Archive for Tom Emerick

Hospitals Move to Limit Low-Volume Surgeries

That is the headline in a recent article in US News and World Report. The author is Steve Sternberg.

According to the article, “…hospitals that do small numbers of common procedures place patients at far greater risk than those that do lots of them.”

Further, “voluntary standards” are expected to be adopted by some hospitals later this year.

Hospitals and surgeons need to do a minimum threshold of surgery to be competent. Beyond that threshold, high volumes mean one of two things: a) an ethical facility with a high volume of patients, or b) more likely high volumes of unethical surgery.

That this problem exists in the US is even more reason to use centers of excellence for surgery for your employees.


Tom Emerick


Dear Loyal Readers of Cracking Health Costs,

Please excuse me for not posting much lately.  I’m putting the finishing touches on my next book, An Illustrated Guide to Managing Your Personal Health—how to improve your health in 40 common sense steps.

This has occupied much of my time but will go to press soon.

Thanks for your patience.


Tom Emerick

More wellness bad news

An article in HUFF Post articulates this message. The author is Al Lewis.

The Health Enhancement Research Organization (HERO) and the Population Health Alliance (PHA) “…convened a joint committee of 39 self-described ‘subject matter experts’ from 27 wellness vendors and health plans, which produced a…tome ostensibly to justify wellness.”

It seems a funny thing happened in the report. “…despite its pro-wellness agenda, this expert report admits wellness harms both employee morale and corporate reputations.” That’s a huge admission…huge.

Further, according to Al, the report shows a gross per annum savings of only $12 per employee, and “optimistically” pegs the per employee cost at $18.  Even if you’re not good at math, this sounds a lot like a negative return.

As more and more of this type of reporting of negative ROI’s from wellness occurs, expect wellness vendors to claim that the very ROI they’ve touted for years doesn’t matter anyway.


Tom Emerick



Why Are These Doctors So Mad? What It Means for You

Rosemary Gibson, author of The Treatment Trap and Wall of Silence, has just published a terrific article  that asks the question whether doctors should be periodically independently assessed for whether they are keeping up to date.

Leah Binder, CEO of Leapfrog, has dedicated her life to patient safety. Leah’s work saves lives. Period. She spoke up in favor of continued assessment of doctors…go Leah… and has been pilloried in social media by the bad guys. Too bad. That makes her detractors look…umm…not so dedicated to patient safety.



Tom Emerick




Centenarians have bad habits too

The NYT published a good article with that title. It was written by Anahad O’Connor.

According to a new study of people who’ve lived to age 100, most of them have had some pretty bad habits.  “The centenarians in the study indulged in smoking and drinking just as much as their shorter-lived counterparts.”  

They also didn’t weigh less, exercise more, or eat better than those who died much younger.  A study at the Albert Einstein College of Medicine found that “… the people who lived to 95 and beyond did not seem to exhibit healthier lifestyles than those who died younger.”

These studies are significant because they use actual measurements, not surrogate measurements

“What,” you ask? “That’s crazy,” you say?  How can that be?

Here’s the hard truth. I want to inculcate readers of Cracking Health Costs with this truth: lack of exercise, being overweight, and smoking are risk factors… but only three of a hundred risk factors each of us have.  If any three are out of bounds but the other 97 are right, you’ll likely do well. Conversely if those three are just right, and the other 97 are out of sync, you know the answer.

Wellness true believers would have you believe that they have a simple formula for a long healthy life, and they want to charge your company a ton of money to use it. Their formulas involve being over-tested by doctors. Nonsense. The real formula, if there were one, would require a balance among at least 50-100 variables.

There is no simple formula. Period.



Tom Emerick







Obesity both Increases and Decreases risk of dementia. Say what?

Yes, you read the headline right. It just depends on which study you look at.

Here’s part of an article published in the Guardian: “People who are obese in middle age are at almost four times greater risk of developing dementias such as Alzheimer’s disease in later life than people of normal weight, according to a study released today.”

This is from a Press Association article: “Obese middle-aged people are nearly 30% less likely to develop dementia than those of a healthy weight, a study has revealed. It also found that underweight people of the same age were a third more likely to develop the condition than those who had a healthy body mass index (BMI).”

No wonder the public is confused…not to mention wellness true believers. This is yet another reason why meddling with peoples’ health and wellness does not belong in the workplace.  You may be seriously steering people in the wrong direction again, as was the case with Vitamin E supplements, etc.


Tom Emerick

Doctors doing a 180 degree flop on many blood transfusions

According to a Business Insider report by Elle Kincaid, “…evidence is mounting that a substantial portion of blood transfusions are not necessary.”

As they’ve reduced blood transfusions, patient admissions have become shorter and patient death rates are down. Stunning, no? Why? For one thing, “transfusions can trigger immune and allergic reactions if the patient’s body and transfused blood cells do not get along.”

“In fact, The Joint Commission, a nonprofit that accredits hospitals, included blood transfusions in a 2012 report as one of five overused hospital procedures.” (Emphasis mineThat’s saying a lot, I know.

If they want to give you a blood transfusion, make sure they give you a good reason.

Tom Emerick

Adopting a culture of good health—no so fast

You don’t change cultural affectations of organizations overnight. That often takes an intergenerational time frame.

Look at the US auto industry. They had a culture of making poor to mediocre cars for 50 years, then only after losing 60% of their business to Japanese car makers did they make real changes, and they’re really not that close yet.

Many companies simply wither because they could not change a destructive culture. See Sears, Kmart, Montgomery Ward, Studebaker, Bethlehem Steel, Eastern Airlines, Pan Am, and on and on.

No, truly changing an organization’s culture sounds like a piece of cake, but is extremely difficult. Bandaids, like adding more salad in the company food service, are easy but that’s not real change.


Tom Emerick is a consultant and co-author of the book Cracking Health Costs, an Amazon trade best seller. Tom is the President of Emerick Consulting and co-founder of EdisonHealth.

Don’t sweat the small stuff

A number of years ago, and older and successful executive at British Petroleum once advised me to not sweat the small stuff.  He said being bothered by things you can’t change is a big waste.  That was good advice.

Well, it turns out that sweating over things you can’t change is quite unhealthy.  A WSJ article by Elizabeth Bernstein titled “It’s Healthy to Put a Good Spin on Your Life” explains how we handle life problems has a big impact our our health.

She writes about a male triathlete who had a very unexpected heart attack while training for his next event.  (Yes, wellness true believers, he was in tip top physical condition.) If something like that happens to you, it can be emotionally devastating, true.  But how you process that kind of life changing event will make a big difference in your future health. Those who adopt a depressing and miserable personal “narrative” about things like that will not recover as well as those who accept it and move on.

A heart attack is not “small stuff” by any means. But are you going to get angry about all the changes you face in life? Or are you going to try to make the best of it and move on?

“When reframing negative events, acceptance is crucial”, says Hal Shorey, a psychologist and assistant professor for the Institute for Graduate Clinical Psychology at Widener University in Chester, Pa., who helps clients with this issue. ‘If negative events and their impacts are not first acknowledged, the experience of invalidation can actually lead people to hold on to the negative narrative,’ he says. But there eventually comes a point when it’s healthier to just move on, he says.”


__________________________________________________________________________ Tom Emerick is a consultant and co-author of the book Cracking Health Costs, an Amazon trade best seller. Tom is the President of Emerick Consulting and co-founder of EdisonHealth.


Longevity is determined by hundreds of risk factors—too many to simplify

Longevity is determined by a hundred or so risk factors we all have, perhaps too many to truly understand and manage. Someday history will judge today’s understanding of health risk factors as poor, at best, dangerous at worst.

Wellness fans would have us believe that if we follow certain diet, exercise, bio-measurement, and primary care protocols, we will optimize our health. Alas, there are deep problems with that notion. Those protocols aren’t working well. It’s extremely difficult to eke out ROIs following the majority of wellness vendor programs.

Most importantly, we have only a crude understanding today of what our health risks really are. As I’ve written here often, factors such as boredom, loneliness, job satisfaction, etc, are huge risk factors, as are family relationships, genetics, anger, worry, resilience, finances, stress, aspirations, spirituality, community, contentment, and many more.

You can drink three Dr. Peppers a day and live to be a hundred. Egad! (BTW: scientists themselves do not agree whether sugar-free sodas are better then sugary ones.)

Some people smoke all their adult lives and live to be a hundred. Yikes! (My own Grandfather is a good example.)

Some people eat bacon nearly every day of their lives and make it to a hundred. Impossible, say wellness true believers!

Some obese people live to be a hundred too. How can that be?

Well, the plain truth is our health and longevity is determined by hundreds of risk factors. (The combinations and permutations of those risk factors is mind boggling.) That applies to all of us, every single one.  Simply put, if you do some wicked behaviors like drinking sugary sodas every day, but your other 100 or so risk factors are in sync, you’ll probably be just fine.

__________________________________________________________________________ Tom Emerick is a consultant and co-author of the book Cracking Health Costs, an Amazon trade best seller. Tom is the President of Emerick Consulting and co-founder of EdisonHealth.