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Physicians Gain In Weight Loss Clinics

 |  By jcantlupe@healthleadersmedia.com  
   August 04, 2011

William Urquhart, MD, delivered hundreds of babies in three decades as an obstetrician and gynecologist. A few years ago, he said bye-bye to the babies, and now he’s counting calories for patients. As the owner of a weight loss franchise, he’s a happy man.

No more weekends. No more nights. No more lousy reimbursements. Not as much paperwork. He misses the babies, but at age 59, the longtime Mobile, AL, physician has more time to see his own grandkids.

As the obesity epidemic balloons, physicians like Urquhart are reducing their regular practices, or leaving them altogether, to open money-making weight loss clinics. By getting involved in these weight loss clinics, physicians are seeing the revenue pile up to replace the lost revenue stream of other practices.

Urquhart opened a franchise of the Medi-Weightloss Clinic in Mobile, and has partnered with other physicians to open seven other clinics. He says he is having financial success beyond his “wildest dreams” and says he’s happily seeing changes in his patients as a result of the weight loss programs.

“My patients, I remember when they were thinner and more active, and they were chasing their little kids, and now they are huffing and puffing,” Urquhart says. “We’re trying to help them.”

A major pitch for these weight loss clinics is that they are “doctor supervised.”

There is definitely some irony here. While many weight loss clinics are marketing that physician connection, many doctors in general practice seem not to know what they are doing when it comes to dealing with patients having weight issues.

A report last year by the STOP Obesity Alliance—a collaboration of consumer, provider, government, labor, and business groupssuggested doctors and patients are frustrated with the conversations they are having about weight.

The patient survey found that only 39% of obese people are being told by a healthcare provider that they are obese. Most of those patients were also told by their doctors to lose weight. But one-third of those patients say their provider never discussed ways to achieve or maintain a healthier weight.

The survey itself revealed conflicts, says Christine Ferguson, JD, director of STOP Obesity Alliance, in Washington, DC. “A huge percentage [of physicians] had never had any [specific weight loss] training. “

“Yet at the same time, they know what people need to do, for the most part: help people eat less and exercise more, with patients needing to change their eating habits,” says Ferguson, a professor of the School of Public Health and Health Services at The George Washington University. “Then, you look at the patient, and they say not only do they not know what the physicians are telling them, but they don't pay attention to what the physicians are telling them.”

A major problem, as indicated in the survey, is that a vast majority of doctors say they have little or no training in weight management and nutrition, Ferguson says. Moreover, they say they’re not likely to have anyone else in their practice who can be of help, she adds. Most primary care physicians say having more time with patients would help them discuss weight issues, but many also cite a need for weight loss tools and other programs, the survey found. 

Ferguson says the “real dichotomy is how people view weight as an issue. A lot of people still don’t believe it belongs in a physician’s office.”

Then, there’s the issue of a physician who may have a “difficult time talking to a patient. It could be the way the office visit was structured: If you have six to 10 minutes, and you have four issues to address, it's kind of hard to go into the weight issue.”

But doctors who leave or cut back on practices are finding success by specifically focusing on weight management issues, Urquhart says.

Medi-Weightloss Clinics, basedin Tampa, FL, has 92 weight loss franchises in 22 states. Physicians who buy a franchise either share a roof with their existing practice, or locate it nearby and refer their patients to the cash-based business. Under a physician's care, patients are given a full health consultation and weekly lessons on eating, exercise, and lifestyle change.

Urquhart says he loves seeing the changes in his patients, many of whom he has known for a long time and who have struggled with weight. “If you get someone to lose weight, lower their blood pressure, help prevent diabetes, help with sleep apnea, and just help them feel better and be more active, then you are doing something good,” Urquhart says. “You have to be very passionate about it. You treat your patients well, and you have a nice business model.”

“I’m making a great living, I’m helping my patients lose weight,” he says, and no longer has to “deliver babies anymore at all hours of the night and weekends.”

Doctors across the country are looking for ways to supplement their income,” he adds. “There are all kinds of sideline business that doctors are trying, whether it's in Botox and spas, or weight loss centers,” Urquhart says.

Ferguson, of the STOP Obesity Alliance, says she can see the pluses for a physician like Urquhart going into the weight loss clinic world. “It may be saying, ‘this is such a relief to me, knowing [patients] are coming in specifically about weight; I'm able to devote this time to this person, and talk to this person, because I'm not worried about insurance, how much time I have, and this person is cash and carry,” she says.

Within the physician-run weight loss clinic, “you've got a motivated provider, a motivated patient, in a direct pay relationship,” Ferguson says. “This will be a better interaction than someone coming into the doctor's office in a pre-diabetic condition and complaining about being tired, and not wanting to talk about weight loss, and the doctor trying to figure out in 10 minutes.”

The STOP Obesity Alliance has no figures on how many physicians are opting to leave or reduce their practices for the weight loss clinic field, Ferguson says, although Medi-Weightloss Clinics issued a statement saying more doctors are going into the field.

As an OB/GYN, Urquhart says he noticed he and his colleagues “just didn't have the time to deal with it and we were not structured to deal with it,” referring to weight loss issues. Now, he's dealing with weight loss, all the time. Bye-bye, babies.

Joe Cantlupe is a senior editor with HealthLeaders Media Online.
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