Tag: alignedculture
Beyond Pharmacology Alone: Integrative Soil Cultivation for Workforce Resilience
Above image: Modern industrial farming (pharmacology alone) can produce short-term results, but only as long as the constant chemical inputs continue. Stop the inputs and the plants quickly decline, because the underlying soil health was never built. Sustainable organic farming (integrative approach) cultivates rich, living soil that sustains healthy, nutrient-dense fruit even without constant intervention.
Part 4: Beyond Pharmacology Alone. Integrative Soil Cultivation for Lasting Chronic Condition Mitigation
February 20, 2026
By Humaculture, Inc.
This is the fourth in a 5-part companion series to ICSL’s analysis of post-COVID health trends and morbidity pressures.
- In Part 1, we examined the broad crisis of rising chronic conditions driving costs.
- In Part 2, we applied the Topological Model to variable-demand operations like trucking.
- In Part 3, we explored chronic surges across large workforces using actual employer data.
- Here, we build on these insights to examine why pharmacology alone falls short, and how an integrative Humaculture® Topological approach (“soil cultivation”) offers a sustainable, organic path forward.
While ICSL’s companion article, “Why GLP-1 Drugs Alone Aren’t Enough – The Case for Integrative Solutions,” highlights the limitations of a pharmacology-first mindset, Humaculture® focuses on the Organizational solution. We refine “soil” (Structure, Assets, Processes—the Organization Domain) to enable natural, lasting resilience and Created Value.
As a leader in health benefits, risk management, or workforce wellness, you’ve seen the promise of GLP-1 drugs. Impressive short-term weight loss. Better blood sugar control. Reduced cardiometabolic risks. Many hoped these medications would finally bend the curve on chronic disease burdens that drive medical claims, disability costs, and absence.
Yet the limitations have become clear: high dropout rates, substantial weight regain upon discontinuation, muscle loss, side effects, and access barriers. These issues persist because pharmacology-first approaches treat symptoms without addressing the root causes. The underlying causes (poor nutrition, sedentary lifestyle, and behavioral patterns), remain unaddressed.
The Limitation of Forcing the “Plant” with Pharmacology Alone
Many people instinctively reach for the newest pharmaceutical tool. They force the “plant” (People) toward outcomes despite depleted conditions. A pharmacology-first mindset is like painting over a mildewed wall. The problem is hidden in the short-term, but reappears quickly because the root cause was only masked. Unintended consequences emerge and natural defenses weaken over time.
GLP-1 drugs deliver impressive short-term results (Diabetes, Obesity and Metabolism 2022), but studies show discontinuation leads to rapid regain, often 50 to 100 percent of lost weight within 12 months (Rubino, JAMA 2022). Dropout rates run high, driven by side effects, cost, and access barriers (Rodriguez, JAMA 2022). Even sustained use carries risks like muscle loss (15 to 40 percent – ScienceInsights, 2025)and long-term risks (Healthhoper 2026).
Weight is just one piece of the puzzle. Elevated weight increases risk for cardiac and circulatory disease, neurological impairment, metabolic and digestive disorders, and many cancers. Yet pharmacology-first thinking treats symptoms rather than first supporting the body’s natural ability to restore health through nutrition, fitness, behavior, and prevention.
Temporary gains fade when the underlying “soil” remains poor. Short-term productivity comes at the price of sustained resilience. This mirrors trends where chronic conditions drive recurring claims, lengthened disability durations, and escalating costs.
Frustration grows as costs climb and workforce health continues to strain the business. You recognize that there must be a better way to manage our health costs. What if a more integrative approach could finally unlock the lasting resilience you’ve been seeking?
The Humaculture® Topological Model: A Practical Guide for Integrative “Cultivation”
The Humaculture® Topological Model gives leaders a clear, practical framework for this shift. It shows exactly where to refine the Organizational “soil” so People can thrive naturally and produce lasting Created Value. Three Domains interact without hierarchy:
| Domain | Challenges (Current State) | Success (Integrative Outcome) |
| Environment Domain | Rigid regulations, high drug costs, limited access to preventive care | Strong partnerships with vendors that prioritize integrative protocols and flexible plan designs |
| Organization Domain | Fragmented benefits programs, misaligned vendors, pharmacology-first defaults | Clear standards across all health, wellness, leave, disability, and workers’ compensation programs; every partner adopts integrative-first protocols (Food as Medicine, Exercise as Medicine); misaligned vendors are replaced |
| People Domain | Unaddressed personal distractions and low intrinsic motivation | Empowered, accountable Talent inclined toward health, with the tools and autonomy to perform at their best |
When leaders intentionally orchestrate these Domains through the Dynamic Matrix, the entire system becomes self-reinforcing. Resilient People produce sustainable Created Value cycle after cycle.
The Decisive Choice: Refine the “Soil” for Integrative Cultivation
Effective workplaces lay the foundation for lasting health and resilience in organizations facing chronic condition pressures. Families and Work Institute defines an effective workplace, and their research demonstrates that an effective workplace yields roughly twice-better health outcomes relative to low-effective workplaces, reducing chronic stress, fatigue-related risks, and claims severity while strengthening retention and engagement.
The turning point comes when the leader chooses intentional, integrative “cultivation” over pharmacology-first fixes. Instead of another drug-centric incentive or coverage expansion, they reallocate Assets toward merit-based Processes designed to attract and retain empowered Talent already inclined toward health. They establish clear standards and expectations across all health, wellness, leave, disability, and workers’ compensation programs and require every solution provider partner to adopt integrative-first protocols (Food as Medicine, Exercise as Medicine), ensuring full alignment and replacing any misaligned vendors that prioritize pharmacology-only approaches. Any vendor whose primary goal is adherence to prescription drug protocols is a clear red flag that they are not focused on improved health and should be replaced to ensure full alignment.
Resolution: Measurable Victory and Renewed Operations
Organizations that consistently feed the Organizational “soil” achieve balanced, lasting success. The resolution is measurable victory: higher People Health Quotient (PHQ) and Organization Healthful Quotient (OHQ), meaningful reductions in disability costs and absenteeism, stronger retention and engagement, substantially multiplied Created Value, and a renewed operation ready for the next cycle. Just as organic gardening produces fruit with significantly higher nutrient density, integrative health solutions is like “soil” cultivation (Organization Domain refinement) that yields resilient People who deliver superior, sustainable outcomes.
For leaders facing chronic condition pressures, the results include:
- Economic. Strong multi-dollar returns on investment. Meaningful reductions in medical and prescription drug spending, disability costs, and indirect disruptions. Easier recruiting of ideal Talent. Reduced turnover. Fewer recurring claims. Recovered productivity that directly protects financial stability.
- Effectual. Tangible risk reduction. Lower chronic disease progression. Decreased utilization severity. Faster recovery from health events. Measurable declines in the key post-COVID morbidity drivers.
- Emotional. Authentic resonance through merit-based recognition, constructive challenge, and mission alignment. This builds voluntary engagement and retention rather than dependency or resentment.
The outcome is multiplied Created Value. Higher retention. More productive teams. More stable operations. Reduced absenteeism and disruptions. The organization becomes self-reinforcing. Resilient People produce sustainable Created Value (“fruit”) cycle after cycle.
Next up, in Part 5, we’ll examine partnering to address chronic risk at scale. Companion to ICSL’s focused analysis.
Take the First Step
As a starting point, contact Humaculture® for a review of your medical, disability, workers’ compensation, and absenteeism data, mapped to the Dynamic Matrix. We’ll identify leverage points to cultivate resilience and Created Value in your unique terrain.
Read the companion ICSL article for the full view of why pharmacology alone isn’t enough. Join us in building organizations where People don’t just manage chronic risk. They flourish despite it.
Contact: Steve Cyboran at [email protected], Wes Rogers at [email protected], or Caroline Cyboran at [email protected]
Website: humaculture.com
LinkedIn: humaculture-inc
Humaculture® — Cultivate Organizations, Grow People.
Strategies to Reduce Total Cost of Care, in Search of the Holy Grail
Come see our presentation at the Houston Business Coalition on Health (HBCH) conference on Thursday, December 8 for Strategies to Reduce Total Cost of Care, in Search of the Holy Grail.
See Our CEO Present at HBCH
Presenter: Steve Cyboran, ASA, MAAA, FCA, CEBS, Humaculture, Inc. CEO presents with Ray Fabius, MD, Co-Founder and President of HealthNEXT
Fee: Free for employers not in health services (use link below)
Time: Thu, Dec 8, 2022, 1:00 PM – 1:50 PM CST
Topic: TCoC Reduction Through Organizational Culture
Location: 6100 Main St, 77005 (Rice University Bioscience Research Collaborative)
Leadership & Tomatoes: 3 Business Principles from My Garden
About 1 in 3 people aspire to a leadership role in business.1 About 1 in 3 people grow a kitchen garden.2 The motivation is the same with both demographics. What is it? The tomatoes, of course. Business success. The harvest.
In turn, successful businesses and successful gardens also have something in common: the people who are rooting (pun intended) for it all to be a thriving ecosystem, resulting in a bountiful harvest for everyone.
Over the years, I have observed that many horticulture principles can provide insights and understanding to help those in leadership build more successful organizations.
Leadership Principle #1 — First build the soil.
Without first building healthy soil, gardening is unlikely to be successful. Well-prepared, deep garden soil gives plants the best opportunity to grow a strong root system.

In my garden, I till the soil each spring while the temperatures are still dipping below freezing. I add compost, fall leaves, and grass clippings to add nutrients and texture to the soil. I add alkaline wood ash from winter fires to maintain the soil’s pH balance, since I know my iron-laden well water tends to acidify the soil over time.
Well-prepared soil ensures the plants have the nutrients they need. Good soil also maintains a more consistent temperature, and it allows excess water to drain away faster, retaining only a healthy amount of moisture and retaining it longer.
If we think of businesses and organizations as the soil in which we grow and earn our living, we can easily begin to see parallels between a garden and an organization. An organization that is well prepared has sufficient capitalization, delivers products and services consistent with its vision and mission, is conducive to employee health and well-being, has reserves to weather economic storms, etc.
Most new businesses fail because those who form them are focused primarily on the success they hope to achieve (i.e. harvesting a bumper crop of metaphorical tomatoes), rather than first focusing on the soil preparation that will be critical to that success.
Leadership Principle #2 — Support the plants as they grow.
Once the soil is prepared, the hardest work is done. I have created a nutrient-rich, foundational environment the tomato plants can send deep roots down into and draw resources from to thrive.

In addition to building the soil, I also have further resources to ensure the tomatoes’ success. I supply supports for the plants as they grow taller and bend under the weight of their fruit. I provide irrigation, giving plants the extra water they need in the dry summertime. I walk through the garden almost every day to identify stressors affecting the plants so I can intervene with extra support if necessary.
Employees—even those in the best-prepared organizational soils—will experience negative stressors and challenges from time to time. Distressed tomato plants, just like people experiencing excessive stress, will never be as productive as they would be if they were healthy, and the quality of what they produce will likely be lower as well. Like a horticulturist walking through the garden, a person in a leadership position needs to be able to recognize when something is preventing the employees within their span of care from fully thriving.
Perhaps the employee is not well-matched to the job; they might benefit from transplanting to another area of the organization. Perhaps some benefits, compensation, recognition and performance management programs, advancement pathways, etc. are not properly designed to align with the organizational vision or mission; more beneficial behavioral designs could be put in place instead. Perhaps there are organizational climate challenges; the team might need special support during especially trying times to overcome the difficulties and thrive.
Often, the problem lies not with the employee, but with the organization and whether it optimizes the availability of its resources so employees can effectively leverage them and thrive.
Leadership Principle #3 — Plants don’t exist for soil; soil exists for plants.
The primary focus of a successful garden is never actually the plants. Plants come and go. If they are happy and healthy in well-built soil, they will thrive and produce a great crop.
Yet I never think of my tomato plants as resources to be exploited. Rather, in partnership and anticipation, I provide them with great soil and support them as they grow and produce. Most of my effort is directed into building the soil for the plants and making sure they have everything they need to thrive; the plants themselves do the rest. Both my tomatoes and I work in this gardening venture, looking ahead to the reward – a bountiful harvest.
One of the most important lessons I have learned from gardening is that just as the plants do not exist for the soil, people do not exist for the organization. Employees—humans—are not “resources” or “capital.” In fact, these terms have come to bother me deeply. “Capital” and “resources” are things an organization owns, rents, or acquires through debt to produce a product or deliver a service. Grouping people into a category of owned or rented assets is very discomforting to the thoughtful person.
Further, I have observed that developing policies and practices based on the analogy of owning or renting people (as the capital/resources terminology implies) leads to confusion on many fronts. Ultimately, it often leads to employees who are demoralized and perform poorly.
So, what if we thought of businesses and organizations as soil created for people to grow and thrive in? What if we thought of the organization’s resources as the support people need to produce abundant value (the harvest)? Organizations do not own employees. Employees are not the resource. Organizations are the soil in which people can root themselves to do meaningful, fruitful work – to grow and to thrive.
Just like I build the soil for my tomato plants because they grow better in a prepared garden, people create organizations of all sorts because we grow better and accomplish more together.
Practical Applications
So, if we change the way we think about organizations and people, how do we also rethink the way leadership handles traditional “human resources” or “human capital” topics (e.g. pay, talent development, performance management, benefits, time off, total rewards, etc.)? In other words, what is the practical application of these principles?
The Humaculture® approach addresses this. In order to apply the concept of building the soil, we first have to ask some questions: Why does the organization exist? What is its vision? In what sort of climate does the organization operate?
After gaining some clarity about these factors, the Humaculture® approach leads us to consider which people will best achieve the organization’s vision and mission (peach trees are unhelpful if the goal is a tomato crop, just as nurses are unlikely to design the best engine for a cutting-edge vehicle prototype).
The Humaculture® approach also leads us to consider what structure and delivery of the organizational resources will allow the people—and, in return, the organization—to thrive and be abundantly fruitful.
It might seem like more work at the outset, but the tomatoes (the fruit, the value created) are always worth it.

1 http://press.careerbuilder.com/2014-09-09-Majority-of-Workers-Dont-Aspire-to-Leadership-Roles-Finds-New-CareerBuilder-survey
2 http://www.farmerfoodshare.org/farmer-foodshare/2017/6/15/gardening-boom-1-in-3-american-households-grow-food
Author:
Wes Rogers, Chief Guidance Officer for Humaculture, Inc. Wes has almost 35 years’ experience in consulting and senior management positions with a variety of organizations, facilitating groups of people with diverse perspectives and objectives to coalesce around a singular vision and marshal resources to achieve the vision. This experience provides exceptional insights into how organizations operate and succeed. Contact Wes at [email protected].
Contributor:
Steve Cyboran, ASA, MAAA, FCA, CEBS, Chief Behavioral Officer, Consulting Actuary for Humaculture, Inc. Over the past 30 years, Steve has worked extensively with leading corporations, higher education institutions, and health systems across the country to articulate a vision for a healthy and effective workplace culture, develop a total rewards strategy to support that vision and brings deep benefits expertise with a behavioral approach and sound analytics to achieve and measure the desired outcomes. Contact Steve at [email protected].
Edited by:
Rachel Rogers, Editor for Humaculture, Inc. Rachel holds an A.A. in Liberal Studies with an emphasis in English and Communications. As a published writer with training in creative storytelling and corporate storytelling, her experience with writing, editing, and advising writers includes both technical and academic documents, as well as creative works.
About Humaculture, Inc.
Humaculture, Inc. transforms organizations—the way organizational leaders understand the organization and the relationships among the people in it, and the way people think about their position and role in the organization. Humaculture® is a philosophy and systematic approach for creating profitable, aligned, and healthy organizations conceptualized as “soil” in which people can thrive. Humaculture® helps organizations create the right culture in order to naturally attract, retain, sustain, grow, and transition people who enable the business—and each other—to thrive. More information can be found at: Humaculture.com.
Weathering the Storm: Is Your Organizational “Soil” Healthy Enough to Weather Both Floods and Droughts?
During these unprecedented times with businesses having been shut down due to an outside order by the government in response to COVID-19, many sectors of the economy, labeled as “non-essential,” were ordered to close business for a period. Organizations that are highly leveraged (a significant portion of the revenue is used to pay debt) or in lower margin businesses face an even greater challenge. Organizations need to figure out how to weather the storm. These options may include reduction in force to rolling furloughs, and potentially reorganizing through bankruptcy. What is the right decision for your organization?
If we think about an organization like the soil, the employees like plants growing in the organization, and the fruit they bear as the value or profit of the organization, then horticulture can provide a good analogy from which to view options for addressing the current situation. From a horticultural perspective, the current “storm” is like a drought. The first thing a horticulturist might do, for example, when faced with a drought is add mulch and preserve soil moisture, not jerk plants out of the garden. As another example, during an unexpected late freeze, it may become necessary to cover plants to enable them to maintain their heat.
“It is not nice to garden anywhere. Everywhere there are violent winds, startling once-per-five-centuries floods, unprecedented droughts, record-setting freezes, abusive and blasting heats never known before. There is no place, no garden, where these terrible things do not drive gardeners mad.” Henry Mitchell, author of the Essential Earthman
When weighing options to reduce costs and capacity such as layoffs, furloughs, rolling unpaid time off, treatment of unused PTO, leadership needs to weigh several considerations. For example,
Culture – One of the most important considerations may be how the organization wants to come out of this trying time. The approach may vary depending on the type of culture currently in place. For example:
- Strong, Productive Culture and Balance Sheet – If an organization has a strong, productive culture, with good talent and is financially strong enough to weather the current challenges (e.g., well prepared, fertile soil, that is more resilient), layoffs can be one of the most detrimental actions an organization can take to the long-term health of the organization and its people. There will be a drain on talent that may later be needed to support a strong recovery for the business, and that talent may wind up joining, or starting, competitors and taking a certain portion of knowledge with them. Layoffs made too hastily, where the remaining jobs aren’t redesigned to accommodate the reduction in staff and pick up the essential tasks of those leaving, may result in the need to rehire many of those positions. Then the organization assumes the cost of the layoff, and training of the new hires for the same positions, without any long-term value gain. In addition to considering the impact of the loss of talent from layoffs, the organization should budget for an increase in health, absence, and disability costs. We have seen 5% to 10% unanticipated increase in these costs depending upon the size and nature of the restructuring. The implications of a layoff may have long term impact that may make the long-term cost not worth the short-term gain. Other considerations may achieve the same goal while preserving the culture and health of the organization and its people.
- Culture is In Need of a Refresh – On the other hand, if there has been a need to rethink the culture and business structure (remove plants not well-suited for the garden, transplant some to different soil, and prune existing plants to shape them to be more productive), then it may make sense to consider some form of restructuring of the leadership and/or workforce. This can present a great opportunity to accomplish the organizational change that has been desperately needed but deferred. The type and nature of the restructuring may depend upon the suitability of the employees to achieve the business strategy. Organizational leaders should consider aspects of both cultural alignment and cultural health. A few examples (certainly not comprehensive) to consider may include:
- Working Retired – If there is a segment of the workforce at normal retirement age that may still be employed, but lack the energy and commitment necessary to take the organization where it needs to go. Then the organization may get more energy and innovation from a younger, less costly resource. In this case, an early retirement window may make sense. One client has a location where 70% of the workforce is retirement eligible and has the highest labor costs, but the employees are unprepared and afraid to retire. An early retirement window may be beneficial to those eligible for retirement and the organization.
- Strategically Misaligned – If there are certain businesses or shared service segments that may not be a good strategic fit (not directly driving the strategic priorities of the organization), then the organization may consider selling off, outsourcing, or co-sourcing those functions. For example, if your business is higher education, an outsourced food services contract affords greater flexibility during periods where the campus is shut down.
- Re-alignment – If there are opportunities to automate, streamline, or eliminate positions, then the organization may need to restructure. If the organization chooses this route, it is important that jobs are redesigned to ensure important functions don’t fall through the cracks, that you have the right talent in those positions, which may involve “transplanting” employees to other areas of the organization, and retraining or hiring different talent. Some of our clients have worked with a management consulting firm to evaluate staffing ratios to determine how many people should be appropriate. Following those recommendations, the client reduces staffing levels as indicated, but without redesigning the remaining jobs, they must often rehire those positions because critical work isn’t getting done.
Temporary Nature – Organizations will also need to consider if, and to what extent, this challenge will be a short term. If this will only be a temporary set-back and demand is simply deferred (e.g., delayed purchases such as iPhones, or elective procedures), or even if business will rebound to similar levels of activity from prior to the current downturn, then the organization may want to consider more of a shared responsibility approach with rolling unpaid time off or even furloughs. With the right messaging, the organization may be able to enhance its relationship with employees, letting them know the organization doesn’t want to let any of its teammates go during these challenging times, so we all need to consider ways to save money and share in the sacrifice. However, with 40% of the workforce living paycheck to paycheck[1], they may need to consider the potential impact on the financial well-being of the workforce if they are asked to work less (for example, 20% reduction in hours, and a corresponding 20% pay cut).
“My heightened awareness of stewardship to those within my span of care gave me a clear sense of purpose and clarity through which to view the situation. I thought to myself: We’re a family at Barry-Wehmiller so we need to act like one. What would a responsible family do in this crisis? A loving family would share the burden. Rather than watching a few of our colleagues face devastation, we decided that our reaction would be one of shared sacrifice.” Bob Chapman, CEO of Barry-Wehmiller
Other Cost Saving Opportunities – There are a number of dials in the various reward programs that can be considered. For example, time off programs can be leveraged to save cost and moderate the capacity of the workforce. The time off policies, and other state and local regulations, often drive a number of cost considerations, such as:
- Do you pay out unused PTO upon termination or at the end of the year?
- How does time accrue (e.g., front-load, weekly accruals)?
- To what level and extent should time accrue, or temporarily stop accruing during an economic downturn?
- What is the right level and balance between scheduled time off (PTO/vacation/holidays) vs. unscheduled time off (sick leave, disability, emergency)?
While there may be pressure to make rash decisions to lay people off for quick cost savings to preserve the profitability of the organization, take a step back and consider alternatives that may be similarly impactful, but preserve the “tilth” of the organization for the future.
Authors:
Steve Cyboran, ASA, MAAA, FCA, CEBS, Chief Behavioral Officer, Consulting Actuary for Humaculture, Inc. Over the past 30 years, Steve has worked extensively with leading corporations, higher education institutions, and health systems across the country to articulate a vision for a healthy and effective workplace culture, develop a total rewards strategy to support that vision and brings deep benefits expertise with a behavioral approach and sound analytics to achieve and measure the desired outcomes. Contact Steve at [email protected].
Wes Rogers, Chief Guidance Officer for Humaculture, Inc. Wes has almost 35 years’ experience in consulting and senior management positions with a variety of organizations, facilitating groups of people with diverse perspectives and objectives to coalesce around a singular vision and marshal resources to achieve the vision. This experience provides exceptional insights into how organizations operate and succeed. Contact Wes at [email protected].
About Humaculture, Inc.
Humaculture, Inc. transforms organizations, the relationship with their people, and how they think about their people. Humaculture® is a philosophy of, and systematic approach to, creating profitable, aligned, and healthy organizations conceptualized as “soil” in which people can thrive. By creating the right culture, the organization naturally attracts, retains, sustains, grows, and transitions people who enable the business to thrive. More information can be found at: Humaculture.com.
[1]Research from the Federal Reserve found that 4 in 10 Americans couldn’t afford a $400 emergency, and 22% say they expect to forgo payments on some of their bills (https://www.marketwatch.com/story/half-of-americans-are-just-one-paycheck-away-from-financial-disaster-2019-05-16).
