By Chris Davis
Disclaimer: Chris Davis is not a registered nor licensed dietitian. He has never played one on TV. He is not related to one. He has only met five or six in his life. None of them have ever paid him. He just understands their overall value to modern healthcare.
Over the past few years, I have contributed a few wellness-related articles to HR Professionals Magazine, none of which paint corporate wellness in the most flattering of lights. I penned the article “Is Your Workforce Being Over-Screened for Medical Conditions?” in the June 2014 issue. Then, my January 2015 article had the ominous title: “Has Your Benefits Broker Told You the Truth About ‘Wellness’ Programs?” To the untrained eye, it would appear there might be a penchant of cynicism towards employer-sponsored wellness programs – and that untrained eye would be correct. Alas, in my 12-year career in health management, I have always had a fondness for a particular deliverable not always uniformly classified as “wellness,” but I cannot find a better label for it, as this is wellness at its most efficient: the use of registered dieticians.
The articles that I authored in 2014 and 2015 still apply in regards to the three fundamental constructs of a traditional wellness program: a biometric screening, a health risk assessment (HRA) and usually a “paydirt deliverable” of sorts – ex. health coaching, online educational courses or health challenge contests. All three constructs need to be budgeted for, along with the incentives that will be provided to employees. Additionally, these constructs are approached as one-size-fits-all for an entire workforce with little personalization to the unique needs of each employee. What most employers aren’t aware of is that a registered dietitian’s role as a medical professional is to actually assess a member’s nutritional and health needs, and work with them to craft a plan to achieve their personal wellness goals using peer-reviewed research and medically appropriate best practices. It’s exactly what most employers are hoping to achieve with traditional wellness programs, just without the costly and logistically burdensome constructs that both limit participation and member satisfaction while creating a higher degree of personal accountability.
Generally, dietitians like, or may require, employee-patients to complete a health history form and a three-day food record when they have introductory meetings. This creates context for the dietitian, such as understanding what medical conditions that member has or when and where they eat their food – all of which provide insight when understanding a member’s needs and preferences and how to build realistic nutritional and lifestyle goals. Knowing limitations and preferences, such as accounting for sugar intake for a diabetic, addressing particular allergies or accounting for religious/lifestyle choices, is important when personalizing meal plans, developing strategies for modification of caloric intake or to address other specific goals an individual may have, such as planning for pregnancy or beginning a new exercise regimen.
Employer-sponsored dietitian programs can function in several ways to accommodate the needs of their workforce. Some employers prefer for a dietitian to conduct one-on-one meetings at the worksite and schedule employee-patients in 30- to 45- minute increments to meet with the dietitian on a recurring basis. Other mediums include the use of video conferencing, telephonic counseling or app-based contact that mimics an in-person presence for accountability. Regardless of the format, the intent is to ensure members have periodic access to the dietitian to help monitor personal progress, answer questions and listen to their needs on their healthcare journey to ensure they are getting qualified, reliable information on nutrition, lifestyle modification and help in managing long-term conditions, whether they are chronic (such as high cholesterol, heart disease or diabetes) or genetic (celiac disease, lactose intolerance, etc.) in nature.
When building out a strategy for a dietitian, an employer must consider if their insurance coverage includes dietetic services for the members. Then, the employer must ensure the dietitian they choose to work with is in their healthcare network, or willing to accept payment through another format, such as billable hours on a retainer format. The employer should also ensure they support the dietitian’s involvement with proper communication, assertive scheduling practices and creative ways to get members to complete their first visit with the dietitian.
When compared to a traditional wellness program, the cost of a yearlong relationship with a dietitian is significantly cheaper to an employer while creating a higher degree of personalized engagement with the employee on their health status. Many companies that win local “Best Places to Work” awards often have concierge services, such as recurring onsite dietician consults available to employees.