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Weight loss services can produce new revenue streams that may offset, at least partially, stagnant or declining income from existing services, while helping patients with type 2 diabetes, hypertension, cardiovascular risk, high levels of cholesterol and other medical issues tied to obesity.
Drew, a family practitioner in Thousand Oaks, California, was getting reacquianted with a medical school classmate from his native South Africa who had a thriving practice in Beverly Hills. Drew asked how he had attained his success.
"He said, 'You've got to start doing weight loss with your patients,' Drew says. I did, and not only did it wind up being the single best thing I was able to do for my patients' health, but the income stream it's generated has kept my practice alive."
The membership roles of the American Society of Bariatric Physicians (ASBP) offer evidence that more doctors are offering such services. The organization saw its membership increase from 1,061 in 2006 to 1,418 in 2011. Nicola Grun, ASBP director of marketing and communications, says the society is seeing "a definite increase" in the number of its members offering weight loss services as an adjunct to their existing practices. The number of primary care doctors offering weight loss services but not affiliated with ASBP is growing as well.
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Regardless of the method(s) you choose, once you begin offering weight loss services, you must provide continuity or risk damaging your credibility, says Judy Capko, a practice management consultant with Capko & Co. in Thousand Oaks. "I've seen too many cases where doctors get real gung-ho [on weight loss] and start promoting it in the community, then wind up dropping it after 6 months. It's more harmful to your relationship than doing nothing," Capko says.
Ellyn Levine, MD, a partner in a San Diego, California, internal medicine practice, began offering weight loss services in 2009 through Medifast's Take Shape for Life (TSFL) program, which combines meal replacements and dietary coaching. Her impetus was the recommendation of another physician, along with frustration over her previous inability to help overweight patients. "Until that point, I hadn't been able to make a dent in obesity," she says. "Basically, I would just give them a spiel about needing to eat better and move more, but the messages were never effective."
Levine began using the program with a handful of existing patients and after a few months found she was getting new patients through referrals. Currently, she receives about eight referrals per month, with approximately 80 patients purchasing food through the program at any one time. She accommodates the increased volume by extending her office hours and sometimes seeing patients during lunch. "If I have someone who's motivated to get to a healthy weight, I want to be there to help them," she says.
Levine trained to become a TSFL health coach, which entitled her to receive "compliance fees" (a percentage of the amount patients spend to purchase food from the company). Between those fees and performance bonuses, her monthly income from TSFL averages more than $6,000. Out of that, she pays for a second physician's assistant, in part to help her cope with the additional patient volume. "The fact that I'm a strong provider able to meet my overhead costs is very important to my partners," she says.
Beyond word-of-mouth, she markets her services via posters in her examination rooms and a photo album containing before-and-after pictures of patients who have used the program. "I let those tools guide the conversation," she says.
Levine believes passionately that primary care doctors need to be doing more to help their patients lose weight. "If physicians don't get on the front lines and do something about obesity, who's going to help these people?" she says. "I don't believe the healthcare system can continue doing what it's been doing: watching obesity rates soar, increasing the amounts of medication we're prescribing, and tolerating increasing rates of bariatric surgery."