The Waste in Wellness

Esteemed bioethicist Ezekiel Emanuel recently wrote in The New York Times that he wouldn’t get his annual physical. Can’t say I’m surprised. In numerous investigations, clinicians have found that these yearly exams, which were once heralded as the pinnacle of prevention, are actually of dubious benefit. I’m not denying the occasional life-saving benefits of these check-ups, but for the most part, younger and healthier individuals don’t gain much from them, unless we’re talking about building relationships with healthcare providers.

Nevertheless, plenty of people get these screenings every year because insurers and employers incorrectly regard and publicize unnecessary screenings as necessary. They don’t reduce morbidity and mortality significantly, yet insurers and employers often tie incentives to completion, giving employees no choice but to comply and overuse services. How else will they get their employers to fund their HSAs?

Employers should incentivize actual evidence-based worksite wellness programs. The USPSTF, aka the panel of primary care experts that researches, revises, and drafts preventive care recommendations, advises use of health risk assessments with feedback plus health education, seasonal on-site vaccine clinics, enhanced access to places for physical activity, smoke-free policies, obesity prevention/control programs (e.g., educational strategies, skill-building activities, carrots for positive behavior changes).

Last year, we coordinated upwards of 100 flu vaccine clinics and spearheaded many obesity-related educational campaigns—you’ll seldom find an employer that doesn’t recognize the benefit of healthy-weight, flu-free employees. We’re staunch advocates of pushing out programs that work. So this year, instead of continuing the rhetoric of traditional wisdom (read: rewarding completion of the annual physical), participate in the rhetoric of reality… It’s where you’ll find the evidence, and it’s where you’ll find success.

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