George Pfeiffer is the founder and president of the Workcare Group in Charlottesville, Virginia. He draws from almost four decades of experience in worksite health promotion and provides consulting, training, and program design services for corporations, government agencies, and not-for-profit organizations.
In this Expert Interview, AdvancingWellness CEO Mari Ryan discusses with George the evolution of workplace well-being programs.
Mari Ryan: Welcome to the Workplace Well-being Essentials Series. I'm Mari Ryan, I'm the CEO and founder of Advancing Wellness. It's my pleasure to welcome you today to this expert interview, where we explore topics that impact employee well-being. My guest today is George Pfeiffer.
George is the founder and president of the Workcare Group in Charlottesville, Virginia. He draws from almost four decades of experience in worksite health promotion and provides consulting, training, and program design services for corporations, government agencies, and not-for-profit organizations.
George has developed and managed numerous award-winning health management programs, including one he developed at the Xerox Corporation. George gives back to our industry in various ways, including as the immediate past president of the International Association for Worksite Health Promotion, and as a former board member of the National Wellness Institute.
George is a former competitive distance runner, and lives with his wife outside of Charlottesville, Virginia. George, welcome. I’m delighted to have you here today.
George Pfeiffer: Thanks Mari, pleasure to be here.
Mari Ryan: Great! Today we are going to explore the evolution of workplace well-being. As I have introduced you, you have been working in this field for many years, much longer than I have, and I’m curious, from your experience working all of these many years in the field, where did it start, and what were the early motivators for businesses to care about employee health and well-being?
George Pfeiffer: Worksite health or wellness has been around for hundreds of years in the sense that corporations offered exercise programs, and of course, some safety programs. In the late 1800s, for instance, Ford and Pullman companies, National Cash Register – they offered employee fitness programs, or exercise programs. I’m not sure how formalized they were, if they were ad hoc. Of course, Occupational Health and Safety has evolved over the years, and also Employee Assistance Programs.
I got my foot in the door – my background – I was in grad school, studying exercise physiology, and I was able to do an internship at Xerox Corporation back in ’73. Based on that, there was an opportunity for me to replace my mentor at that time, Frank Arnold. So, I started managing the executive fitness program in Rochester, New York, and then I eventually got promoted to corporate headquarters in Stanford, Connecticut.
At that time, most of the programs that were being offered, which I would call more sophisticated approach to employee health was really executive fitness programs. They were made primarily medical models. I reported to the medical director. We did stress testing, exercise prescriptions, really to prevent at that time the so-called executive heart attack. So, Mobile, Exxon, American Can, Pepsi-Co – they were all primarily targeting middle aged white guys. (laughs)
That was the fact. Very few women, people of color at that time were at that level, to be qualified – qualified in the sense that was based on title and that. So, it wasn’t very democratic.
I know at Xerox, their rationale back in 1968, 1969, I believe -- I started in late ’73 and then in ’74 -- Joseph Wilson, who was the chairman of Xerox, was making a keynote speech at the Waldorf-Astoria. He was at the podium, halfway through his speech, and he dropped dead right there. Heart attack. That was the rationale at Xerox, to try and avoid that. Again, it was the cardio-vascular-based model, and then it evolved over the years to become a more comprehensive model. In fact, within five years – I was there for ten years – I got pretty bored and I’d like to think of myself as a creative person, and I was able to, through these executives, crowd-fund, if you will, to create a pilot program and a mass communication initiative for all sixty-thousand employees. We were the first to do that. We got an awful lot of exposure and we think we made some innovative things back then that people are discovering today. There’s nothing new under the sun, if you will.
I’m curious, George, over the time that you’ve been working in this field, what would you say would be the most significant elements of the evolution that you’ve seen take place from this medical model that’s focused on the traditional middle-aged white guy?
George Pfeiffer: I think a critical touch point was the creation of the health risk appraisal. That came out of Robinson Hall, that the CDC eventually developed the algorithms and the mainframe software, and then you saw proliferation of private companies take that algorithm and develop their own version of an HRA. In HRA, now we’ve gotten into that stage of risk reduction. We can identify individuals who are at risk for modifiable risk factors and based on that develop interventions. Now we were moving from basically an exercise-focused program to a more comprehensive risk reduction model.
I think that was a critical turning point for worksite health. We also found out very quickly that HRAs in themselves don’t change behavior. You need a more comprehensive model around individualized coaching, and so on. Today, we are more into the culture and the environmental supports. Based on the data and the interest in HRAs, we saw this slowly evolving as more data was being collected and sliced and diced. We started finding how risk as associated with productivity, what first medical care costs. One of the seminal research papers was by Dave Anderson and Ron Getzel around the so-called Hero Study. They studied ten mild risk factors, they found that seven of them had statistical impact on cost on employers. That hit the Wall Street Journal, and all of a sudden used, and that gave us some credibility.
Out of that, health and productivity management evolved. Again, health and employee productivity is basically joined at the hip. That work by Dee Edington and Wayne Burton, who was at Capital One at the time, started doing a number of research papers, published research papers that showed how not just health affected direct medical costs, but more importantly those indirect costs. So, disability and Workers Comp claims and this whole concept of presenteeism, that people are around the job, but not necessarily into their jobs, because most of it was around some kind of health issue.
Out of that, the business case started to be more broad. From that, we realized that targeting individuals, which makes sense, but targeting the people who are high-cost is erroneous from a program design perspective. Population health management evolved out of health and productivity management, in my opinion, where we have to address the entire population of the employees, and also the dependents if they are being covered. Your low-risk people today are a proportion of those who will be high-risk tomorrow. Dee Edington always had the mantra “keep the healthy, healthy.” He’d call that, if that’s your market share and the more you can increase that market share of your healthy population, you’re saving money. It’s a currency, if you will. That will buy more productivity and so on.
Mari Ryan: That’s great. I appreciate that. It’s interesting to see how we’ve moved from health promotion and population health to wellness, and now to well-being. Where do you see the field going at this point?
George Pfeiffer: Wellness has been around for a long time. Bill Hettler, who founded the National Wellness Institute at University of Wisconsin at Steven’s Point, came up with his eight dimensions in 1976. I think we basically got the message that you need to manage the total person – support, not manage – support the total person. I think the well-being model that the Gallup folks came out with, and the book Wellbeing, five dimensions, basically it’s really addressing the same stuff. That we’re trying to look at the total person, and how can we provide information, support, to help them live a better life. A byproduct of that is, hopefully, they’re a better worker, a better parent, a better friend, more involved in the community.
So, I think that is a positive thing. I think that as we’re getting more involved with, let’s call it well-being today, we’re finding that measuring it … you know, Gallup has their instruments and their protocols, but ROI for most organizations are very difficult to measure. As you know, it costs more to have an ROI study than the programs. We’re evolving more into … the more we hear about value on investment, that the organizations make the decisions on what’s important to us, and how do we wish to measure it.
D Edington – that correlates with this more of a well-being approach -- he says we need to move beyond ROI/VOI and go to VOC, Value of Caring. If you’re a caring organization, then you are concerned about how can we support our employees and basically be better people and help them thrive. I think that is one thing we are moving into.
The other area, of course, and your book addresses this, is the whole thing around culture and environment. I have a big issue, myself, with the term “culture of health.” If you are working within an occupational setting, I think that’s erroneous. People are being hired to use their brains, use their hands, to produce stuff. Ideas, being creative, or getting down to nitty-gritty if manufacturing. I really like to think that worksite well-being or health promotion is part of a bigger piece where we are trying to create a culture of engagement.
Engagement is a big buzzword today as well. How do we create this environment that has happy employees, you have an environment that people want to come to in the morning, or whenever their shift is, and when they leave they feel they’ve done something, they’ve contributed. Hopefully by doing that, they are more engaged as individuals, teams especially, and you have a meaningful enterprise, which means they are profitable. Or, if you are a public entity, basically you are serving the common good, whatever your charge is.
Mari Ryan: I can’t disagree at all. Actually, it’s so interesting, and in working with some of my clients … five years ago when I started engaging with a client I’m working with right now, they wanted to manage healthcare costs, and now as we’re back doing another round of strategy planning, it’s not about healthcare costs at all, which they’ve done a very good job of managing. They’ve maintained flat healthcare costs over five years, even while growing their workforce by thirty-six percent. So, that’s not the issue, but what the real issue is, is engagement. They are completely focused on using well-being as a driver of engagement.
Mari Ryan: Well, George, thank you for sharing these insights. It’s interesting to learn from your experience and be able to share that with our audience. If our audience wants to learn more about you and your work, how can they best get in touch with you?
George Pfeiffer: Email me firstname.lastname@example.org.
Mari Ryan: Fabulous, thanks again for being here today. It’s always a pleasure to spend time with you.
George Pfeiffer: Same here, thank you.
[End of audio]