WebMD - Weight-Management Services

This recent article from WebMD’s Medscape Business of Medicine - Ancillary Services in Primary Care.

Obesity is a national concern and a source of health problems and self-esteem issues. More than one third of US adults — 72 million people — were considered obese in 2005-2006, according to the American Society of Bariatric Physicians.

Primary care doctors are adding weight-management programs not only for extra revenue, but also because of how important weight loss is to a patient’s health. Weight-loss programs vary widely and may include medication, nutritional supplements, and counseling.

“If I can get people to lose a significant amount of weight, they’re really happy and I get a kick out of seeing that,” says Larry Maguire, MD, an internist in Lexington, Kentucky. Dr. Maguire works 4 days a week at his primary care/internal medicine practice; he devotes Fridays to his weight-management clinic, Obesity Reversal Program, in the same location.

“I mainly do medication-focused weight loss, using the medicines that are currently available, plus some new ones,” says Dr. Maguire. “I’ve also learned that there is a strong psychological element involved.”

Dr. Maguire devised an 8-week program that includes bloodwork, dietary counseling, exercise physiology recommendations, and physician monitoring and management for a fixed price. His overhead includes the hourly fees of an American Diabetes Association-certified dietician (fees range nationwide from about $25 to $50 per hour) and an exercise physiologist (fees range from $20 to $30). Patients pay cash for the clinic’s weight-management services.

The Obesity Reversal Program, now almost 2 years old, is moderately profitable. “My goal is to build it into a commercially viable activity and cut back on my internal medicine practice,” says Dr. Maguire. “An experienced, established practice can do significantly better than an internal medicine practice, and the hours and hassles are much less.”

Jean Welch, MD, runs the Primary & Alternative Medical Center in Silver Spring, Maryland. She established a weight-loss program after deciding that most of the nutritional advice being given to consumers was wrong. Dr. Welch provides nutritional counseling, promotes exercise, monitors patient progress, and also sells nutritional products, which she feels promote good health.

Her nutritional products, made of herbs and other nutrients, also contribute to revenue. However, physicians can be introducing conflict of interest when they sell these supplements. A report from the AMA Council on Ethical and Judicial Affairs notes, “Patients rely on physicians for objective advice on whether they need a particular item.”

Dr. Welch says that weight management is a small part of her overall practice. “I see each patient every 2 weeks. In between, they come in and interact with someone in my office. It’s a good business to have, but you have to be near an area where patients are able to pay money and are willing to do so.”

To learn more about developing a weight-management practice, the American Society of Bariatric Physicians provides information and training on weight-loss techniques.

STRATEGIC TIP: To get patient referrals, Dr. Maguire recommends face-to-face meetings with specialists. “Cardiologists have patients who have had heart attacks and could benefit from weight loss; orthopaedists see patients who have knee trouble, partially as a result of overweight. Those referrals make sense for you.”

PROS

Cash business, no reimbursement hassles
Results provide excellent health benefits to patients and support overall clinical goals
Nutritional products can bring additional revenue

CONS