The following op-ed was published on June 15th, 2010 in the New York Times’ Room for Debate blog.
In an effort to control health spending, companies are spending more money than ever to keep their employees healthy. More than half of large businesses, for instance, offer financial incentives to employees who complete smoking cessation or weight management programs.
When you consider that over 40 percent of premature deaths in the U.S. is associated with smoking, inactivity or obesity, it seems like money well spent. There is evidence to support such an approach.
Last year, the New England Journal of Medicine found that paying patients $750 significantly increased their chances of quitting smoking. And in a Journal of the American Medical Association study in 2008, cash rewards made patients more likely to lose weight.
One question, however, is whether every socioeconomic class will respond to such incentives. The patients in the studies cited above were well-educated, white, and had high incomes — hardly a representative demographic cross-section.
Those with more limited economic means may not have the ability to pay for gym memberships, smoking cessation drugs, or more nutritious food. Indeed, data from several studies confirm that those in lower socioeconomic classes have poorer smoking cessation rates and diets with less whole grains, lean meats and fresh fruits and vegetables.
A financial incentive for health therefore has the potential of worsening the socioeconomic disparity between people who have the resources to become healthier, and those who don’t.
As a primary care doctor, it’s frustrating to see patients fail to lose weight or continue to smoke despite my counseling attempts. A monetary incentive program can indeed be a powerful motivating tool. But it has to be carefully implemented so that all patients, from every background and class, can potentially benefit.
Kevin Pho, MD, is a practicing, board-certified internal medicine physician and the founder and editor of KevinMD, which he built from scratch in 2004 to give clinicians and patients a place to be heard. Over two decades, it has become one of the most recognizable physician-led publications in health care, drawing more than 7 million annual page views and over 500,000 followers across social media. He still sees patients in primary care in Nashua, New Hampshire, the practice he says keeps the platform honest.
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An acclaimed keynote speaker, Kevin speaks nationwide to clinicians and non-clinicians on health care, digital media, physician leadership, and burnout. His signature keynote, “Connect and be heard: Make a difference in health care with social media,” traces his social media journey since 2004 and inspires audiences to strengthen the doctor-patient relationship, make their voices heard in health reform, and turn the tide against clinician burnout. He is the founder of Physician Speaking by KevinMD, a physician-run speakers bureau, and is available for speaking opportunities.
Kevin earned his medical degree from Boston University School of Medicine and completed his internal medicine residency at Boston University Medical Center. The New York Times called KevinMD “a highly-coveted publishing place for doctors and patients,” and Forbes called it a “must-read health blog.” He is an inductee of the Healthcare Internet Hall of Fame, a recipient of the American Medical Writers Association McGovern Award, and a New Hampshire Magazine Top Doctor.
