No 'Health' In Healthcare: Readers Weigh In

Molly Rowe, Senior Editor, Leadership , September 28, 2007

Earlier this month, I wrote about companies penalizing workers for being unhealthy ("No 'Health' In Healthcare?"). This growing trend has received mixed reviews from employees, employee rights advocacy groups, and companies alike. I asked readers to weigh in on whether punishment for unhealthy habits is a good solution. Readers had a lot to say.

"I agree with you that penalties such as increased premiums or potential loss of health insurance could be the impetus that may spur healthier lifestyles. It works for the automobile industry, why not healthcare?" wrote Denise Mika, Healthcare Compliance Specialist at LSU Health Sciences Center in Baton Rouge.

Other readers argued that negative effects outweigh positives when it comes to forcing good health on workers. These efforts hurt morale, making for less effective workers and possibly even worsening behavior. As one physician pointed out, some people just have bad luck.

"My concern about being too heavy-handed in mandating a healthy lifestyle in the workplace is that it oversimplifies the relationship between lifestyle and illness. It is true that at the population level those who exercise more, maintain an ideal BMI, avoid saturated and trans fats, and, of course, avoid cigarettes, are less likely to suffer illness than those with a less healthy lifestyle. On the other hand, as an oncologist I see patients every week who are thin, fit, never smoked, do not drink, and keep up with all of their recommended health maintenance including cancer screening, but are nevertheless diagnosed with an incurable cancer. Without exception, they ask, 'How could this have happened to me, I was doing all the right things?'" wrote Dr. Harvey Mamon, Clinical Director of the Department of Radiation Oncology for Dana Farber/Brigham and Women's Cancer Center.

Regardless of their take on penalizing employees for unhealthy behaviors, readers were unified in the belief that, right or wrong, healthcare workers have to set the bar a little higher.

"As workers in the healthcare industry we have a higher calling, like it or not, as role models. People notice when they see someone dressed in scrubs sucking on a cigarette in the smoking area outside the hospital. It must not be that bad, right? That healthcare worker is doing it . We should all stop complaining about the rising cost of operations and decreased profits while reaching for that second glazed donut," wrote Rachel Linnehan, who works for an international provider of medical technology and services.

A number of healthcare companies have implemented programs to improve employee health through reward and access rather than punishment.

Memorial Sloan-Kettering Cancer Center requires all employees to complete an annual employee health survey. A vaccination reminder service prompts employees when they're due for certain tests, and employee wellness and health screening programs are offered throughout the year. One health plan offers paycheck deductions for not smoking (a worker-friendly twist on penalizing workers who do smoke), and another health plan encourages team fitness by offering prizes like new running shoes to the employee teams that walked the most or lost the most aggregate weight.

Whether it's in the form of punishment, reward, or just easy access, leadership does have a responsibility when it comes to employee health, but "wellness incentives" need not be company-organized events. In fact, time may be the greatest incentive of all.

"Instead of brow beating those absent from work for sick days, how about giving your employees pats on the back for breaking away for a lunch-time run or walk? Chances are they'll have fewer sick days as a result, work happier, and consume fewer healthcare dollars," suggested Linnehan (an Ironman athlete).

We work in a culture that encourages missed lunch breaks. However, as Linnehan suggests, leaders who encourage--or even force--employees to step out of the office, may find that their employees are fresher, more efficient, and yes, healthier, because of it. After I write this, I'm headed for my lunchtime run -- a run I'm not sure I'd do if I had to wedge it between work and dinner. And for that wellness incentive, I'm thankful.

Molly Rowe is leadership editor with HealthLeaders magazine. She can be reached at

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