuitive eating, and positive body image initiatives

    Rationale: Nothing is more conclusively evidence-based in the health literature over the past 30 years than the abject failure of weight loss initiatives to produce sustained weight loss or improve health. And there is growing evidence of negative consequences from the increased risk of eating disorders, heightened weight stigma, and weight cycling that ensues as a result. It is fiscally and ethically irresponsible to continue to offer initiatives that have been documented for decades to fail for at least nine out of 10 people who participate in them. As workplace wellness legend Dr. Dee Edington put it so eloquently a decade ago:

    “Weight loss money is money down the toilet”

    Instead of wasting valuable resources on programs that attempt to make people smaller, or prescriptive nutrition and physical activity programs that end up appealing to few of the folks who could most benefit from them, we recommend investing in initiatives that help people find peace with their bodies, their food, and their movement.

  6. Finally, we turn our attention to the subject of Language. The great English writer and poet Rudyard Kipling said, “Words are, of course, the most powerful drug used by mankind. Not only do words infect, egotize, narcotize, and paralyze, but they enter into and colour the minutest cells of the brain.” With that in mind, we recommend:

    Instead of these:  Wellness, human resources, human capital, “driving” participation, “getting” people to change

    Consider these: Wellbeing, partners, team members, creating the conditions, and nurturing autonomy.

    Rationale: As we move through our The 7 Points of Transformation, we deliberately omit certain words and terms commonly used with organizational and employee wellbeing. We do this to better align our language with the updated scientific discoveries of the 20th and 21st centuries. Instead of mechanistic, reductionist, dualistic, biomedical underpinnings, we employ understandings from quantum physics, chaos and complexity, psychoneuroimmunology and neuroscience as the foundations for all of our recommendations. In Daniel Pink’s groundbreaking book “Drive,” entrepreneur and CEO Jeff Gunther explains:

    “More companies will migrate to this as more business owners my age come up. My dad’s generation views human beings as human resources… for me it’s a partnership between me and my employees. They’re not resources, they’re partners.”

So, what are the take-home messages here? We are certainly not naive enough to think: 1) that just because what we are doing in workplace wellness is not working, and 2) just because these approaches may actually be negatively impacting both organizational and employee wellbeing, and 3) just because there are far more effective approaches available, that the end of “wellness or else” is in sight. As we have learned, old paradigms die hard; and adding to the problem, as the prolific American author Upton Sinclair so accurately observed,

“It is difficult to get a man to understand something, when his salary depends upon his not understanding it.”

What we do know is that more and more people are questioning what is being done, reacting to an industry that has revamped Einstein’s definition of insanity to read:

“Doing the same things over and over again and hoping no one will notice.”

But people are noticing, and we are encouraged by the revolts against these approaches and the increasing scrutiny under which the industry is coming. We believe this is a good prognosis for organizational and employee wellbeing, and critical for the survival of our industry.

With that in mind, we invite business leaders and workplace wellness professionals alike to refocus on the employee experience and get back to doing things for rather than to employees with the goal of making “wellness or else” a thing of the past as quickly and completely as possible.

Note: This article has an accompanying video — watch now.

Check out Part 1 of this article and watch the accompanying videoSelling Workplace Wellness: Rhetoric vs. Reality.

Jon Robison, PhD, MS, MAJon is an accomplished speaker, teacher, writer and consultant. He has spent his career advocating that health promotion shift away from its traditional, biomedical, control-oriented focus, with a particular interest in why people do what they do and don’t do what they don’t do. Jon has authored numerous articles and book chapters and is a frequent presenter at national and international conferences. He is also co-author of the book, “The Spirit & Science of Holistic Health — More than Broccoli, Jogging and Bottled Water, More than Yoga, Herbs and Meditation.” This work formed the foundation for one of the first truly holistic employee wellness programs — Kailo. Kailo won awards in both Canada and The United States, and the creators lovingly claim Jon as its father. Contact Jon at: jon@salveopartners.com or jonrobison.net.

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