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 –



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