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Can You Really be Addicted to Fun?

Hello, my name is Mike Rucker, and I am a fun addict.

This should not surprise anyone. I pretty much have been my whole life. Admittedly, this passion has gotten me into trouble from time to time. For me, channeling this obsession by creating better user experiences (UX) grounds my passion with a purpose. I want people to enjoy what they are doing. I want people to have more fun.

Can You Really be Addicted to Fun?

Unfortunately, it is not uncommon for things that are initially described as “fun” to turn into addictions — and, at extremes, pathological obsessions. For instance, neuroscience has shown us that the brain structure changes in people who obsessively play video games (but who are not yet considered addicted). In these individuals, the volume of the player’s gray matter increases in their left ventral striatum — an area of our brain associated with both reward/pleasure and addiction (Kuhn et al., 2011). This region of our brain is also known for being rich in dopamine (the feel-good neurotransmitter) and is connected with the pursuit of desired experiences. It should be no surprise that dopamine has been playfully described as the sex, drugs and rock and roll neurotransmitter, as all three of these activities affect dopamine in the brain — so does sugar and gambling (Avena, Rada, & Hoebel, 2008).

Considering the role dopamine plays in experiencing pleasure, it is not that difficult to understand how addictive behaviors (that release dopamine) can evolve out of initially pleasurable and fun experiences. Having fun in a healthy manner is a rewarding endeavor. Moreover, the allure of fun can motivate us, at least at the onset, to dare big and pursue worthy goals.

Too Much of a Good Thing

“Behavioral” addictions have now been widely recognized as non-substance addictions (that can also develop with or without substance addictions). Neuroimaging techniques and recent research show that it is not only alcohol and recreational drugs that are addictive. Behavioral addictions trigger the same fundamental responses in the body as, for example, cocaine (Grant et al., 2010).

A lot of common activities have the potential to become addictive, though the topic of what behaviors can be considered behavioral addictions is still open for (popular and scientific) debate (Grant et al., 2010). The word addiction has a Latin origin that translates as “bound to” or “enslaved by.” In general terms: I have been addicted to running; I am a recovering addict to travel; I would like to think I am addicted to trying to be a good father and friend.

There is perhaps a fine line between something being an enjoyable activity that brings us fulfillment and an activity that we become dependent on and/or use as a technique for escapism — a distraction that can stand in the way of dealing with real-life situations and feelings. Like Airbnb and Everlast executive Chip Conley recently discussed with me about those that get trapped roaming from one festival to the next looking for fun, “… if you just constantly go to festivals because you cannot live your normal life, or live in real life and/or you are searching for a utopian experience … festivals always come to an end. If you are going to festivals as a way to vacate in some manner, I think you need to ask yourself, ‘What could I do in my ‘normal’ life to make it better?’”

In this context, you can interchange festival attendance with whatever you do for fun. I think Chip’s wisdom applies to all of us in a broader context.

Escapism is a well-known phenomenon in psychology that is often described in conjunction with addictive behaviors. In my youth, especially during my years in high school, I levitated to mood-altering experiences to avoid my boredom and loneliness. I certainly was not alone in this pursuit. Unfortunately, many often continue down this path even when they are aware they’re not getting to the crux of their problem (Reid et al., 2011). And like many, I am still not out of the woods. I traded counterproductive vices for more productive ones … entrepreneurship, Ironmans, this neurotic writing habit. Long distance running or a 2-hour session at the gym can be paradoxically both healthy and unhealthy — just because an activity is marketed to you as healthy does not mean it is being put to use for its intended purpose. Psychologists believe that escapism can become harmful when you start splitting your world into two versions: the real version and the version that is connected with the activity you frivolously pursue (Ohno, 2016). Jesse Israel’s post on his wellness hangover does a great job highlighting this phenomenon.

Furthermore, as modern life becomes more and more stressful and demanding, there is a whole new level of “mind-programming” going on (facilitated by the media and society) that tells us we need to constantly have fun just to make life bearable. A new generation of pleasure seekers has emerged, and they are not necessarily having fun — they are redlining their psyche as they battle cry, “turn down for what.”

In their recent book Stealing Fire, Steven Kotler and Jamie Wheal estimate that we spend over 4 trillion (yes, with a ‘t’) dollars on various types of escapism. As such, questioning the reasons and motives for us having fun is, therefore, a relevant pursuit. A lot of my livelihood, especially as it pertains to UX design, is providing fertile ground for people like yourself to have fun experiences. Maximizing fun is a personal passion, but it needs to coexist with my personal value of not causing harm.

Hedonism vs. Ego Depletion — an Evolutionary Perspective

In my interview with Chip, Chip juxtaposes pleasurable experiences that are guided by hedonistic self-interest with experiences that give you a sense of being a part of something greater than yourself (and that move you beyond your own selfish needs) — collective effervescence. Both types of experience can be a source of fun. However, while the first takes you to your basic instincts, the latter has the ability to enable you to transcend your ego.

Hedonism and hedonistic activities have traditionally been considered a special variety of egoism. Philosophers talk of psychological hedonism. This refers to engaging in certain activities because we believe that they will lead to the fulfillment of a desire that will promote our pleasure, or, alternatively, will help us avoid pain (Garson, 2016). This type of fun has instant gratification, but it also has its faults.

Of important note, from an evolutionary standpoint, a strong argument has been made against hedonism. Philosopher Elliot Sober and biologist David Sloan Wilson, the authors of Unto Others, argue that hedonists are likely not good at child-rearing and that such behavior can be energetically costly — hence evolution has probably prioritized altruists (Sober & Wilson, 1998). Natural selection has promoted behaviors that are reliable, available through genetic mutations, and energetically efficient.

Those in the constant pursuit of fun through hedonists’ means might not fare that well in the long run if they constantly run around seeking their own pleasure (without considering others, especially their offspring). When we blend psychology, biology, anthropology and philosophy — care for others and selfless behavior somewhat surprisingly emerge as important features of human nature that, according to Sober and Wilson, have developed through natural selection.

In Defense of Hedonism

Associate professor Justin Garson, a philosopher of biology from Hunter College, explains another form of hedonism, which he refers to as “reinforcement hedonism” or R-hedonism (as opposed to inferential hedonism or I-hedonism, which is the more egoistic type described above). In this type of psychological hedonism, we have fun from just thinking about the satisfaction of a desire. In Garson’s view, hedonism does not need to be linked only to your own hedonistic desires; it can expand to the welfare of others as well (Garson, 2016). For instance, you can derive great pleasure thinking about the possibility of world peace — which is a very non-egoistic desire that could be considered closer to altruism. Dr. Raj Raghunathan, professor at the McCombs School of Business at The University of Texas, Austin, also suggests that having fun can bring you closer to being more altruistic, happy, healthy, productive and creative. In his view, it is important to have fun, in a way that specifically works for you (for more on that, see my discussion with Raj).

Can you really have too much fun or be addicted to fun?

There is a body of evidence that too much of anything can be harmful, and any addiction has the potential to psychologically enslave you in some way. A hard truth is that our time on this rock is finite — so you probably do not need this perspective from a psychologist to intuitively know that if we overly commit to one pursuit, we will likely live an unbalanced life.

A strong indication that “fun” of any sort has become a problem is if you start having diminished control over your behavior and experience undesirable consequences, as these are common characteristics of addiction (Grant et al., 2010). Also, the distinction between fun and escapism is not always clear-cut and requires some deep reflection on your part. It is up to you to decide if the pursuit of fun has become counterproductive. Make no mistake, fun is an important ingredient of a meaningful and happy life. However, since I am advocating a life full of fun, I have felt compelled to provide an important service announcement: a dose of mindfulness might be required if/when fun gets in the way of you living. In fact, it might be one of only a handful of ways an ecstatic life can truly be reached.

Sources & further reading:

Avena, N. M., Rada, P., & Hoebel, B. G. (2008). Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake. Neuroscience and Biobehavioral Reviews, 32(1), 20–39. doi:10.1016/j.neubiorev.2007.04.019

Garson, J. (2016). Two types of psychological hedonism. Studies in History and Philosophy of Biology and Biomedical Sciences, 567-14. doi:10.1016/j.shpsc.2015.10.011

Grant, J. E., Potenza, M. N., Weinstein, A., & Gorelick, D. A. (2010). Introduction to Behavioral Addictions. The American Journal of Drug and Alcohol Abuse, 36(5), 233–241.

Kuhn, S., Romanowski, A., Schilling, C., Lorenz, R., Morsen, C., Seiferth, N., & … Gallinat, J. (2011). The neural basis of video gaming. Translational Psychiatry, 1. doi:10.1038/tp.2011.53

Ohno, S. (2016). Internet escapism and addiction among Japanese senior high school students. International Journal of Culture & Mental Health, 9(4), 399. doi:10.1080/17542863.2016.1226911

Reid, R. C., Li, D. S., Lopez, J., Collard, M., Parhami, I., Karim, R., & Fong, T. (2011). Exploring Facets of Personality and Escapism in Pathological Gamblers. Journal of Social Work Practice in the Addictions, 11(1), 60-74. doi:10.1080/1533256X.2011.547071

Sober, E., & Wilson, D. S. (1998). Unto others: The evolution and psychology of unselfish behavior. Cambridge, MA: Harvard University Press.

Is Ignorance Bliss?

I am an endless knowledge seeker, so on first pass I naturally scoff at the notion we could somehow be blissfully ignorant. AS such, on face value, “is ignorance bliss?” seems like an asinine question. My desire to educate myself on how to be happy has fueled my involvement with the International Positive Psychology Association and my study of academic thought leaders in this space — people like Martin Seligman, Ed Diener, and Barbara Fredrickson — to learn ways to be happier. However, lately I have observed that there are a lot of instances where more information leads to dismay. At a basic level, I watched my one-year-old son thoroughly enjoy a simple train set for months.

Is Ignorance Bliss?

There is a great store where we live that has cheap, recycled toy train parts, so my wife and I continued to introduce train pieces and have made my son’s set more robust over the past few months. We loved doing it for him because he couldn’t get enough… until the day he did. As we continued to add disparate train pieces with the best of intentions, some trains do not fit certain tracks — some trains fit the existing track but are too tall to go under the existing bridge that came with the original set. What has ensued is confusion and frustration. I have let it go on because I think the development of problem solving outweighs the loss of bliss my son used to achieve when the set was simply enjoyable. However, this loss of bliss is observably noticeable and therefore significant. We are basically making my son unhappy by introducing new information.

Scientifically, happiness is a choice. It is a choice about where your single processor brain will devote its finite resources as you process the world. —Shawn Achor

Have you ever found yourself in a supermarket, surrounded by an aisle of different choices, wishing there was only one available? Science tells us endless options can be anxiety-provoking. When faced with choice, we use a lot of energy to make our final choice. When there is an abundance of choice, the cost is an increased chance that you will regret your final decision later. If you want to feel like you made a solid choice, you need to scrutinize all the available information you have available and then (once you process all this information) make your decision. But, as a general rule, does more information actually contribute to a more satisfactory outcome? How much information do we need to make an informed decision, engage in play, achieve flow, take action or simply be happy?

The topic of choice touches on different areas of our personal and professional life. Choice contributes to our happiness, as well as our social arrangements. We can view the argument of “ignorance is bliss” through the lenses of behavioral psychology, philosophy, politics, education and marketing sciences. The topic is provocative since it juxtaposes our general wish for autonomy with a more paternalistic and prescriptive view. In a world that is filled with seemingly constant impulses and endless options, we would often like to believe we are happier when we have all the information. However, this might not always be congruent with the desire to reduce our stress and feel balanced.

When Choosing Feels like Losing

The paradox of choice is not a new phenomenon; we can observe it in different areas of our lives, from the food we eat to who we are attracted to. Nowadays, there are so many options available to us in every aspect of our life. If you are not completely satisfied or happy, why not dump what you have and replace it (or even him/her) with another version?  Why should you practice discipline and perseverance when it is so easy to find yourself a superior model to what you have now? Psychologist Barry Schwartz wrote extensively about the paradox of choice and argues that Americans do not seem to be benefiting from all the choice that is available to us (Schwartz, 2004).

Various research also shows us that when more choice is available, we are more likely to be dissatisfied with what we finally choose. Jonathan D’Angelo and Catalina Toma (2016) explored this idea in their study of online dating. When participants selected their dates from a larger set of people, they were more doubtful about their dating choice a week later (when compared to those who had fewer potential partners to choose from). A similar observation has been made in marketing. Studies show that people who spend more time deliberating about a decision can later feel a sense of loss towards the options they did not pick. During what we perceive to be a careful selection process, we develop a sense of attachment to our decisions, which researchers believe might be harmful to our well-being (Carmon, Wertenbroch, & Zeelenberg, 2003). The premise “choosing feels like losing” has been introduced. Choosing from a set of options can lead us to a feeling of post-choice discomfort.  Once we opt for one option, we no longer possess the other — that’s just a fact. Instead of feeling a sense of relief about finally making a decision, we let negative feelings creep in and we start to feel dissatisfied. Rebecca Ratner of the University of Maryland and her colleagues explored different strategies that can help us help others in their decision-making process. They indicate that providing good information is one of them, but restricting options or adding restrictive options are also recommended (Ratner et al., 2008). For instance, pre-committing to a choice can free us from having to face the decision later, and can also help with self-control when more options become available. It is part of the science that makes restrictive diets like WHOLE30 episodically successful. Simply put, if we can manufacture a predisposition to making (and sticking with) a decision it makes our life a lot less challenging.

When Are You Most Free to Make Autonomous Choices?

Although we all generally value autonomy, there appears to be some ambivalence surrounding this topic. For instance, in education, some studies of problem-based learning showed that while students welcomed some degree of autonomy afforded by this technique, they were also engaged during more prescriptive approaches to studying (Harmer & Stokes, 2016). It appears that paternalism can sometimes free our energy to engage in life in a more efficient way.

From a philosophical stance, there is also a vibrant debate about what constitutes choice. It is pretty easy to find critics anytime the idea of a “forced choice” is brought up. For example, in the West, we have the freedom to choose (and this is widely lauded). However, sometimes, there is the subtle (unspoken) condition that we ought to choose the right thing. If we fail to do that, we can be ostracized and, and in a way we lose some of our freedom to choose (Žižek, 1989). How many “forced choices” do we make just to remain a part of our community (or “tribe”) and conform to the expectations of our environment? In choice, too, there appears to be a degree of ignorance we are willing to accept to “keep the peace” and avoid the cognitive dissidence of malalignment with the philosophy of our peers.

So a strong scientific argument can be made that a plethora of choices can create decision fatigue. Our mind simply cannot cope with an endless amount of information; our decision capacity runs out, and at this point we run the risk of making bad decisions. Our mood can worsen when we are faced with too many choices as well. Research shows that too much choice leads to suboptimal decisions (Schwartz, 2004). Therefore, significant decisions should not be made when we are fatigued or in a bad mood. This was illustrated by a study of judicial decisions conducted at four major prisons in Israel (Danziger, Levav, & Avnaim-Pesso, 2011). The authors examined parole decisions made by experienced judges. It transpired that having a break (thus feeling less fatigued) influenced the judges’ ruling. More favorable decisions were made in the mornings (at the start of the work day) and after food breaks — this pattern was predictable, possibly confirming our need to rest and replenish our energy before making an important decision. It appears a good decision can sometimes be more about the timing, and less about the choices we are presented with. The saying “sleep on it” might sound simplistic, but it has some scientific credence.

Then, there is the scientific theory behind choice architecture. If you are interested in going down the rabbit hole of choice and well-being, I suggest following Brian Wansink. In various studies, Dr. Wansink has shown that if you crowd out the ability to make bad decisions by rigging your environment towards a bias to make good ones, you can steer yourself and/or others towards healthy behaviors (never the wiser that they’ve been unwittingly influenced). As I became aware firsthand in my study about workplace wellness strategies, people do not like to know their choices have been limited; however, if the reduction of choice is unobserved, one can rig the system for people to make specific decisions (arguably in their best interest) based on controlling the information available to them.

When Are You Most Free to Be Creative?

A study by Associate Professors Anne-Laure Sellier and Darren W. Dahl challenged the established belief that having more choice fuels creativity. They conducted two experiments that focused on knitting and crafting. The selection of creative inputs was increased from moderate to extensive: a bigger selection of yarn colors in the case of knitting; and a larger selection of shapes for a Christmas tree decoration in the case of crafting. Interestingly, the creative output of experienced and knowledgeable participants was negatively affected by more choice. Those who were less experienced, on the other hand, didn’t seem to be effected by the change in choice but it did not enhance their expereince either. The authors concluded that restricted choice could be better for creative success as it allows us to focus more — and actually enjoy the creative process more — particularly if already experienced or skilled in that pursuit (Sellier & Dahl, 2011).

One of my heroes, Mihalyi Csikszentmihalyi, a couple of decades ago wrote how restricting choice could reduce stress and anxiety. Choice does give us the feeling that we can be more creative. However, this feeling is just that — a feeling — it is generally an illusion. Science suggests we have more difficulty focusing and enjoying an activity when provided with an extensive choice.

Is Ignorance Bliss?

Is Ignorance Bliss? Maybe.

Science tends to back up why my wife and I might have been unintentional wet blankets. When we have too much information, we risk the potential of decision paralysis. We are given less room to follow our creative paths, engage in flow and — let’s face it — sometimes enjoy ourselves. Other studies by Darren Dahl also highlighted that the highest level of enjoyment is achieved when there is a right balance between restriction (e.g. providing limits around a task) and the freedom to create with autonomy (Dahl & Moreau, 2007). It is important to note that while researching this topic has in no way curtailed my thirst for knowledge, but it has garnered a new respect for the relationship our happiness has with information and choice. For many of us, happiness is a choice. We don’t need to be ignorant to be blissful, but waiting around for the right information does not appear to help any either. To contrary, in some cases it may do the opposite.

Sources & further reading:

Carmon, Z., Wertenbroch, K., & Zeelenberg, M. (2003). Option attachment: when deliberating makes choosing feel like losing. Journal of Consumer Research, 30(1), 15–29.

Csikszentmihalyi, M. (1990). Flow: The Psychology of Optimal Experience. New York: Harper and Row.

Dahl, D. W., & Moreau, C. P. (2007). Thinking Inside the Box: Why Consumers Enjoy Constrained Creative Experiences. Journal of Marketing Research (JMR), 44(3), 357. doi:10.1509/jmkr.44.3.357

D’Angelo, J., & Toma, C. (2016). There Are Plenty of Fish in the Sea: The Effects of Choice Overload and Reversibility on Online Daters’ Satisfaction With Selected Partners. Media Psychology, 1-27. doi:10.1080/15213269.2015.1121827

Danziger, S., Levav, J., & Avnaim-Pesso, L. (2011). Extraneous factors in judicial decisions. Proceedings Of The National Academy Of Sciences Of The United States Of America, 108(17),6889-6892

Harmer, N., & Stokes, A. (2016). “Choice may not necessarily be a good thing”: student attitudes to autonomy in interdisciplinary project-based learning in GEES disciplines. Journal of Geography In Higher Education, 40(4), 531-545. doi:10.1080/03098265.2016.1174817

Ratner, R. K., Soman, D., Zauberman, G., Ariely, D., Carmon, Z., Keller, P. A., & … Wertenbroch, K. (2008). How behavioral decision research can enhance consumer welfare: From freedom of choice to paternalistic intervention. Marketing Letters, (3/4). 383

Schwartz, B. (2004). The Paradox of Choice: Why More is Less. New York: Harper Collins Publishers.

Sellier, A., & Dahl, D. W. (2011). Focus!! Creative Success Is Enjoyed Through Restricted Choice. Journal of Marketing Research (JMR), 48(6), 996-1007. doi:10.1509/jmr.10.0407

Žižek, S. (1989). The Sublime Object of Ideology. London: Verso Books.

Workplace Wellness Strategies for Small and Mid-Size Businesses

Businesses are continuing to look towards viable workplace wellness strategies, and these programs are increasing in popularity, despite inconclusive evidence regarding their return on investment and effectiveness. Analysts are so bullish on the growth of workplace wellness programs that the sputtering consumer wearable market is banking on their success by speculating on the opportunities being made available as large enterprises continue to expand their employee well-being programs through technology.

According to a government-funded RAND study in 2013, about one in every two American employers offers some form of initiative that promotes employee wellness (Mattke et al., 2013). Going into 2017, this saturation is probably higher. Corporate wellness stakeholders often want to know how much money they will save if they introduce or expand a wellness program for their employees. They look for hard data to support their decisions, and many decision makers continue to rely on return on investment (ROI) as a quantitative measure to gauge program efficacy. However, because proving program ROI has been elusive, it has been suggested by those in corporate wellness trade organizations that other factors should be considered when assessing the long-term benefits of these programs. As an alternative to ROI, there has been an attempt to introduce value on investment (VOI) to capture some of these program’s intangible benefits. These “intangibles” include subjective measures such as: contributions to knowledge, collaboration, innovation, presenteeism, retention and employee engagement (Hight, 2012; Norris, 2003). The contrived VOI model has basically become essential in attempting to financially justify funding and investment in most programs (Norris, 2003).

Workplace Wellness Research for Small and Mid-Size Businesses

For the most part, the primary focus of academic research regarding workplace wellness programs has been large enterprises. However, the findings of these studies are often not generalizable to companies with fewer than 1,000 employees. There is a significant and growing need for models and strategies that can benefit smaller organizations. This need is especially significant considering that a majority of employees in the American workforce serve small and mid-sized companies (McPeck, Ryan, & Chapman, 2009). My recent study “Workplace Wellness Strategies for Small Businesses” attempted to fill the knowledge gap that exists in this area. My purpose was to determine what common strategies are being used by small to mid-sized business (SMBs) that had both effective and viable workplace wellness programs.

Workplace Wellness Strategies in Small and Mid-Size Businesses (SMBs)

Four organizations participated in the study: a beverage distributor, a boutique hotel, a general contracting firm and a service-based company. I conducted in-depth interviews and studied company artifacts. The data collected was compared for similarities, differences and patterns (a comparative case study approach), and data analysis was performed according to the standards of thematic analysis (Braun & Clarke, 2006). This process provided me the opportunity to uncover and better understand the commonalities of effective and viable SMB workplace wellness strategies that were demonstrated by these four companies.

My findings found 19 strategies used by these effective programs. Five overreaching concepts are identified that helped organize these strategies:

  • Innovation
  • Company culture
  • Employee-centric
  • Environment
  • Altruism
Effective and Viable Workplace Wellness Strategies

One of the common characteristics (“concepts”) of the programs studied was their ability to be innovative. The positive company culture within the businesses themselves was another commonality of successful programs. The employee-centric concept referred to the company’s desire to care for the well-being of its employees. All companies that participated in the study also worked proactively to create healthier work environments and provide healthier options for their employees. Finally, the concept of altruism referred to the company’s inherent desire to help others, and included the presence of a selfless leader running the workplace wellness program.

These five primary concepts each had corresponding strategies presented as themes. For instance, innovation was connected with non-traditional approaches, constant iteration and refinement, ideas that were internal to the company, thoughtful use of technology and the “fail fast” concept (often found in lean methodology). Company culture presented themes that include employee influence and involvement, authenticity and leadership that did not directly get involved (in program design), but instead provided autonomy to the right people within the business to run the programs effectively. The concept of employee-centric got expressed through various holistic approaches to employee well-being, starting with the employee’s well-being as a foundation (in contrast to considering economic motives), as well as through shouldering the financial burden of employee health care costs and tailoring their wellness approach to the needs of the employees. Concern for the external and internal corporate environment was shown in themes that described the designation of physical space for well-being considerations, company community involvement and the provision of healthy options for the employees. Altruism related to a selfless program leader, appreciation of program feedback and a program budget that was based largely on recommendations rather than mandates.

Why is this SMB Workplace Wellness Study Important?

I am proud of this study and believe it provides new insights into the characteristics of successful workplace wellness strategies. While some of the themes that emerged will feel familiar to my contemporaries, several rather surprising findings were identified as well. A better understanding of these factors — combined with validation of the more common strategies already well-established — this study gives SMBs programs a new, unique map to improve their workplace wellness strategies. What I have documented is a set of strategies that transcends the cookie cutter advice commonly disseminated by workplace wellness providers (generally tailored for big business) because their motive is to move large corporate clients into their sales funnel.

A poignant example of this is a theme that surprised me: that some of the most successful program ideas were internal. This is contrary to the established belief that workplace wellness ideas get cascaded down from vendors and brokers that offer employee well-being services at scale (Hughes et al., 2011). Although my professional role is working for a provider (Active Wellness), my study was conducted as a doctoral candidate, and in taking an unbiased look at these programs the data suggests health promotion vendors (catering to big businesses) might not be the optimal providers of workplace wellness strategies to SMBs. Another interesting assertion I make is challenging the common wisdom that successful programs rely on involvement from leadership. Historically, it has been generally advised that managers should personally promote wellness initiatives, act as role models and engage with employees in wellness (O’Boyle & Harter, 2014). My study, however, did not support this established view. In the case of the four companies that participated, wellness thrived in environments where leadership passed the responsibility for wellness programs to the right person within the organization. That person was given the autonomy to implement the program in a viable way based on the culture of the organization. Intuitively, one might posit managers within SMBs might not always be the best qualified to lead by example. Running SMBs often is fairly stressful and requires managers to play multiple strategic roles. Therefore, these individuals in many cases should not necessarily champion wellness initiatives if they are already struggling to maintain their own wellness due to high levels of stress (Swaby, 2016).

My sincerest hope is that the findings of this study break new ground and can fuel a positive discussion about the importance of creating healthy workplaces and supporting employees in small and mid-size business — so these businesses can support employee well-being as effectively as larger enterprises. If you would like to learn more about this study on workplace wellness strategies, please feel free to reach out and/or you can view the study in its entirety over at the International Journal of Workplace Health Management by clicking here.

Sources & further reading:

Braun, V., and Clarke, V. (2006), “Using thematic analysis in psychology”, Qualitative Research in Psychology, Vol. 3, No. 2, pp. 77–101.

Hight, C. (2012,), “Move from ROI to VOI” Institute for Organization Management, available at http://institute.uschamber.com/move-from-roi-to-voi (accessed 30 June 2016).

Hughes, M. C., Patrick, D. L., Hannon, P. A., Harris, J. R., and Ghosh, D. L. (2011), “Understanding the decision-making process for health promotion programming at small to midsized businesses”,  Health Promotion Practice, Vol. 12, No. 4, p. 512.

Lincoln, Y. S., and Guba, E. G. (1985), Naturalistic inquiry. SAGE Publications, Newbury Park.

Mattke, S., Liu, H., Caloyeras, J. P., Huang, C. Y., Van Busum, K. R., Khodyakov, D., and Shier, V. (2013), “Workplace wellness programs study: Final report”, RAND Corporation, Santa Monica, CA.

McPeck, W., Ryan, M., and Chapman, L. S. (2009), “Bringing wellness to the small employer”, American Journal of Health Promotion, Vol. 23. No. 5, pp. 1–10.

Norris, D. M. (2003), “Value on investment in higher education”, EDUCAUSE Research Bulletin, No. 18, pp. 1–13, available at https://net.educause.edu/ir/library/pdf/erb0318.pdf

O’Boyle, E. and Harter, J. (2014). “Why your workplace wellness program isn’t working”, Gallup Business Journal, available at  http://www.gallup.com/businessjournal/168995/why-workplace-wellness-program-isn-working.aspx (accessed 5 July 2016).

Swaby, S. (2016). “Leadership wellness: The conversation no one is having”, The Good Men Project, available at http://goodmenproject.com/featured-content/leadership-wellness-the-conversation-no-one-is-having-part-1-snsw

 

What is the Meaning of Legacy and Why Do You Want to Leave One?

What is the Meaning of Legacy?

Have you ever thought what you want on your tombstone? Or wondered what gives you the drive to hustle? Are you the benevolent type, but still have enough ego that you want to be remembered for all the good you did in the world? There are many forces that help drive us to pursue, and the desire to leave a legacy is one of the strongest.

This inherent drive to leave a legacy can manifest in a range of ways: from a desire to have children to wanting to lead a visionary movement that transforms a society. Although the manifestation of the process might differ between individuals, most of us seem to have a desire to create a legacy — to leave something behind when we go. Our desire for legacy can be biological, material, and/or it can be expressed as our values and hard-won knowledge that we pass on to family and friends (Hunter & Rowles, 2005).

What is the Meaning of Legacy?

The word legacy comes from a Latin word legatus, translated as ‘embassador, envoy, deputy.’ In the late 14th century, an old French word legacie was used to describe a body of persons sent on a mission. We can therefore look at legacy metaphorically that when we create a legacy, what we are really doing is appointing our spokesperson for the future. Most of us —  either explicit or unknowingly — have a desire for either symbolic or literal immortality (i.e. literal immortality is some belief that there is an afterlife). This seems especially strong in those of us that understand death is inevitable (Sligte, Nijstad, & De Dreu, 2013). Our legacy, if adequately left, transcends the realms of our physical life and brings symbolic immortality.

As our awareness of mortality grows, it brings into focus internal concerns and questions about why we exist. For many, this quest for purpose begins once we realize that the opportunity to leave our mark is finite. For others, this realization can lead fear — a threat to one’s sense of self that we will likely soon be forgotten. Thus, people try to negotiate what us scientists call ‘mortality salience’ in different ways (Sligte, Nijstad, & De Dreu, 2013). When reminded of our impending death, we often look for ways to transcend that feeling and employ different psychological mechanisms to reach symbolic immortality. For instance, we are compelled to connect with influential social groups, because a group’s existence generally transcends the existence of a single individual. Furthermore, groups also bolster our self-esteem and nurture our belief that the world meets the standards and values within our worldview — a rationalization that everything will end well. This has been explored in depth by Terror Management Theory or TMT, which was proposed by Jeff Greenberg, Tom Pyszczynski and Sheldon Solomon (1986).

To create legacy some of us — I fall into the category —turn to our creative side. By introducing new ideas, designs, novel products and original solutions into our current reality we possess the potential to influence societies (and dare I say the world) in a way that will outlive ourselves. Studies have shown that creativity is often used as a force of legacy, especially when the expression of creativity is socially valued — after all, we love our friends… our peers… our ‘tribes’ and most of us either explicitly or secretly want their recognition (Sligte, Nijstad, & De Dreu, 2013).

Why Do You Want to Leave a Legacy?

The crux of legacy is that we look for ways to be existentially reassured our life mattered. We bargain with death as we go through the psychological cycle of grieving our inevitable non-existence (Ross, 1969). We want to leave a legacy because before we can psychologically accept the reality of our own physical annihilation, we put up one hell of a fight. Science suggests a desire to leave something behind when we pass naturally increases as we age (Newton, Herr, Pollack, & McAdams, 2013). Those of us that have had long and productive careers seem to be challenged the most by the process of aging (Wexler & Long, 2009). Intuitively this makes sense; if you worked hard all your life — inevitably making personal sacrifices along the way — you want to believe your life amounted to something in the eyes’ of others because you will not be around to tell your story. You want some recognition for living a dedicated life. Again, various studies suggest the closer to death we get, the more we crave this immortality. A study of women that were faced with a life-threatening illness showed that all subjects consciously started the process of legacy transmission (Hunt, 2007), which could be interpreted that legacy closely links with our relationship to death and mortality.

Many authors also think that the wish to create a legacy is connected both with generativity and narcissism (Newton, Herr, Pollack, & McAdams, 2013). Generativity is a psychological concept, usually regarded as a positive one — generativity often emerges in midlife and can be connected with parenthood or other social roles, such as mentoring. Erikson (1974) defined it as “…the establishment, the guidance, and the enrichment of the living generation and the world it inherits.” Erikson viewed it as a concept that is often focused on the next generation and an inherent individual care for its well-being. Narcissism, on the other hand, is usually viewed as a more negative concept (though there is a distinction between normal and pathological narcissism). Generativity is focused on others, while the concept of narcissism focuses on one self. We could therefore conclude that wanting to leave a legacy on some level is associated with narcissism since you do not need to be remembered to help society. It appears that legacy is likely a combination of both selflessness and narcissism (Rubinstein, 1996).

Many people indeed associate a need for legacy with ego; an act of ego beyond death. In contrast, the desire to selflessly change the world is viewed as more altruistic in nature — those that do things anonymously and do not wish to be recognized for it. Nonetheless, some point out that legacy has the potential to go beyond the ego and be weighted in altruism. It can surpass cultural constraints and become a broader aspect of human development that is a psychological driver of greater good (Hunt, 2007).

One thing about legacy that science seems to agree on is that this desire is somewhat universally seeded in us. Since it is often connected with having children and passing either goods, values, knowledge and/or wisdom onto them, being childless can (in some people) create a feeling of despair and/or sadness as they feel they are no outlets to leave a legacy (Rubinstein, 1996). It was observed that some childless women looked for other ways to meaningfully influence and support others (e.g. family members, community), or alternatively they wanted to create a legacy that related to the whole human species. This desire can sometimes drive very old people to participate in, for example, antinuclear protests even if building more nuclear power plants probably isn’t going to influence them anymore. Some studies show that older people, it can be more important to pass on values and beliefs than material possessions (Hunter, 2007). It is clear that legacy means different things to different people, but that for most of us it is the pursuit of symbolic immortality that drives us.

 

Sources & further reading:

Erikson, E. H. (1974). Dimensions of a new identity. New York, NY: W. W. Norton & Company, Inc.

Greenberg, J., Pyszczynski, T., & Solomon, S. (1986). The causes and consequences of a need for self-esteem: A terror management theory. In R. F. Baumeister (Ed.), Public self and private self (pp. 189-212). New York, NY: Springer-Verlag.

Hunter, E. G. (2007). Beyond death: inheriting the past and giving to the future, transmitting the legacy of one’s self. Omega, 56(4), 313-329.

Hunter, E. G., & Rowles, G. D. (2005). Leaving a legacy: Toward a typology. Journal of Aging Studies, 19, 327–347.

Kübler Ross (1969). On Death and Dying. New York: Scribner Classics.

Newton, N., Herr, J., Pollack, J., & McAdams, D. (2013). Selfless or Selfish? Generativity and Narcissism as Components of Legacy. Journal Of Adult Development, 21(1), 59-68.

Rubinstein, R. (1996). Childlessness, legacy, and generativity. Generations, 20(3), 58.

Sligte, D., Nijstad, B., & De Dreu, C. (2013). Leaving a Legacy Neutralizes Negative Effects of Death Anxiety on Creativity. Personality And Social Psychology Bulletin, 39(9), 1152-1163.

Wexler, G., & Long, L. (2009). Lifetimes and Legacies: Mortality, Immortality, and the Needs of Aging and Dying Donors. The American Archivist, (2). 478.

The Interesting History of Workplace Wellness

The Interesting History of Workplace Wellness

The history of workplace wellness starts with the Italian physician Bernardini Ramazzini (1633-1714) who is believed to be one of the first to write about the effects of work exposure on workers (occupational diseases) and was interested in the possibilities of taking preventative measures (Gainer, 2008) to help improve employee well-being. Half a century after Ramazzini’s death, the Industrial Revolution brought with it many new health problems and injuries due to the way work was reformulated and systematized.

In 1810, Welsh social reformer Robert Marcus Owen proposed a 10-hour work day to help protect the well-being of workforces. By 1817, he purposed a more aggressive measure — the 8-hour work day — and coined the phrase “eight hours labor, eight hours recreation, eight hours rest” (Donnachie, 2000). One of the first organizations to implement Owen’s ideal on a wide scale in the United States was the Ford Motor Company in 1914 ([Ford] Gives $10,000,000, 1914; Chalmers, 2013).

In 1832, Charles Turner Thackrah is credited for having created the first written account of the health problems of industrial workers (Gainer, 2008). Accordingly, Thackrah’s book is considered a pioneering work in the pursuit of improving employee well-being. In his book Thackrah wrote, “The evil of the employ is the incidental one of intemperance (Thackrah, 1832, p.18).” In context, I believe this quote from Thackrah is likely highlighting that employers often operate their organizations with disregard for moderating or restraining their employees’ working conditions.

These notable milestones notwithstanding, workplace wellness was generally an afterthought for organizations up until the advent of Employee Assistance Programs (EAPs) in the 1950s, when companies began to offer wellness interventions primarily focused on alcoholism and mental health issues (Owens, 2006). According to Reardon (1998), true workplace wellness programs did not really begin to exist until the mid-1970s. During this timeframe, there was a perceived shift in financial responsibility for health care, from government to employer. The development of worksite wellness was motivated primarily by cost containment (Reardon, 1998). It was also linked with the activities of the occupational safety and health movement (OSH) and the worksite health promotion movement (WHP), which developed in the late 1970s (DeJoy & Southern, 1993). Greiner (1987) cites the following reasons behind the emergence of worksite wellness during this period:

  • A general culture shift that promoted fitness
  • Emerging research findings that showed the cost of employees’ unhealthy habits
  • Newly formed workplace health promotion groups such as the Washington Business Group on Health and the Wellness Councils of America.

Furthermore, in 1974, the Employee Retirement Income Security Act (ERISA) was established, which was a further signal of the increased concern for employee health. It set the minimum standards for most voluntarily established pension and health care plans in private industry to provide protection for the individuals in these plans (Call, Gerdes, & Robinson, 2009).

The Johnson & Johnson’s Live for Life program, which became known as the prototype for big corporate worksite wellness programs, was started in 1979. The program included a questionnaire and a physical assessment with the purpose of collecting information on each person’s activity levels and body fat measurements. The company then provided support to control risk behaviors — weight control, nutrition, and stress management (Pencak, 1991). 

In 1980, with the arrival of a new political administration in the United States, health promotion focus was lost at the federal level (Greiner, 1987). However, workplace wellness programs began appearing in academic literature in the early 1980s. The articles of this time were mainly discussions of the effects of physical fitness efforts on workers’ health and performance (Call, Gerdes, & Robinson, 2009). In 1982, the Journal of Occupational Health started featuring articles that looked at how workplace wellness programs could reduce absenteeism and other costs related to illness, as well as a few articles that discussed how fitness centers could potentially attract top talent (Call, Gerdes, & Robinson, 2009).

Outside EAPs, workplace wellness programs in the United States during the 1980s seem to have primarily focused on the physical aspect of health, while ignoring other health dimensions. In the late 1980s, companies started addressing issues of psychological well-being as part of a more encompassing workplace wellness strategy. In 1986, the OSH started an initiative that emphasized workers’ mental health. Its aim was addressing the issue of work-related mental health disorders (mainly focused on stress-related illness). This was followed in 1991 with another initiative, Managing Depression in the Workplace, which was launched by The National Institute of Mental Health (Reardon, 1998).

In the 1990s, the federal government launched an initiative called Healthy People 2000 that proposed that 75% of employers with 50 or more workers should offer health promotion services as a benefit (Reardon, 1998). The evidence for the advantages of worksite wellness was scarce; nonetheless, the belief that workplace health promotion brings benefits to a company by having a positive impact on employees was becoming a popular concept among managers who started supporting such programs more widely (Pencak, 1991). During this period, wellness and health promotion programs were generally divided into three levels (Pencak, 1991):

  1. Level one addressed awareness (e.g. classes, posters, health fairs)
  2. Level two was concerned with lifestyle and behavioral change (education to support habit change — these programs generally lasted up to 12 weeks)
  3. Level three targeted the environment (these programs had no time limit and encouraged the work environment to support the changes through organizational structure and increased knowledge)

In 1994, The National Survey of Worksite Health Promotion Activities found that 80% of enterprises were offering educational activities to raise their employees’ health awareness, 44% had facilities for fitness and were encouraging activities, and 30% were doing HRAs of their employees (Reardon, 1998). In 1996, Pender’s Health Promotion Model provided guidance for the development of worksite wellness programs (Reardon, 1998). The Pender Model adopted a holistic view of an individual and went beyond the physical dimension of health. It targeted reversible behaviors and gave organizations a framework to work with.

In 2000, the U.S. Department of Health and Human Services published a new version of the program Healthy People 2000Healthy People 2010. The new program had a similar goal to its predecessor: it aimed for 75% of worksites with 50 or more employees to have a comprehensive health promotion plan (Hughes, Patrick, Hannon, Harris, & Ghosh, 2011) consisting of 5 key elements: (a) health education, (b) supportive social and physical work environment, (c) integration of the program into the administrative structure, (d) related programs (e.g. assistance for workers), and (e) screening programs.

Over the past fifteen years, workplace wellness programs have seemingly taken off. These programs have moved from providing health information, counseling, and fitness delivery to using monetary rewards to incentivize employees to stay well (Wieczner, 2013). In particular, the United States has made significant strides toward ensuring the well-being of employees. With this increase in exposure, there has been an increase in attention paid by big businesses to the efficacy and cost-effectiveness of wellness programs, yet very little research exists for small and mid-sized business. Unfortunately, much of the data from large-sized organizations regarding workplace wellness cannot be generalized to SMBs due to SMBs’ smaller budgets, different business strategies and different employee considerations (Hughes, Patrick, Hannon, Harris, & Ghosh, 2011). Furthermore, barriers still exist with SMBs to be able to offer these types of programs at scale. Small companies seem particularly challenged in offering wellness programs (McPeck, Ryan, & Chapman, 2009). According to one study, less than 7% of small businesses offer wellness programs (Carter, Gaskins, & Shaw, 2005). Hughes, Patrick, Hannon, Harris and Ghosh (2011) describe several factors that hinder health promotion programs in small and mid-sized companies. First, there is the additional cost such programs impose on a company that might already be financially overburdened. Mandatory health and safety regulations generally take priority over voluntary health promotion programs, and as such any ideas of participatory workplace wellness programs fall by the wayside. Small companies often lack a health and safety department, which tends to be the initiator of workplace wellness programs in many larger companies. Another factor is that small companies might not offer health insurance and employee benefits that would often be the motivation for preventative programs (Hughes, Patrick, Hannon, Harris, & Ghosh, 2011). Burke (2006) also suggests that there is generally a lack of awareness and understanding about worksite wellness in smaller companies.

There are, however, other characteristics that perhaps make wellness programs in small companies easier to deploy than they would be in large corporations. These include reduced bureaucratic demands, which give easier access to health promotion vendors; better connections between the management and workers, easier communication and, possibly, more empathy towards workers who are seen as “a part of the family” (Divine, 2005).

Little, if any, research has been done on the topic of the decision-making process in relation to the adoption of wellness programs in SMBs (Hughes, Patrick, Hannon, Harris, & Ghosh, 2011). Hughes, Patrick, Hannon, Harris, and Ghosh (2011) conducted a qualitative study that explored some of the factors (structural, cultural, work factors) that support the development of wellness programs in small and mid-sized companies. The participants in the study stated that they rely on brokers or health insurers for health promotion education. The main criterion for a SMB adopting a wellness program was its cost and cost-effectiveness (program cost-benefit). The employers in that study expressed that they desire information on the cost-effectiveness of the program, as well as data showing that the programs will bring the benefits they sought (e.g. reduced absenteeism). Simply summarized, high program cost and low program cost-benefit may be barriers to adopting these programs with SMBs. Employers in the study considered both direct and indirect costs (such as the cost associated with employees taking time off work to participate in the program).

According to Hughes, Patrick, Hannon, Harris and Ghosh (2011) there are three key tactics that need to be considered when working with SMBs:

  1. Health promotion needs to be related to overall company success-related factors (usually financial success). Some of these factors include employee productivity, recruitment, and retention. These factors are more convincing to small businesses than the actual quantifiable health care cost savings.
  2. Insurers and benefits brokers should be the potential channel for expanding health promotion.
  3. Senior management and human resources should be the targets. The members of senior management are often the final decision makers, so they need to be presented with the relevant health promotion information.

More research is required on the subject of optimal design and funding of health promotion and preventive care benefits for small to mid-sized businesses. There is a lack of knowledge of the impact of workplace health promotion on small to mid-sized businesses’ bottom line, employee retention rates, and productivity levels (Hughes, Patrick, Hannon, Harris, & Ghosh, 2011). These findings need to be conveyed to insurers, brokers, and workplace health promotion vendors and could help build the business case for worksite wellness programs.

It is important to note at least one study contradicts the findings of Hughes, Patrick, Hannon, Harris, and Ghosh (2011). Divine (2005) found that humanitarian reasons and employee-relation goals prevail over financial motives when trying to inspire SMBs to take up workplace wellness. Putting aside a SMB’s motives for workplace wellness, the available literature does generally support that SMBs rely on benefits brokers and health insurers for wellness solutions (Marquis and Long, 2000). A national study by Marquis and Long (2000) supports the assertion that SMBs generally use outside experts to pick their programs. Studies by McPeck, Ryan, and Chapman (2009) and Goetzel and Ozminkowski (2008) also support the reliance on outside vendors and the role of senior management.

Sources:

Burke, B. (2006). Public policy options for small employer health insurance. North Carolina Medical Journal, 67(3), 222–224.
Call, C., Gerdes, R., & Robinson, K. (2009). Health and wellness research study: Corporate and worksite wellness programs: A research review focused on individuals with disabilities (Government Contract Number: DOLU089428186). Gaithersburg, MD: Social Dynamics, LLC. Retrieved from http://www.dol.gov/odep/research/CorporateWellnessResearchLiteratureReview.pdf
Carter, M., Gaskins, S., & Shaw, L. (2005). Employee wellness program in a small rural industry: Employee evaluation. AAOHN Journal, 53(6), 244–248.
Chalmers, W. D. (2013). America’s vacation deficit disorder: Who stole your vacation? Bloomington, IN: iUniverse.
Chapman, L. (2004). Expert opinions on “best practices” in worksite health promotion (WHP). American Journal of Health Promotion, 18(6), 1–6.
DeJoy, M., & Southern, J. (1993). An integrative perspective on worksite health promotion. Journal of Occupational Medicine, 35(12), 1221–1229.
Divine, R. L. (2005). Determinants of small business interest in offering a wellness program to their employees. Health Marketing Quarterly, 22(3), 43–58.
Donnachie, I. (2000). Robert Owen: Owen of New Lanark and New Harmony. Edinburgh: Tuckwell Press.
[Ford] gives $10,000,000 to 26,000 employees. (1914, January 5). The New York Times. Retrieved from http://www.nytimes.com/learning/general/onthisday/big/0105.html
Gainer, R. D. (2008). History of ergonomics and occupational therapy. Work, 31(1), 5–9.
Goetzel, R. Z., & Ozminkowski, R. J. (2008). The health and cost benefits of work site health-promotion programs. Annual Review of Public Health, 29, 303–323.
Greiner, P. (1987). Nursing and worksite wellness: Missing the boat. Holistic Nursing Practice, 2(1), 53–60.
Hughes, M. C., Patrick, D. L., Hannon, P. A., Harris, J. R., & Ghosh, D. L. (2011). Understanding the decision-making process for health promotion programming at small to midsized businesses. Health Promotion Practice, 12(4), 512. doi:10.1177/1524839909349162
Marquis, M. S., & Long, S. H. (2000). Who helps employers design their health insurance benefits? Health Affairs, 19, 133–138.
McPeck, W., Ryan, M., & Chapman, L. S. (2009). Bringing wellness to the small employer. American Journal of Health Promotion, 23(5), 1–10.
Owens, D. M. (2006). EAPs for a diverse world: Employers that provide culturally competent employee assistance programs show employees they care. HR Magazine, 51(10), 91–96.
Pencak, M. (1991). Workplace health promotion programs: An overview. The Nursing Clinics of North America, 26(1), 233–240.
Reardon, J. (1998). The history and impact of worksite wellness. Nursing Economics, 16(3), 117–121.
Thackrah, C. T. (1832). The effects of the principal arts, trades, and professions, and of civic states and habits of living, on health and longevity: With a particular reference to the trades and manufacturers of Leeds, and suggestions for the removal of many of the agents, which produce diseases, and shorten the duration of life. From the London ed., with improvements. London: Porter.
Wieczner J. (2013, April 8). Your company wants to make you healthy. The Wall Street Journal. Retrieved from http://www.wsj.com/articles/SB10001424127887323393304578360252284151378

Do the Corporate Wellness PEPM & PMPM Models Support Meaningful Utilization of Corporate Wellness Programs?

Many corporate wellness programs are charged through a per-employee-per-month (PEPM) or per-member-per-month (PMPM) model. These subscription-based business models work by employers paying a set price to get access to a particular workplace wellness service. Critics of PEPM and PMPM models have highlighted that while the arrangement brings predictable and constant revenue to the vendor, it does not necessarily benefit the costumer as employers often pay for services they do not utilize (Cheng, 2015).

Shortcomings of the PEPM Model in Corporate Wellness

When employers pay PEPM fees, they are essentially paying for services that will almost never be fully utilized or found valuable by the entirety of their workforce. This is because PEPM fees are collected regardless of how many employees use the service. James Powell (2014) articulated this situation well when he compared it to inviting 250 people to a party just to get one to attend. In other words, employers assume much of the engagement risk — which is neither in their interest, nor compels the vendor charged with fostering employee well-being to have a vested interest in program engagement.

Furthermore, subscription fees make it harder to generate positive return-on-investment (ROI). Many companies are now looking for a return on their corporate wellness programs to justify their existence (“Doctors on Demand,” 2015). In Powell’s post cited above, the author presents an example of a client with 40,000 employees who had access to a second opinion program. Out of all employees, only 140 used the service in one year, which means the utilization rate was less than 0.4 percent. Services with low utilization are not cost-effective, so it is somewhat startling they are not questioned more rigorously by our industry.

Alternative to the PEPM Model

An alternative to the PEPM model has been suggested by those who argue that a non-subscription model is better suited to the health and wellness needs of businesses. They propose a pay-as-you-go model, which places the financial risk upon the vendor. This suggests the vendor needs to take initiatives and offer services the client will actually use.

Furthermore, a no-PEPM model will likely offer better ROI that can be realized from Day 1 of usage. With this model, a consistent utilization rate of 1.5 to 3 percent has been reported; and in some complex cases it increased to up to 20 percent (Powell, 2014).

Overall, the non-subscription model probably offers a more meaningful utilization of wellness initiatives and ensures that employee wellness services represent the client, which should be considered a major goal for a progressive vendor that is truly interested in providing quality workplace wellness programs.

Examples of a no-PEPM Model in Corporate Wellness

Fortunately there are progressive providers that are starting to successfully implement a pay-as-you-go model of business. A shining example is Doctor on Demand, the country’s leading video telemedicine company. Its unique business model supports the next-generation telemedicine services, which are becoming a very popular benefit as showed by a survey among U.S. employers (Towers Watson, 2014).

Doctor on Demand regards its model of work as a no-risk model that allows for the employer to offer its services to everyone, including non-benefit-eligible and non-benefit-enrolled employees (Cheng, 2015). In this way, access to high-quality, low-cost health care is becoming a reality, which resonates with the values of the wellness industry.