Flying home now from a convention of aesthetics physicians that was held in Vegas.
So many phyicians in the field of making people look prettier and younger do not do "weight loss" as part of their practices. However, of all the things for doctors to do to help their patients look younger, getting involved with true weight loss is 'A-Number-One". What I mean by "true" weight loss is NOT subjecting people to 500 calorie a day meal plans and injections of chemicals of dubious merit. Shakes, bars and prepackaged foods are not a long-term weight loss solution.
At the convention we met a number of primary care physicians who are doing some aesthetic procedures in their offices. These physicians are coming out of the box from just treating disease states and starting to focus on prevention. Unfortunately insurance companies do not foster this type of attention because they do not pay for it and physicians, in order to stay in business cannot spend time on unreimbursed services....
All physicians should be ionvolved with helping patients lose weight. If we, as a profession , became more involved, some great strides could be made in this national epidemic.
Showing posts with label weight loss and physicians. Show all posts
Showing posts with label weight loss and physicians. Show all posts
Sunday, May 23, 2010
Thursday, April 22, 2010
weight loss and the medical profession
Okay, today I need to vent a bit about a subject that really annoys me sometimes...and that is the approach that some of my collegaues have to helping their patients lose weight. Yesterday I saw in followup a patient who entered our program last week and she had an abnormal EKG. I did not prescribe phentermine, recommended that she have further cardiac workup but I did start the serotonin and Phase 1 of our dietary plan, neither of which would adversely affect any potential heart issue.
The patient went to her primary care physician to initiate the work up and right off the bat, the guy tells her the serotonin is not safe and she should stop the program entirely. The patient of course was perplexed and confused because she has one physician (me) telling her its okay to sytart the supplement and Phase 1 and her own doctor tells her it is dangerous.
This is not an isolated case....all along the way over these past 8 years, when I do a consultation about our program and the patient tells me that he/she needs to go back to their own doctor to get their opinion, I laugh to myself because I know there is no way that patient ever comes back. Why? Because upon hearing about the elements of our program, most (not all, as we do ahve a number of referring doctors who "get it") doctors will tell their patients 'Phentermine is not safe and neither is that serotonin". These same physicians do NOTHING to help their own patients lose weight, and if they did, then we wouldnt have their patients coming through our doors to either sytart our program or find out more about it. A doctor handing out a 1200 calories diet sheet and telling their patients to "eat less and exercise more" is not obviously a time-tested effective measure.
I guess like any other profession, physicians will be "territorial" about their patients and not want them going to any other doctor for "help" unless they do the referring themselves. I guess it is a bit of a slap in the face when a patient has to look elsewhere for help that could be provided by their own physician. The same physicians who are prescribing boat loads of blood pressure, cholesterol, diabetic pills etc. to their overweight patients are fearful about a supervised weight loss program where patients are being monitored weekly? Give me a break.
I strongly believe that we, as physicians, need to play a more active role in weight loss efforts for our patients rather than nay-saying others efforts.
The patient went to her primary care physician to initiate the work up and right off the bat, the guy tells her the serotonin is not safe and she should stop the program entirely. The patient of course was perplexed and confused because she has one physician (me) telling her its okay to sytart the supplement and Phase 1 and her own doctor tells her it is dangerous.
This is not an isolated case....all along the way over these past 8 years, when I do a consultation about our program and the patient tells me that he/she needs to go back to their own doctor to get their opinion, I laugh to myself because I know there is no way that patient ever comes back. Why? Because upon hearing about the elements of our program, most (not all, as we do ahve a number of referring doctors who "get it") doctors will tell their patients 'Phentermine is not safe and neither is that serotonin". These same physicians do NOTHING to help their own patients lose weight, and if they did, then we wouldnt have their patients coming through our doors to either sytart our program or find out more about it. A doctor handing out a 1200 calories diet sheet and telling their patients to "eat less and exercise more" is not obviously a time-tested effective measure.
I guess like any other profession, physicians will be "territorial" about their patients and not want them going to any other doctor for "help" unless they do the referring themselves. I guess it is a bit of a slap in the face when a patient has to look elsewhere for help that could be provided by their own physician. The same physicians who are prescribing boat loads of blood pressure, cholesterol, diabetic pills etc. to their overweight patients are fearful about a supervised weight loss program where patients are being monitored weekly? Give me a break.
I strongly believe that we, as physicians, need to play a more active role in weight loss efforts for our patients rather than nay-saying others efforts.
Friday, February 12, 2010
weight loss and physicians Part Deux
I appreciate MHartleyDC's comment about the positive aspect of "encouragement" as this relates to helping people with their weight loss efforts. There are many opportunities for DIS couragement to take place..usually discouragement at one's own self for not being able to achieve siginifcant weight loss without help. For everyone out there: PLEASE do not get discouraged in your efforts to become healthier and happier. There will be some weeks when you get on that scale and the number may have gone up. Turn this negative feeling into resolve...make the next week a much more aggressive weight loss week. Always focus on the reasons as to why it is so important for you to lose weight. Use these reasons as positive motivation and do not allow negativism into the mix.
I reviewed the topics of the medical lectures that are at the conference I am attending. NONE about weight loss in the primary care setting. This leaves me incredulous...the most important health problem facing America is not even addressed at a primary care physician continuing education credit conference. Welcome to the world of the training of physicians...based on treating disease states and not even a hint of approaching the prevention of the nations largest killer. I suppose learning aboutHIV/AIDS advances or treatment of obscure cancers is more interesting than learning how to combat obesity. For every AIDS patient there are probably hundreds of thousands of Americans who have potentially lethal or life-altering co-morbidities related to weight problems. Insurance companies will cover treatment for HIV/AIDS but will not cover weight loss programs for their subscribers. Hey, I am not minimizing the impact of HIV on people who contract it, but I am certainly making the point here that obesity affects tremendously more people and the impact on society of obesity eciipses by far and away any other medical condition. For the medical profession, government and insurance companies to minimize this is completely irresponsible and neglect in its highest medical form.
Okay, Posner will now go the gym, get dressed up and go to the convention center..and he better get off his soapbox as I am certain the conference organizers could care less what he thinks about what topic should be focused on, rather than neglected, at this convention.
I reviewed the topics of the medical lectures that are at the conference I am attending. NONE about weight loss in the primary care setting. This leaves me incredulous...the most important health problem facing America is not even addressed at a primary care physician continuing education credit conference. Welcome to the world of the training of physicians...based on treating disease states and not even a hint of approaching the prevention of the nations largest killer. I suppose learning aboutHIV/AIDS advances or treatment of obscure cancers is more interesting than learning how to combat obesity. For every AIDS patient there are probably hundreds of thousands of Americans who have potentially lethal or life-altering co-morbidities related to weight problems. Insurance companies will cover treatment for HIV/AIDS but will not cover weight loss programs for their subscribers. Hey, I am not minimizing the impact of HIV on people who contract it, but I am certainly making the point here that obesity affects tremendously more people and the impact on society of obesity eciipses by far and away any other medical condition. For the medical profession, government and insurance companies to minimize this is completely irresponsible and neglect in its highest medical form.
Okay, Posner will now go the gym, get dressed up and go to the convention center..and he better get off his soapbox as I am certain the conference organizers could care less what he thinks about what topic should be focused on, rather than neglected, at this convention.
Thursday, February 11, 2010
weight loss and Physicians
Yesterday I was seeing stories about the First Lady becoming very involved with a campaign targeting childhood obesity. As I have mentioned previously, the life expectancy of the younger generation is LESS THAN their parents' generation. This is because of the epidemic of childhood obesity. This problem has incredible ramifications for the national health, healthcare expenditures, etc. I applaud the efforts of the First Lady and any other high profile politician/actor/actress to become involved with putting a higher focus on this problem.
I am supposed to go to a conference today (good luck at the airport) of primary care physicians. The INBODY body composition device in our office is from General Electric and I am a "speaker/expert" for them. They have a device on the show floor of a primary care physician convention. I will be meeting many physicians ALL of whom have overweight patients in their practices. Yet, very few of these doctors take a proactive role in helping their patients lose weight. I am certain that most of them will recommend to their overweight patients with co-morbidities such as hypertension, diabetes, etc. that they lose weight. However, if losing weight was that easy, America would not be 68% overweight.
I do believe that every physician should be proactive in helping thier patients lose weight. I am not saying they need to have a full blown program such as ours, but there has to be more of an effort than just telling a person they need to lose weight (the overweight person knows this already) and handing them a 1200 calorie dietary sheet.
In most cases, overweight people are left to their own devices and then turn to the commercial programs such as buying Nutrisystems, supplements off the internet etc.
I do not blame my colleagues in primary care because the insurance companies have forced most into a volume-driven practice were there is virtually no time to really get intoi weight loss with the patients and moreover the insurance companies will not reimburse for nutritionists or otjher weight loss services. The insurance companies still do not get the concept that they would save much money by helping physicians prevent medical conditions rather than paying for the medications, hospitalizations etc that accompany the co-morbidities of obesity.
I am supposed to go to a conference today (good luck at the airport) of primary care physicians. The INBODY body composition device in our office is from General Electric and I am a "speaker/expert" for them. They have a device on the show floor of a primary care physician convention. I will be meeting many physicians ALL of whom have overweight patients in their practices. Yet, very few of these doctors take a proactive role in helping their patients lose weight. I am certain that most of them will recommend to their overweight patients with co-morbidities such as hypertension, diabetes, etc. that they lose weight. However, if losing weight was that easy, America would not be 68% overweight.
I do believe that every physician should be proactive in helping thier patients lose weight. I am not saying they need to have a full blown program such as ours, but there has to be more of an effort than just telling a person they need to lose weight (the overweight person knows this already) and handing them a 1200 calorie dietary sheet.
In most cases, overweight people are left to their own devices and then turn to the commercial programs such as buying Nutrisystems, supplements off the internet etc.
I do not blame my colleagues in primary care because the insurance companies have forced most into a volume-driven practice were there is virtually no time to really get intoi weight loss with the patients and moreover the insurance companies will not reimburse for nutritionists or otjher weight loss services. The insurance companies still do not get the concept that they would save much money by helping physicians prevent medical conditions rather than paying for the medications, hospitalizations etc that accompany the co-morbidities of obesity.
Friday, January 29, 2010
weight loss and physicians
Good morning from Orlando...supposed to be sunny and 75.....(alright, all of you STOP groaning)
re: question about laser liposuction.....seems safe...but always remember...this is NOT a weight loss procedure...it is a resculpturing procedure.
We are on the show floor of a cosmetic surgeons conference meeting physicians and explaining our weight loss program to them. There are MANY booths of laser lipo, injectable botox and other chemicals, skin lasers, etc....we are one of only 2 booths devoted to weight loss and th other is some HCG shot/500 calorie a day plan....
How can it be that the nation's largest medical issue that is killing hundreds of thousands of people per year is represented at a show like this by only two booths and there are well over 100 of the other types of fields, all cosmetic with really no "health" benefit?
ANSWER: MONEY MONEY MONEY
Insurance companies do not recognize weight loss programs and for a physician, sucking fat or injecting botox makes lots of $$$$ compared to sitting down with patients for behavior modification discussions. Also, for many people, the "outside" appearance is more important to them than the "inside". Cosmetic procedures may help psychological issues of poor self-esteem and such but it doesnt rid the person of diabetes, hypertension, heart attack risk, cancer risk etc. Weight loss does it all, but yet physicians do not feel motivated to become involved, not because they do not want their patients to be healthier, but rather because the system does not reward doctors for taking the time to become involved.
Americans are going to be buried financially and physically by the obesity epidemic, and aside from the government, we as phyicians need to play a more active role. No offense Jenny Craig, but physicians are better positioned to really help their patients lose weight and keep it off.
re: question about laser liposuction.....seems safe...but always remember...this is NOT a weight loss procedure...it is a resculpturing procedure.
We are on the show floor of a cosmetic surgeons conference meeting physicians and explaining our weight loss program to them. There are MANY booths of laser lipo, injectable botox and other chemicals, skin lasers, etc....we are one of only 2 booths devoted to weight loss and th other is some HCG shot/500 calorie a day plan....
How can it be that the nation's largest medical issue that is killing hundreds of thousands of people per year is represented at a show like this by only two booths and there are well over 100 of the other types of fields, all cosmetic with really no "health" benefit?
ANSWER: MONEY MONEY MONEY
Insurance companies do not recognize weight loss programs and for a physician, sucking fat or injecting botox makes lots of $$$$ compared to sitting down with patients for behavior modification discussions. Also, for many people, the "outside" appearance is more important to them than the "inside". Cosmetic procedures may help psychological issues of poor self-esteem and such but it doesnt rid the person of diabetes, hypertension, heart attack risk, cancer risk etc. Weight loss does it all, but yet physicians do not feel motivated to become involved, not because they do not want their patients to be healthier, but rather because the system does not reward doctors for taking the time to become involved.
Americans are going to be buried financially and physically by the obesity epidemic, and aside from the government, we as phyicians need to play a more active role. No offense Jenny Craig, but physicians are better positioned to really help their patients lose weight and keep it off.
Thursday, March 12, 2009
weight loss and physicians
Some things really do not change very much. During medical school and my internal medicine residency, we basically learned nothing about helping people to lose weight. We, of course, were taught about the causal relationship of weight problems to heart disease, diabetes, arthritis, hypertension, hypercholesterolemia, certain cancers, etc. We basically saw our mentors hand overweight patients diet plans or tell them to go to Weight Watchers, but little else was done to intervene. This was 1977-1984.
Fast forward to 2009. Posner has lots of gray hair, The Bee Gees are not on the radio every other song, and now the government is the major investor in car companies and banks. Lots of change. But, not in the physician's training/approach to weight loss. I was invited to give a Medical Grand Rounds talk to the Portsmouth Naval Hospital medical staff which is very exciting for me. I have not been back to the place I did my residency and they have built a new hospital since I left. Apparently, there is still virtually no "training" in helping people lose weight during the residencies.
Preventing major medical illnesses such as heart disease and diabetes is so much better than having to treat the sequelae of these life-altering diseases. If the epidemic of obesity can be reversed, millions of lives will be saved, quality of life would improve, and multiple billions of dollars could be saved. It starts in the school system teaching children about nutrition and the risks of being overweight, it continues at home where as parents, we should be more vigilant of our households' nutritional approach, and certainly in medical schools and residencies, young physicians should be given much more training in helping people lose weight. I appreciate very much the physicians in charge of the Grand Rounds at the Naval Hospital giving me the opportunity to educate some young physicians.
Fast forward to 2009. Posner has lots of gray hair, The Bee Gees are not on the radio every other song, and now the government is the major investor in car companies and banks. Lots of change. But, not in the physician's training/approach to weight loss. I was invited to give a Medical Grand Rounds talk to the Portsmouth Naval Hospital medical staff which is very exciting for me. I have not been back to the place I did my residency and they have built a new hospital since I left. Apparently, there is still virtually no "training" in helping people lose weight during the residencies.
Preventing major medical illnesses such as heart disease and diabetes is so much better than having to treat the sequelae of these life-altering diseases. If the epidemic of obesity can be reversed, millions of lives will be saved, quality of life would improve, and multiple billions of dollars could be saved. It starts in the school system teaching children about nutrition and the risks of being overweight, it continues at home where as parents, we should be more vigilant of our households' nutritional approach, and certainly in medical schools and residencies, young physicians should be given much more training in helping people lose weight. I appreciate very much the physicians in charge of the Grand Rounds at the Naval Hospital giving me the opportunity to educate some young physicians.
Saturday, February 7, 2009
SP Weight Loss to New Jersey
Good morning....this morning we have Dr. Linda Cho, a GYN physician from Bergen County New Jersey visiting with us with her staff and they will be implementing the Serotonin-Plus Weight Loss Program at their offices in Bergen County. They will be seeing some patients with me and learning more about how our weekly patient encounters are used to help people achieve their maximal weight loss.
It makes me very, very happy to see other physicians starting to get more proactive in helping their patients lose weight. EVERY physician has overweight patients in their practices, and those patients have health issues BECAUSE of the weight problem. Most physicians (not all) will advise their patients to lose weight, but very very few get more aggressive than just simply telling their patients to "eat less and exercise more". Overweight people know this already...this is not some type of earth-shattering revelation. Enacting a strategy as to how to navigate the stressful obligations of life..family, business , etc and focus on behavioral changes is very difficult, if not impossible for many. This is where the physician needs to come in and offer a comprehensive solution for their patients. Not just handing them a 1200 calorie dietary sheet.
Personally, I feel a great sense of pride that the SP Program, which I started out of my Burke office in October, 2001, is now appearing in different parts of the country...Rhode Island, Massachusetts, Southern Maryland, and now New Jersey. Helping people lose weight changes their lives, and as physicians, there is no better feeling than helping someone be healthier and happier. I want to thank all of you for allowing me to help you.
It makes me very, very happy to see other physicians starting to get more proactive in helping their patients lose weight. EVERY physician has overweight patients in their practices, and those patients have health issues BECAUSE of the weight problem. Most physicians (not all) will advise their patients to lose weight, but very very few get more aggressive than just simply telling their patients to "eat less and exercise more". Overweight people know this already...this is not some type of earth-shattering revelation. Enacting a strategy as to how to navigate the stressful obligations of life..family, business , etc and focus on behavioral changes is very difficult, if not impossible for many. This is where the physician needs to come in and offer a comprehensive solution for their patients. Not just handing them a 1200 calorie dietary sheet.
Personally, I feel a great sense of pride that the SP Program, which I started out of my Burke office in October, 2001, is now appearing in different parts of the country...Rhode Island, Massachusetts, Southern Maryland, and now New Jersey. Helping people lose weight changes their lives, and as physicians, there is no better feeling than helping someone be healthier and happier. I want to thank all of you for allowing me to help you.
Monday, August 25, 2008
Weight Loss and Physicians
First, I wanted to announce an event that will not take place for a number of months, but this day of the year is always a very important one to me. I opened my internal medicine practice on December 5th, 1988 so this December 5th will be our 20th year anniversary of providing medical services in the Burke/Springfield/Fairfax area. I consider myslef the luckiest doctor in the entire area. I have been fortunate and privileged to attend to the medical needs of an incredible group of intelligent, fun, and wonderful patients and their families. I love coming to work and although some of my professional career has morphed into product development and weight loss centers, I never (repeat NEVER) forget that I am a primary care doctor and even to this day, my patients know that if they call me on Sunday afternoon or holiday or if they need me to see them for followup after office hours I am always there for them. Sometimes I feel that my medical patients see the marketing signs for our weight loss program and think to some extent I am giving up my internal medicine practice but this could not be further from the truth. I LOVE the internal medicine part of what I do, and yes, the weight loss program and serotonin product development have been incredibly rewarding and fun for me as well, but I still love the medical part. Anyway, I wanted everyone...patients who see me for internal medicine...patients who see Linda and I for our weight loss program to put Friday, December 5th (5 PM to 8 PM)on their calanders for our very very special Patient Appreciation Nite. We will serve healthy choices (some unhealthy ones), Karioke (this was a huge hit last year) and my GREAT staff and I will love the opportunity to tell you, in a more social atmosphere, just how much we appreciate you calling us "my doctor". We will have some great door prizes as well! (wod of the day: Anniversary)
This week I met with a physician in Manhatten and he was lamenting that for his patients who need to lose weight, he has been referring them out to weight watchers and other commercial programs but their successes have been limited. I strongly believe that physicians need to be much more proactive in helping their patients lose weight. It is not a simple matter of handing them a diet plan and expecting them to follow this. Every primary care doctor should understand the need for a comprehensive approach to helping people lose weight. We are actually on a project right now of trying to help physicians elsewhere (hey, not here....we want you coming here in the d.c. market!!!) open up weight loss centers in their own clinics. If you know of any doctor out of state that may have an interest, please call me.
This week I met with a physician in Manhatten and he was lamenting that for his patients who need to lose weight, he has been referring them out to weight watchers and other commercial programs but their successes have been limited. I strongly believe that physicians need to be much more proactive in helping their patients lose weight. It is not a simple matter of handing them a diet plan and expecting them to follow this. Every primary care doctor should understand the need for a comprehensive approach to helping people lose weight. We are actually on a project right now of trying to help physicians elsewhere (hey, not here....we want you coming here in the d.c. market!!!) open up weight loss centers in their own clinics. If you know of any doctor out of state that may have an interest, please call me.
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