Sadhna Paralkar Of Segal: “Realize what you don’t know”

Realize what you don’t know. Become more self-aware; know your weaknesses and surround yourself with people who can complement your talents, not people who are exactly like you. That’s how you’ll create a more powerful and effective team. Hiring the right people is the most important task of a leader. The global health and wellness market […]

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Realize what you don’t know. Become more self-aware; know your weaknesses and surround yourself with people who can complement your talents, not people who are exactly like you. That’s how you’ll create a more powerful and effective team. Hiring the right people is the most important task of a leader.

The global health and wellness market is worth more than 1.5 trillion dollars. So many people are looking to improve their physical, mental, and emotional wellness. At the same time, so many people are needed to help provide these services. What does it take to create a highly successful career in the health and wellness industry?

In this interview series called “5 Things You Need To Create A Highly Successful Career In The Health and Wellness Industry” we are talking to health and wellness professionals who can share insights and stories from their experiences.

In this particular interview, we had the distinct pleasure of interviewing Sadhna Paralkar.

Dr. Sadhna Paralkar has more than 20 years of health and wellness experience. She is the National Medical Director and a Senior Vice President at employee benefits and HR consulting firm Segal. She leads Segal’s Medical Management consulting and has specialized expertise in on-site clinics, wellness programs and medical management program design and focuses on optimizing health improvement while containing costs. Her experience includes a variety of healthcare roles — serving as a practicing physician and working for a large corporate employer in managing employee health as well as working for a managed care organization. She now enjoys supporting wellness via healthcare consulting.

Thank you so much for joining us in this interview series! Before we dive in, our readers would love to “get to know you” a bit better. Can you tell us a bit about your ‘backstory’ and how you grew up?

I grew up in Mumbai, India. After I finished my medical school degree at the University of Bombay (Mumbai) I came to the USA for higher education. I switched to a non-clinical track quite early in my career. Right after receiving my Masters in Public Health at University of Illinois, I started working for Navistar, a large company in Chicago, overseeing their multiple on-site clinics. I also got heavily involved on the purchasing side of healthcare for a large self-insured population of over 100,000 beneficiaries. As a physician I understood the one-on-one patient to physician relationship, but I realized that I didn’t have a good understanding of the business side of healthcare. So I then got an MBA from Northwestern University’s Kellogg School of Management. After that, I began working for United Healthcare (UHC) where I received my “managed care 101” education. Now I am in the consulting side of healthcare where I help large employers and plan sponsors assess and select healthcare for their participants.

Was there a particular person or event that inspired you to live a wellness-focused lifestyle? Can you tell us about your main motivation to go all in?

While completing my Masters in Public Health, I got very interested in epidemiology and population health. Population health is an approach that aims to improve the health of an entire human population, and that’s what employers who self-insure their health plan for their beneficiaries manage. While overseeing Navistar’s multiple on-site clinics, which were mainly for occupational health, we decided to convert some of them to offer primary care and that got me more interested in wellness. We started promoting wellness through the clinics. The profound impact we had on employees’ preventive care and wellness after they were advised about healthier behaviors by clinic staff was eye-opening. That experience made me realize that most patients getting medical care from their doctor rarely get any advice on prevention or wellness.

Most people with a wellbeing centered lifestyle have a “go-to” activity, exercise, beverage, or food that is part of their routine. What is yours and can you tell us how it helps you?

I love practicing yoga and walking. I especially appreciate that these activities are simple and don’t need any equipment. So when I had to travel for work (pre-pandemic), I could still do them. Yoga not only helps with your joint health and flexibility, but when done correctly it also helps with mindfulness. And walking is something you can do anywhere — and has a low impact on your back and other joints. A study published in the British Journal of Sports Medicine found that those who adhered to a walking program showed significant improvements in blood pressure, slowing of resting heart rate, reduction of body fat and body weight, reduced cholesterol, improved depression scores, increased measures of endurance and experienced an overall better quality of life.

When it comes to food, it’s hard and stressful to follow any particular diet at all times, especially if you travel a lot. So I believe in “anything in moderation,” as long as you watch those calories. And I try to avoid consumption of unhealthy foods too frequently.

To live a wellness-focused life is one thing, but how did it become your career? How did it all start?

In medical school, I learned three types of prevention. Primary prevention: preventing the onset of illness or injury before the disease process begins. For example, immunization or never smoking. Secondary prevention: includes early detection, any preventive measures that lead to early diagnosis and prompt treatment of a disease and to prevent more severe problems from developing. Examples include screening for high blood pressure or obtaining a mammogram for early detection of breast cancer. And tertiary prevention: preventing a second episode after the first adverse event has already happened. For example, adopting a healthy lifestyle and losing weight after the first heart attack.

What I didn’t internalize at that time is how it all comes together in population health. About 75 percent of our health or illness is determined by our own life choices — what we eat, whether we smoke, whether we exercise, whether we’re overweight and in general whether we make good health choices. When I started promoting wellness through the clinics at Navistar, I revisited my basic training in preventive health, and had an “Aha!” moment. I realized that this is what companies should be offering in their wellness programs. This is where medicine and public health really came together for me.

Can you share a story about the biggest challenges you faced when you were first starting? How did you resolve that? What are the main lessons or takeaways from that story?

One of my biggest challenges was proving the financial return on investment (ROI) of a worksite wellness program. Early on in my career at UHC, I was put in charge of Optum’s Care Management ROI story. We came up with a fantastic, actuarially driven ROI model — or so I thought…but it was very hard to convince the audience of self-insured employers of the program’s success as their healthcare costs were still going up. It’s difficult to measure the ROI associated with prevention.

How do you prove something that didn’t happen? How do you prove something that you prevented from happening? It’s all about future savings. Healthcare costs are a function of utilization and unit costs, and if unit costs are rising disproportionately higher (such as with new biologic or specialty drugs, innovative medical devices, newer treatments) — even with steady or decreasing utilization, the healthcare costs will continue to rise.

I slowly learned to tweak my message. While measuring financial factors remains vitally important, evaluating the success of wellness programs within health benefit plans requires a different approach. The metrics by which wellness programs get measured may capture whether “population health” is improving overall and whether money is being saved in the areas covered by the wellness benefits.

In the long run, when a wellness program is truly working, it keeps healthy people healthy and reduces modifiable risk factors to slow the onset and progression of chronic disease. A successful program reduces the demand for services, which helps control both short-term and long-term costs. Wellness programs alone can do little to immediately, directly impact the unit costs of care.

Can you share with us how the work you are doing is helping to make a bigger impact in the world? Can you share a story that illustrates that?

Since I made the shift from clinical to population health management, anything I do affects a large group of people. At Segal our mission is delivering trusted advice that improves lives. That is precisely what I practice every day. It’s about population health improvement. I help our clients and their members live better lives by improving their health status.

Health education can be applied at all three levels of disease prevention For example, at the primary prevention level you could educate people to practice preventive behaviors, such as having a balanced diet so that they can protect themselves from developing diseases in the future. At the secondary level, you could educate people on the value of preventive screenings, such as obtaining a colonoscopy and mammogram when appropriate for their age. And at the tertiary level, you could educate people to take their medication appropriately or work on weight loss after their first heart attack. Everything we do in terms of population health management improves people’s overall health.

What are some of the most interesting or exciting projects you are working on now? How do you think that might help people?

Since the pandemic started, I have spent a great deal of time researching various aspects of COVID-19’s spread, disease progression, tests, treatments, vaccines and long-term effects — including its mental health impact. The Kaiser Family Foundation reports that in the first few months of the coronavirus pandemic, the share of U.S. adults who said worry and stress related to the coronavirus was having a negative impact on their mental health increased from about one-third (32 percent) in March 2020 to roughly half (47 percent) in March 2021.

I have been actively working on finding solutions to bring to clients that will help their members address mental health issues. There are so many new apps and solutions out there — but not all of them are built based on evidence and science. Some have better engagement rates and improved outcomes than others. My team and I are conducting extensive research to find the best solutions that will make the most meaningful impacts in improving mental health.

You are a successful leader. Which three character traits do you think were most instrumental to your success? Can you please share a story or example for each?

  1. “Don’t let urgent get in the way of important.” I love this quote originally attributed to the former U.S. President, Dwight Eisenhower. It has stayed with me ever since I heard it. My take on it is: “Never lose sight of your ultimate goal” — whether it’s professional or personal. Women especially tend to take on a lot of busy tasks, lose sight of what’s important and let the urgent things get in the way of our long-term goals — whether it’s family obligations or work related tasks. We need to make a conscious effort to separate the urgent from the important and prioritize accordingly. Responding to that email can wait while you’re working on something more important. Make a to-do list in the order of priorities — starting with urgent AND important. That will help you get really important things done first. But don’t stop there. Add a few “don’ts” to your list. As in “don’t take on everything” — learn to delegate, don’t say yes to everything, and lastly, don’t shy away from speaking up. There’s never going to be a precisely right moment to speak. Just grab the moment — don’t let thoughts like “I don’t feel like I’m ready” get in the way.
  2. Realize what you don’t know. Become more self-aware; know your weaknesses and surround yourself with people who can complement your talents, not people who are exactly like you. That’s how you’ll create a more powerful and effective team. Hiring the right people is the most important task of a leader.
  3. Encourage critical thinking and innovation. My courses at Kellogg focused a lot on leadership. Not all examples and lessons were applicable to all the industries — for example when they talked about manufacturing or operational leadership for a factory making widgets, I used to struggle in applying it to my industry. But encouraging critical thinking and innovation are universal. Leaders should maintain a flexible mindset and be willing to try new ideas. Take a genuine interest in your projects or clients or work, and your team will pick up on your enthusiasm. Set a practical vision and suitable targets for all your projects. Consider assigning specific, measurable, attainable, realistic, and timely (SMART) goals for all the work you assign to your team so they know what to expect.

OK, thank you for all of that. Let’s now shift to the main focus of our interview. Let’s begin with a basic definition of terms so that all of us are on the same page. Wellness is an incredibly broad topic. How would you define the term “Wellness”? Can you explain what you mean?

My understanding of wellness is captured best in a definition from the University of California, Davis — “Wellness is an active process of becoming aware of and making choices toward a healthy and fulfilling life. Wellness is more than being free from illness; it is a dynamic process of change and growth. It is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.” In addition, I’d add financial well-being to the mental health aspect of wellness. Learning to effectively manage your economic life is so crucial, yet they don’t often teach that in schools. Employers are beginning to incorporate financial wellness into their total well-being efforts through their retirement education plan.

As an expert, this might be intuitive to you, but it will be instructive to expressly articulate this. Can you please share a few reasons with our readers about why focusing on our wellness should be a priority in our lives?

Making wellness a priority, especially during the COVID-19 pandemic, is essential. I wrote a blog post on this topic: (Re)Making the Case for Wellness During the COVID-19 Pandemic. While there are many factors that can lead to the quick spread of COVID-19 — including lack of access to clean water, living in close quarters to others, limited access to nutritious food, working on the front lines, and challenges to accessing care — if you review data on outcomes from COVID-19 cases to determine who recovers quickly, who becomes severely ill and overall survival rates, a general pattern seems to emerge. Those in good health have fewer complications and less risk. For example, ICU admissions for COVID-19 are linked to chronic diseases, such as diabetes and hypertension. As the risk of COVID-19 infection persists, maintaining one’s health and well-being remains key to virus prevention — and has taken on increased importance during a time wrought with challenges to physical, mental and financial health.

Healthy habits, including good nutrition and frequent physical activity, are the first steps in protecting your health and staying well. Promoting these and other beneficial activities is the foundation of any well-being campaign or wellness program. Chronic diseases (diabetes, heart disease, and lung disease) account for 86 percent of healthcare costs. Several research studies, including one from the Cleveland Clinic, have linked lifestyle risks to most chronic conditions, including those that increase risks related to COVID-19. Many of these chronic diseases are preventable and/or manageable with the adoption of a healthy lifestyle.

Since the COVID-19 pandemic, there has been an increasingly growing understanding of the necessity for companies to be mindful of the wellness of their employees. For the sake of inspiring others, can you share steps or initiatives that companies have taken to help improve or optimize their employees’ mental and physical wellness?

Companies stepped up immediately to address the uncertainties surrounding the COVID-19 pandemic. When possible, people were allowed to work from home, and given the tools they needed to do so. Several mindfulness apps were made available free of charge to healthcare members. The same with telemedicine. At Segal, we helped our clients select and set up several telemedicine programs. Online fitness classes were made available and employers encouraged carving out an hour for physical activities. In fact employees within the companies volunteered to offer virtual group fitness classes. And regular communication was shared with members to help employees better understand the physical and mental health impact of COVID-19.

Employers stepped out to provide support like never before — including helping employees with their ergonomic needs to work from home. Or providing tips on work-life balance to parents with young children at home. It was a new experience to all employers. And they handled it very well.

Ok super. Here is the main question of our interview. What are your “5 Things You Need To Create A Highly Successful Career In The Health and Wellness Industry”? If you can, please share a story or an example for each.

1. Believe in the power of health and wellness.

Lead by example. You need to be a firm believer in how practicing wellness in your daily life adds value. Practice what you preach — you should be practicing wellness activities whether it’s yoga, walking, running, cross-fit, or healthy eating or any other activity you encourage other people to do as part of their wellness program. A doctor can tell a patient to quit smoking but if the doctor is still a smoker, the patient will never quit.

2. Know your numbers.

I once ran a worksite wellness campaign called “Know Your Numbers.” This was targeted to inspire employees to know their biometrics numbers such as their blood glucose, HbA1c, cholesterol/lipid profile, body mass index, etc. This exercise helps participants know the best range they should be in based on their age, measure progress and enable them to set personalized goals.

I recommend taking the “Know Your Numbers” campaign a step further, and apply it to wellness professionals who are managing a worksite wellness program. In this case the numbers they should know very well are participation rate and growth by each program, how much each program costs, which programs are the most popular among members and which programs are getting the most desirable outcomes. Go ahead and create a dashboard with key numbers and update it every month. Once you know these numbers and can talk about the progress in budgeting meetings with your CFO, you’ll get more credibility among executive management — and hopefully more budget for your programs.

3. Embrace innovation in healthcare.

When I started in this career 20 plus years ago, I used to actually send mailings to people’s houses. Half of the time I didn’t have the correct address or they went unopened. So I think most of that effort was wasted. Anything we did at the workplace was because people at least would come to work and they would see the flyers in the lunchrooms and realize that some healthy activity competition was going on at work. Not everybody had computers at work at that time and email was not so prevalent.

There were chronic care management or disease management programs where a third party organization would call people’s houses based on their claim data. I have a feeling most of those calls probably went unanswered, too. Because who wants calls from a random number, especially if the calls comes during your dinner? Those were wasteful as well. But when the smartphone came, I became incredibly excited because it enables health and wellness professionals to actually develop apps that people like.

Another evolution is the tracking devices like an Apple watch or Fitbit that’s something somebody is wearing 24/7. We used to just accept the number of steps people claimed they were taking each day. Today’s devices even monitor walks within an office building. I love this feature because when people take the trouble of taking the stairs or walk within the building, members can get rewards or incentives based on the walking they actually complete and that data can feed directly into the monitoring program.

4. Integrate physical and mental health.

Mental health is heavily intertwined with physical health — and should not be treated as an afterthought. Yet, some primary care physicians largely ignore the behavioral health aspects of preventive care. Years of research and initiatives focused on prevention and promoting healthier behaviors, but they ignored the most important contributor to the chronic diseases — mental illness.

Primary-care physicians traditionally shied away from considering emotional or mental health as a root cause of chronic diseases. Yet, data show that the two are closely linked. An estimated 44 million adults in the U.S. are living with a mental illness, according to the National Alliance on Mental Illness, yet nearly 60 percent of those with a mental health disorder didn’t receive treatment in the previous year.

Especially given the advances in technology and tele-behavioral health becoming mainstream, we can overcome many of the challenges of the patient getting the much needed behavioral health counseling — that includes improved access, flexibility, convenience and comfort.

5. Speak at conferences and publish articles.

It’s important to give publicity to your work, not only for your own brand development, but to reveal results and share ideas with others. Be brave and sometimes even share what didn’t work. I often tell my colleagues that knowing what didn’t work and why it didn’t work is as important as knowing what works.

You are a person of great influence. If you could start a movement that would promote the most wellness to the greatest amount of people, what would that be? You never know what your idea can trigger. 🙂

My “wishful” movement — creating a fun, educational program to start wellness awareness in elementary schools for 15 minutes once a week. The earlier we start incorporating healthier behaviors into our lifestyle, the better outcome we’ll have. And when we make it fun, children are more likely to learn and adopt. Maybe they will go home and teach their parents!

We are blessed that some very prominent names in Business, VC funding, Sports, and Entertainment read this column. Is there a person in the world, or in the US with whom you would love to have a private breakfast or lunch, and why? He or she might just see this if we tag them.

I admire Warren Buffet not only because he’s a genius investor, but he has taken philanthropy to the next level. And I love some of his quotes such as: “It takes 20 years to build a reputation and five minutes to ruin it. If you think about that, you’ll do things differently.” And “Someone’s sitting in the shade today because someone planted a tree a long time ago.”

I like to think about this quote as I help build the culture of wellness.

How can our readers further follow your work online?

Feel free to connect with me on LinkedIn:

This was very inspiring. Thank you so much for the time you spent with this. We wish you continued success and good health!

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