A couple of years ago, I delivered two hours of health coaching to the chief operating officer (COO) of a large publicly traded company, and his wife, at their capacious home. Ostensibly about how to plan and outfit their home gym, the conversation evolved into a dialogue about the value of a high level of fitness, regular vigorous physical activity, and the need for a businessman, particularly one of his stature, to eat wisely, especially while at frequent work obligations.
This executive had a diligent fitness routine centered on running. The surprise came when I queried his eating habits: four red-meat meals per week and a regular stream of cocktails had left him with an incipient middle aged bulge, and more importantly, sky high blood lipids, for which he was resisting the medical advice of statins. I told the COO that I believed he was only half right in his personal fitness strategy, because he was cavalierly ignoring his nutrition habits and refusing to follow his physician's recommendation to use a statin to lower his cholesterol.
I wondered aloud how long he thought he could get away with this particular strategy and whether he was not setting a poor example for colleagues and subordinates by not taking charge of his lifestyle management in a comprehensive, evidence-based manner. He shot back, "We have great medical insurance, and if I need heart surgery, everything will be paid for." My rejoinder, which his wife later told me infuriated him, was that his haughty dismissal was a breach of his fiduciary duty to stockholders. He was clearly aware of his shortcomings and able to surmount them, but simply did not give a damn.
In my view, this was a breach of his fiduciary duty because he was enrolled in his company's self-insured health plan, meaning that stockholders bore the risk for his arrogance. The "great medical insurance" was, for him, simply part of his compensation package (and a tax-free one at that); but, for shareholders (and his fellow employees), his refusal to address will ful adverse health behaviors represented an unmanaged risk, and, consequently, a preventable potential untoward event that would cost the company not only money, but also time, productivity, and leadership.
The word fiduciary comes from the Latin fiduciarius and means to hold in trust, typically for the benefit of another. Senior managers (and corporate directors) have a fiduciary obligation to operate their organization in a way that maximizes benefit for the shareholders of the firm (which often includes the managers themselves), so that the company remains a going concern, complies with its legal and financial obligations, and provides a return on investment. In a time when health care reform debates predominate, it is a reasonable question to ask: what is the fiduciary obligation of senior managers when it comes to their and their employees' fitness and wellness, and how do their decisions, both personally and professionally, allow enterprises to exercise appropriate risk management?
Enterprise risk management is a concept that came to the fore as a result of Enron, and related corporate scandals, when managers clearly off-loaded risk to shareholders while enriching themselves an absolute misalignment of interests and risk sharing. Hence, the Treadway Commission produced a report on enterprise risk management, which advocates that corporate managers must align their interests with those of stakeholders (which includes both customers and shareholders), appropriately assess both internal and external risks to the organization, and craft strategies that are most likely to succeed in fluid market conditions.
Rather than think of corporate wellness as a form of enterprise risk management, we often consider it a fungible employee perk worth offering if all the human resources stars align. Skeptical corporate leaders who bemoan persistently rising medical care costs often misunderstand what drives health care inflation, and, ironically, belittle the very strategies most likely to restrain medical care inflation improvements in employee wellness and fitness.
The leading causes of health care inflation in corporate America are not drug companies, insurance companies, medical care providers or even lawyers they are us, the employees who, through our horrendous personal health habits, have managed to engender the creation of a medical care system designed to fix us, but not to keep us healthy. Don't blame medical care providers for this dilemma; they have merely responded to market conditions. Essentially, they are much more rational players in this drama than we give them credit for. A commitment to employee wellness - even more specifically, employee fitness - is a crucial form of enterprise risk management because it aligns the interests of the organization with those of its stakeholders.
Fit employees use fewer medical care dollars, produce more, and miss less time from work than their less fit counterparts. This means preservation of capital, stronger relationships with both customers and vendors, more resources retained within the enterprise for the betterment of both the organization and its people, and greater opportunity to improve the return for shareholders. Senior managers have a special responsibility in this regard because their behaviors and decisions not only have tangible financial impacts, they are also powerfully symbolic.
Senior managers who support and participate in enterprise-wide wellness and fitness efforts are more likely to effectively manage their own lifestyle choices and reduce health risks. Their leadership by example is highly likely to encourage employees to join the effort. Senior manager participation also demonstrates an awareness that appropriate enterprise risk management transcends just saving money, because these corporate leaders are often the intellectual core and organizational memory of the firm. Reducing the risk of major chronic illness (particularly amongst middle aged executives), is a critical tool for maintaining the psychological, emotional, and organizational integrity of the company.
It allows for sensible succession and transition planning, rather than abrupt adjustments required when a key person succumbs to heart disease, stroke, depression, or an another foreseeable and preventable health crisis. It is true that not all health risks are equally foreseeable, manageable, or preventable. This is why insurance occupies a central place in employee compensation. But, key major medical care cost drivers and threats to the integrity of companies from coast to coast are foreseeable and preventable: inadequate physical activity and poor eating habits that drive the overweight/obesity crisis, which, in turn, will soon bring us a tidal wave of diabetes and cardiovascular disease.
Corporate managers who continue to give short shrift to employee fitness may soon find that restive shareholders will place increasing pressure on them to change their ways. Indeed, this would make a fascinating shareholder lawsuit. Oh, and the COO, he eventually came down off the ceiling after my lecture and reduced his red meat and alcohol intake, increasing consumption of seafood and vegetables.
And, guess what? Both his waistline and his blood lipids fell. This may have come as a surprise only to him, but it enabled him to seamlessly and nearly effortlessly do something that benefitted both himself and those around him: he led by example and changed his behaviors in a way that aligned his interests with those of others who depend on him and need him to be healthy and operating optimally.
About the Author
Vik Khanna is an America College of Sports Medicine (ACSM) Certified Clinical Exercise Specialist. He is the President and CExO (Chief Exercise Officer) of Galileo Health Partners, LLC of Ellicott City, MD. Vik employs an inimitable brand of evidence-based exercise and nutrition coaching to teach clients that exercise and diet are critical tools for managing health risks, maximizing quality of life, optimizing medical care spending, and improving both physical capacity and cognitive performance. Vik and his coaching team develop and implement wellness coaching programs for employees and management teams at mid-sized businesses in the mid-Atlantic region.
Their work has helped achieve median weight loss of 5.1% over a 12-month period for enrolled employees and helped half their diabetic adults convert to having normal HbA1c levels. Their programs focus on helping employees build consistent physical activity habits and dietary strategies that are science-based. Vik is chief advisor to the Freddie Mac Foundation in its efforts to create health and wellness opportunities for families returning to New Orleans to live in redeveloped affordable housing communities.
His work, a groundbreaking effort improve health behaviors in vulnerable families, evinces a commitment to the principle that personal health management is learned, not intuitive, and that many low-income and working class people get precious little guidance on how to reduce their health risks through judicious physical activity and better diet. The health and wellness program that Vik has created aims to help families build self-efficacy, thus assisting in their economic stabilization and educational advancement.
Vik lectures MBA candidates at the Robert H. Smith School of Business, is a graduate advisor to students in the Physician Assistant Program at Drexel University. Vik is a physician assistant, with a graduate degree in public health from Johns Hopkins University. His unique combination of clinical knowledge and insightful approach to data analysis enables him to strategize solutions for his corporate clients that are evidence-based, scientifically and medically sound, and measurable.
Vik has used his broad health care experience to pen two critically acclaimed books, The Ten Commandments of Faith and Fitness, with Pastor Henry Brinton (CSS Publishing Co., 2008) and Managed Care Made Easy (People's Medical Society, 1997). He has also written nearly four dozen other papers, monographs, and articles. He speaks frequently on health and fitness issues for his corporate clients. Vik is a member of American College of Sports Medicine (ACSM), the Clinical Exercise Physiology Association, and the International Association for Worksite Health Promotion, both affiliates of the ACSM.Contact information: firstname.lastname@example.org. Website: www.galileohealth.net.