This morning's entry is not going to motivate you to lose weight, give you insights into a way of navigating around this weekends food challenges or in any other way help your weight loss efforts. This one is kind of a therapeutic rambling for me. So, if you are looking for weight loss advice or inspiration this morning, click this off now.
Yesterday I saw a long-standing medical patient who remembers when I first opened my doors 21 years ago. That was way before serotonin was a glimmer in my brain and all I did was mainstream internal medicine. The office was much quieter and there were many less workers and 1000% of my attention was on my medical practice. Medical patients knew very well if they were ill, we would ALWAYS see them the same day of their illness, we would not keep people waiting past their appointment times and we treated people with the utmost of respect. This allowed me to transition to a "no-insurance" based medical practice 15 years ago. Evening hours, Saturday hours and after hours meetings visits at the office were a mainstay, separating us from other practices in the area. This allowed us to stay free of insurance companies...people were/are willing to pay extra money for this concierge type of service.
The growth of our weight loss program has been extraordinary and now we are seeing acceleration of our program expansion to other physicians around the country. Personally, this feels incredibly great for me because not only are we helping people become healthier in the d.c. area (and much happier) but we are also starting to help lots of people i other areas. With the obesity crisis being the nation's largest health concern, our intervention could ultimately positively affect millions of people.
Back to my medical patient. Yesterday she asked for a frank discussion with me and proceeded to tell me that she senses a change in my medical practice in that she finds it harder to get me to the telephone. Staff (she did say they are very poilte and helpful) seems to try very hard to not have to get me personally on the phone to answer questions. Moreover, when she comes intot he office, she sees lots of weight loss posters, brochures etc.
I have been thinking for awhile about whether my medical patients see me morphing away from being their medical doctor and more towards being a 100% weight loss doc. I have been self-examining my attitude and approach to my medical practice and this is what I have come up with: I still very much love my medical practice and relationship with my patients. I still run up to the office on Sundays when a patient is ill and when a person needs immediate attention, my staff and I are all over the case. Just yesterday we saw a young man with abdominal pain who saw a different physician the day before and was misdiagnosed with irritable bowel syndrome when in fact, my exam, our immediate setup of a CT scan, an antibiotic injection and calls to surgeon resulted in him being diagnosed with acute, non-ruptured appendicitis and he was in the operatoing room 5 hours after seeing me for the firts time. My staff and I had this all done while many weight loss patients were being seen.
I guess I probably cannot do lots of telephone hand holding anymore because of my responsibilities to our weight loss program but I do know that my medical patients are still getting lots better, more attentive and timely treatment than they could get elsewhere. I also know that our program to help people lose weight is saving lots of lives and I have a responsibility to continue to grow these efforts. Yes, this is a business as well, but I am very fortunate in that for me, this is clearly not all about the business/money....it is about helping lots of people. I try very hard to be the same bright eyed and bushy tailed medical doctor I was over 2 decades ago, but I also know that part of my calling now is to help our patients and people who are not my patients, become healthier.
Sorry for the long and fragmented writing this morning. This helped me! Thanks for listening.
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3 comments:
You're providing an extraordinary service, never forget that. Solid, thoughtful medical advice is difficult to come by, whether it is for internal medicine or weight loss. Me, the woman who thought she would NEVER be able to lose another pound lost 7.4 lbs my first week, and I have a whole new level of motivation going forward. From me, personally, thank you so much for offering your services. Chris Matyas
Dr,Posner,
I am happy that I happened to read your blog today.I thought you are scaling back on internal medicine and changing your specialty to weight loss!
As you can understand the patients see you not that frequent and moreover the newsletter you used to send has stopped.
I been under your care only for the past couple of years. But I can say we are happy for you to see you do well for I know you worked hard and you deserve it!
Dr. Posner,
From my experiences/observations, you are much more accessible than most doctors and remain committed to your patients (whether they are “mainstream” or weight loss patients).
Like the patient you discussed, my husband is also a long-standing patient of yours. He also started when you were doing just “mainstream” medicine. Because he values the medical care you provide, he chose to remain your patient even after you stopped accepting insurance. That proved to be a good decision since we credit you with saving his life twice! In 2004, you diagnosed him with a ruptured appendix (which lead to a same-day appendectomy). In 2006, you diagnosed him with a potential coronary blockage after an abnormal annual stress test (which lead to successful coronary bypass surgery). And yes, both of these were after you had started your weight loss practice.
I have not utilized you as my primary physician, only because you do not accept insurance. However, I have used you when I have acute symptoms or want a second medical option. I have always been able to see you the same day and always received excellent care. And, now I am one of your weight loss patients.
Yes, my husband and I have noticed the weight loss posters, brochures, etc., in your office. However, these do not concern us. As you said, obesity is the nation’s largest health concern. Why shouldn’t an Internist emphasize weight loss, when obesity can lead to such things as hypertension, diabetes, heart disease, cancer, etc.? In fact, it would be helpful if other doctors put more emphasis on this issue as part of their “mainstream” medical practices. I can tell you from personal experience that that it is the rare doctor that will even address weight loss unless you have one or more comorbid conditions.
The bottom line is my husband and I agree that you have provided, and continue to provide, us excellent medical care, which is more attentive and timely than what we have received from many of our other doctors.
Pam L.
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