Wellness Critic Al Lewis on Jeopardy

Archived photo of Al Lewis on Jeopardy

When I attend wellness conferences, everyone has one question for me: “What do you think of Al Lewis?”

It’s a dubious honor: The thing my colleagues most want to know about me is what I think of someone else. It reminds me of cities that promote themselves as “gateways” — Gateway to the West, Gateway to the Finger Lakes, or whatever. You know you’re in a lackluster city when the best thing it can say about itself is that it’s on the way to someplace else. My colleagues view me as a gateway to Al Lewis.

If you aren’t in the wellness industry, you can catch up on who Al Lewis is via his Linkedin profile, in which one of his jobs is listed as “Troublemaker-In-Chief.”

Indeed, starting around 2012, after transforming disease management with, among other things, his easily accessible population health lessons on regression to the mean and planes on the ground, Al came after wellness like a Hellfire missile. In his book, “Why Nobody Believes the Numbers,” he ridiculed the industry’s claims of return-on-investment (ROI) and the principles purported to underlie those claims.

On his blog, at TheySaidWhat.com, and elsewhere on the web, Al has called out specific vendors and employers, embarrassing them online by deconstructing their misstatements and careless calculations. He belittled wellness vendors and consultants by calling them “ignorati” and accusing them of having math skills less sophisticated than those of a fifth grader. And he has targeted specific researchers, proudly proclaiming his willingness to “name names.”

A couple of years ago, declaring to the world their determination to pull the tiger’s tale, Al and his partner-in-crime Vik Khanna penned “Why Are Al Lewis and Vik Khanna Such Jerks?” In the process of fulfilling their prophecy, they became the target of their own share of name calling and dismissal.

[Here’s the first disclosure: I’ve been in touch personally with Al Lewis for a few years now.  Al subscribes to my blog and will undoubtedly read this upon publication.]

The Encounter

I was a bit nervous when I heard that Al would be stopping by Rochester — near where I live — on his way to deliver a presentation in a neighboring city. What would it be like to face this guy, whose screeds on the web are so acerbic? Would I have to watch every word I uttered in case I accidentally revealed, say, one of the many things I still love about wellness, for fear that he’d humiliate me in a future post or realize that my math skills really aren’t much better than a fifth grader’s?

Al and I met at a Starbucks near University of Rochester on a warm summer evening. I got there first and ordered an iced coffee. (So it wasn’t really “dinner with Al.” It was beverages. But “dinner” made for a better blog title.) Shortly after I’d settled into a table, a lanky, casually dressed man came in, easily recognizable from his Linkedin profile photo. We made eye contact, and Al warmly exclaimed, “Bob!”

I stood up, we shook hands, and Al ordered some iced frappy thing. I immediately warmed up to him. We sat down, chatted about this and that — where we each were raised, and so forth. Al struck me as one of the nicest guys in the world. His wit was on display, as always. But it was friendly and humble.

al_bio

Al Lewis

When we got around to talking about wellness, Al recited his usual concerns that many of us have become familiar with, bemoaning participant-vs-nonparticipant comparisons, exhorting the use of plausibility tests, and the rest. He was drawing imaginary line graphs in the air — as I nodded in agreement, hoping he didn’t detect that I wasn’t smart enough to follow.

After chatting for a couple of hours, we agreed that we could enjoy our banter through the evening but that both needed to get going. We stepped out into the muggy Rochester twilight, the smell of fumes from traffic whizzing by, and said our farewells as Al folded his 6’5”-ish frame into his compact rental and rumbled off toward the thruway.

I was left with a sense of bewilderment — disarmed by the warmth and humility of this man who is so brash in his books and web postings. But I was also struck by what we shared, a commitment to the truth about wellness, despite not being fully aligned on what that truth is. I spent the next day or so trying to make sense of this encounter.

Disruption Hurts

For the seven years I’ve been active on the social web I’ve been hearing self-proclaimed thought leaders call for “disruption,” especially in health and health care. To them, disruption translates to innovation and radical transformation. As an example, if you’re not familiar with the term “disruption” in this context, we might say that Uber has disrupted transportation. AirBnB has disrupted the hospitality industry. E-cigs are disrupting the tobacco industry.

In wellness, I’ve seen little disruption. Wearables are cool — I’m all for them — but I’ve seen no evidence that they’ve disrupted anything other than the inconsequential pedometer market. Health promotion programs, gamification, apps, websites, resilience programs, behavioral theories, and the now-trendy financial wellness programs have not amounted to anything I would call disruption.

Like it or not, Al Lewis, with help from Vik Khanna, disrupted wellness. We may complain about his tactics when he humiliates vendors and researchers touting ROI. But, to be honest, I’d been trying to expose unfounded ROI claims for years. I was one of the first — though certainly not the best — to challenge the most cited wellness ROI study, which drew the preposterous conclusion that health care expenses fall by $3.27 for every dollar spent on wellness. I also was the first workplace wellness manager to challenge the value of our health screening practices.

Hardly anyone listened or cared. The nice guy approach served my need for self-expression, but had no chance of evoking change in the industry.

Al Lewis has changed the wellness industry. The main reason that in 2015 everyone was disavowing ROI in favor of “value on investment” (based on dodgy program outcomes related to recruitment, engagement, retention, etc.) was because of Al’s influence. Vendors and employers who are aware of industry chatter are now more responsible in proclaiming ROI and positive health outcomes.

Disruption can be painful. In fact, it probably has to be. I don’t know whether Al’s ends justify his means, but I do believe the wellness industry is more honorable today — at least trying to be more honorable — under Al’s watchful eye.

I confess there’ve been times when I’m convinced Al has gone overboard, but then soon discover the latest hijacking of “wellness” as a subterfuge for cost-shifting (like in the infamous case of Penn State University) or deception (like in one notorious employer’s abuse of employee wellness data), and every unkind word Al has published seems justifiable.

[More disclosure: Al and Vik have always been unequivocally supportive of me — sometimes more than I deserved. In their book Surviving Workplace Wellness, they singled out me and my work as exemplary.]

Quizzify 

In what seems like almost an inevitable twist of fate, Al and Vik have now become vendors, with their health literacy product Quizzify. I’m not a Quizzify client and I don’t do product endorsements. But I can say that employers who are looking for a new approach, especially as it relates to health care costs, should take Quizzify for a test drive.

Employers also should check out Quizzify if they

  • Have lost faith that their wellness programs lead to meaningful change
  • Are leery of claims made by conventional wellness vendors
  • Believe an important part of their health care solution must take place on the demand side of the equation
  • Value that Quizzify content is reviewed by Harvard Medical School faculty physicians

And even employers who have adopted high-deductible health plans, or who — for whatever reason — want their employees to understand the benefits of judicious use of the health care system, and the risks of overuse, should check out Quizzify.

As Quizzify continues to build its team, develop and refine its product, and gain traction in the market, it has a chance to represent the embodiment of disruption and an important piece of the solution many employers are seeking.

That’s what I think of Al Lewis.


[Originally posted on LInkedIn in February 2016]