Business of Well-being

The Employee Health and Wellness Program Code of Conduct

Many employers assume that their wellness vendors will not harm their employees. Yet there have been myriad examples of exactly that. Employees are harmed every time vendors flout clinical guidelines, as they are wont to do. (Most vendors don't even disclose that guidelines advocate much less screening than they themselves recommend, for the obvious reason that less screening means lower revenues.)

One could also argue that any crash-dieting contest harms employees, and the more money at stake in these contests, the greater the potential for harm. If you think there is no potential for harm, just look at this article employees how to abuse their bodies to cheat in these contests.

The proliferation of potentially harmful programs spurred a group of wellness executives to conclude that, in the absence of government sanctions discouraging harms to employees, the industry had to regulate itself. For me personally, the deciding factor to join this group (originally consisting of Ryan Picarella of WELCOA, and Jon Robison and Rosie Ward of Salveo Partners, and now including many others) was -- as reported in the healthcare daily STATNews by award-winning reporter Sharon Begley -- Wellsteps harming the employees of the Boise School District.

Adjusted for age, self-reported employee health status deteriorated while organization-wide risk factors significantly increased, according to Wellsteps' own data. In other sectors of healthcare, a provider showing such outcomes might have its licensure called into question.  

Of course, wellness vendors don't need licenses, so instead of being investigated, Wellsteps and Boise shared a C. Everett Koop Award. This anomaly - rewarding harms -- exemplifies why the wellness industry needs to step up to patrol itself, and hold itself to a reasonable standard of competence and integrity.

Too many years of cronyism, statistical sleight-of-hand, and the pursuit of profit at the expense of mission have caused many vendors and consultants to stray from the principles on which wellness was founded.

Ethical Wellness and the Code of Conduct

This group developed what is now known as the Employee Health and Wellness Program Code of Conduct to do exactly that. It can be found at  The highlights are:

  • Don't harm employees
  • Respect employee dignity
  • Don't lie about outcomes.

Yes, one would hope wellness vendors could do better, because, yes, those are very low standards. Vendors shouldn't have to be cajoled into agreeing to strive to hit those standards. Yet many vendors of all stripes can't hit them.

I say "of all stripes" because The Code isn't just for vendors of wellness programs. My company, Quizzify, is a health literacy vendor, and these standards apply to us as well. We endorsed the Code without any cajoling from clients. The Code is totally open-source.

If you are a vendor, we welcome your endorsement of The Code, as well as your participation in the associated Linkedin group. If you employ vendors, you should insist that they endorse The Code, and endorse it yourself. There is no cost involved here.

Money is raised ($1530 right out of the opening gate) through donations, all of which are used to educate employers and vendors on the importance of having a Code. You can endorse The Code individually, or you can put your corporate logo on the website as well. In addition to being the right thing to do, the advantage to employers of insisting that its vendors endorse The Code concerns the avoidance of liability.

Obviously, as yet no case law exists to support this assertion, but it would appear that a vendor specifically promising not to harm employees has no contractual defense, if indeed its program does harm employees. The reverse is true too, of course. An employer hiring a vendor that refuses to endorse The Code is taking on extra liability.

The much more likely case would be a vendor lying about outcomes after promising not to. Curiously, most vendor contracts currently include no provision about not fabricating outcomes. Widespread adoption of The Code is one of many steps that the industry can and should take in order to restore its legitimacy and popular (meaning employee) support, which tumbled following the Penn State debacle and has yet to recover.

One need only review the articles, and comments to articles, in the lay media to see that restoring legitimacy and employee support should be a major priority. Future columns will propose other steps, but clearly a commitment to doing no harm should be the first.

About the Author

Al Lewis is CEO of, which teaches employees health literacy in a Jeopardy-meets-Comedy Central quiz format, and is author/co-author of three books on wellness outcomes measurement: Why Nobody Believes the Numbers: Distinguishing Fact from Fiction in Population Health Management, Cracking Health Costs, and Surviving Workplace Wellness with Your Dignity, Finances and (major) Organs Intact.

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