Simple Measures of Employees’ Subjective Wellbeing and its Potential Impact on Employers’ ROI from their Health Investments


Mitchell R. Weisberg, MD

Board Certified Internist

Clinical Psychopharmacologist

Chief Medical Officer, ViMedicus


Executive Summary

Somewhere in the labyrinth of our healthcare system, the simple question “How do you feel?” has gotten lost. Today, we are paying the price for this in unrealized human potential and corporate earnings. Increasing evidence in the literature shows a correlation between employees’ wellbeing and factors such as work performance, employee retention, and healthcare expenditures. 1, 2, 3 Ironically, employer based wellness programs have done nothing to measure or improve the wellbeing of the workforce and not coincidentally, they have been unable to show any significant ROI for employers. At the crux of the collective under-performance of these initiatives is the industry-wide adoption of the health risk assessment (HRA) as the compulsory entrée for employee participation in workplace wellness programs. A more detailed critique of HRAs is instructive for the road forward in workplace wellness. According to the recent Rand Corporation’s meta-analysis of workplace wellness programs, only 46% of those offered a wellness program completed an HRA, although in many instances, employees were given a financial incentive to do so.4 While the biometric data collected in a n HRA indeed measures health risks, arguably this   data has no correlation to participants’ subjective sense of wellbeing. Therefore, HRAs give no internal impetus to an employee to complete an HRA or to further engage in a wellness program if they do complete one.

As a Board Certified Internist in private practice for three decades, the author has earned the right to point out that the standard health risk assessment  brazenly abrogated the most fundamental rule of clinical diagnostics, best summarized by Albert Einstein, “If I had only one hour to save the world, I would spend fifty-five minutes defining the problem, and only five minutes finding the solution”. Expecting to begin with a person’s biometric data and reach meaningful solutions or outcomes for this person is the ultimate example of clinical naiveté. Obtaining a thorough patient history always precedes and rationally guides any physical examination or diagnostic testing; and a thorough patient history always begins with a detailed inquiry into the patient’s subjective wellbeing, commonly known as the patient’s Chief Complaint. This is just basic medicine. Thus, it is this veteran clinician’s assertion that the employees wellbeing is indeed the missing piece of the employer sponsored healthcare system as well as the employer based workplace wellness puzzles.

Contrary to seemingly everybody else on the planet, this doctor’s diagnosis for the healthcare crisis is not the cost, but rather, the productivity lost. The author posits that a person cannot perform better than he or she feels. When we describe our subjective sense of wellbeing, we are describing the current structure of our ever-changing neuroplastic state; and for every structure exists functional limitations. For example, if an engineer designed a bridge with a load capacity of 20 tons, try putting 21 tons on this bridge it fails. In its broadest terms, the author’s hypothesis states that the underlying structure of a human being’s current performance is his or her current neuroplastic state.

This author predicts that wellness programs that dispense with the standard HRA and opt instead to prospectively measure and improve employee subjective wellbeing will engage and activate those employees who have the most to benefit from their programs, cut Employers’ direct healthcare expenditure, absenteeism, presenteeism and employee turnover. The author has designed a progressive series of Employer based studies that he believes will lend support to his hypothesis and prove that something as simple as asking employees, “How do you feel?”, has the potential to disrupt the employer based healthcare system and workplace wellness spaces and thus optimize employers’ returns on their health investments.


Mitchell R. Weisberg, M.D., M.P.


  1. Overall Well-Being as a Predictor of Health Care, Productivity, and Retention Outcomes in a Large Employer.pdf POPULATION HEALTH MANAGEMENT Volume 16, Number 6, 2013 a Mary Ann Liebert, Inc. DOI: 10.1089/pop.2012.0114
  2. Evaluation of the Relationship Between Individual Well-Being and Future Health Care Utilization and Cost.pdf POPULATION HEALTH MANAGEMENT Volume 15 Number 6, 2012 a Mary Ann Liebert, Inc. DOI: 10.1089/pop.2011.0089
  3. Does worker wellbeing affect workplace performance_.pdf Alex Bryson, John Forth and Lucy Stokes, NIESR OCTOBER 2014
  4. Workplace wellness programs study S Mattke, H Liu, J Caloyeras, CY Huang… – Rand health …, 2013 –




February 9, 2018

When describing the clinical experience of  treating a person who has multiple chronic illnesses, negative synergy, where the whole is greater than the sum of its parts, is what comes to mind. Such patients almost always have these additional symptoms, usually around the their level of vitality that cannot be explained away by any one of their underlying, well-defined conditions yet are often quite functionally impairing.  Moreover, these are the symptoms that patients with multiple chronic illnesses rarely if ever mention nor are they inquired about, in any critical way, by their healthcare providers. These are precisely the symptoms that me, Corey and our patients with multiple chronic illnesses find the most gratifying to recognize and treat aggressively.


January 29, 2017

Your mission is to create a High-Performance Organization.

You have invested significant capital and resource in attracting and retaining talent; the key asset in your organization’s portfolio.

You are committed to providing a workplace culture of continuous growth so you diligently measure the performance of your enterprise, your executives and your employees. You reward your stars and you find those employees who are lagging and need further attention.

You have all the personal attributes and tools of a high performance leader, which is rare and valuable in today’s highly competitive business environment.

However, in spite of these achievements some of your executives performance is lagging behind their true potential. You give them coaching and performance improvement plans. Yet, you are frustrated over the negative impact on your bottom-line from lost productivity and in the worst case scenario the financial and human toll from the loss and replacement of talent.

I am certain that I can help you.

I am a Board Certified Internist and a Clinical Psychopharmacologist with nearly 30 years of clinical experience in helping people optimize their health, wellbeing and performance.

I do much more than simply coach executives and employees.

Einstein said if he had just one hour to save the world he would spend fifty-five minutes defining the problem and five minutes finding the solution. As a seasoned clinical neuroscientist I am able connect an executive’s performance to its structural underpinnings, thus defining his or her performance problem, from which I derive a solution. This is the tool in my skill-set that separates me from  all other executive coaches.

I don’t expect you to take my word for it, so please see what my clients have to say about my clinical services.

I offer my executive coaching services with strict adherence to HIPAA. I am confident that the performance outcomes of my executive coaching will speak for itself.

If I can be of service to you and your high performance organization, it would be my pleasure and privilege to serve.


Mitchell R. Weisberg, MD, MP

The Executive Whisperer at Optimal Performance, MD

Phone: (847) 999-5120

Leave the Well Enough Alone Read the rest of this entry »

Medicalizing Obesity

September 8, 2016

The Argument for the Rational Use of Prescription Medications for Treating Obesity

From a report in 2009, Obesity in the United States carried the hefty price tag of $147 billion per year in direct medical costs, just over 9 percent of all medical spending. People who are obese spend almost $1,500 more each year on health care — about 41 percent more than an average-weight person. The biggest driver of these excess costs are prescription drugs, the author said.

However, virtually none of these prescriptions were for the treatment of Obesity. Rather, they were for treating the health consequences, or co-morbidities of Obesity such as Diabetes, Hypertension, Osteoarthritis just to mention a few.The good news is, effective and safe prescription medicines for treating Obesity have been in existence for several decades. The not so good news is that very few of these medications are actually approved by the US Food and Drug Administration (FDA) for treating obesity, and those that are FDA approved are rarely prescribed by US physicians. As preposterous as this seems in light of the burden of the the primary obstacle to Medicalizing Obesity is the Medical Establishment. For example, it was not until July 2013 that the American Medical Association (AMA) even recognized Obesity as a disease. In October of 2010 the FDA pulled the Obesity medication, Meridia (Sibutramine) from the market because in some patients it caused a rise in blood pressure and in patients with pre-existing coronary artery disease, Meridia caused heart attacks, some of which were fatal. While, high blood pressure or a fatal heart attacks are by no means minor risks, they are risks that can easily be avoided by any prescribing physician by following standard-of-care practices, such as monitoring of Blood Pressure and the appropriate screening for Coronary Artery Disease in at-risk populations. Furthermore, the majority of patients that experienced greater than a 5% reduction in their body weight while on Meridia enjoyed a net lowering in their blood pressure. The group of people prescribed Meridia are the same group with the highest risk for developing coronary artery disease, and physicians worth their weight in salt can fully assess their patients for coronary disease before, as well as closely monitor their patients’ blood pressure after prescribing Meridia for their patients. Apparently missing from the debate over withdrawing Meridia from the market place was consideration of the outcome of doing nothing about Obesity, which is as clear-cut a case of medical negligence if there ever was one. To add insult to injury, the medication Sudafed (psuedoephedrine), an over the counter decongestant, taken by millions of Americans every day, has a similar risk as Meridia for raising blood pressure and causing heart attacks in people with pre-existing Coronary Artery Disease (CAD). Seemingly, according to the FDA the benefits of clearing our stuffy noses warrants such risks while a clinically significant reduction in our body weight does not. To further illustrate the Medical Establishment’s perspective on Obesity, Aspirin which was first introduced to the marketplace by the Bayer Corporation in 1905, and the myriad of other non-steroidal anti-inflammatory drugs, or NSAIDs, that have proliferated since, cause 7,500 deaths per year in the US from gastrointestinal hemorrhage, most of which occurred spontaneously without prior warning. Why is there no issue within the Medical Establishment about the risks of these medications, which most of the time they are prescribed it is done so to treat the co-morbidities of Obesity? Yet if a medication that actually treats Obesity poses any of these same risks, it is pulled from the market? According to the prevailing perspective in the Medical Establishment, if you have pain and fever and happen to be obese the advice you will likely get from your doctor, will be to take two aspirins and call her after you become a contestant on The Biggest Loser. Clearly this is an irrational perspective and the time for a change is long overdue. In my next post, I am going to do my first comprehensive update since 2005 on the current medications available to treat the disease of Obesity, so please stay tuned.

End Post

Mitchell R. Weisberg, MD, MP

Internist-Psychopharmacologist-Corporate Wellness Consultant

Founder-CEO and Personal Physician at,

Optimal Performance MD LLC

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