Helping Your Patients, Helping America, Helping Yourself - How to Incorporate Weight Loss Into Your Practice

Helping Your Patients, Helping America, Helping Yourself---How To Incorporate Weight Loss Into Your Practice

Robert Posner, M.D.

Founder, Serotonin-Plus Weight Loss Centers

PART ONE---Adapting to Changes

When I graduated from Medical School in 1981, being a Physician was amazing from a professional and financial standpoint.  What a field!  You get to help lots of patients AND make lots of money.  Physicians would work 4 ½ days a week, golf on Wednesdays, own boats and drive the fanciest automobiles.  Doctors were respected in the community and you were made to feel incredibly special in many ways.

After fulfilling a scholarship obligation to the United States Navy in 1988, I opened up a private Internal Medicine Practice in Northern Virginia.  With great enthusiasm, I signed up to participate with many insurance companies, sent marketing materials to the community, gave lectures at local schools and churches, attended health fairs and tried very hard to become part of the community.  I had privileges at several hospitals, went on a handshaking tour to meet other Physicians for potential referrals, established evening hours and Saturday hours to provide great convenience for my patients.  I even was (and still am!) willing to come up on Sundays and holidays to see my patients if they were ill after office hours.

It worked! I quickly built up a very profitable Primary Care Practice with most new patients finding us via the participating Physician lists from the insurance companies, local community marketing (this was before the internet) and “word of mouth” referrals.  I was able to grow the practice to the point of having several other Physicians working for me and I was making lots of money and getting a good amount of time off.

Then the winds of change started blowing.  Every year we would get notices from the insurance companies about lowering the rates they were paying for office visits, procedures and laboratory testing.  Even the best paying insurers started reducing their rates in line with what Medicare was paying.  Hospital visits were reimbursed appallingly low and it got to the point where it was not worth drawing bloods in your office because the labs were charging more than what the insurance companies were paying. 

I started to find myself being angry with these companies and even more upsetting to me was allowing myself to start looking at patients differently:  “This patient who is calling me on a Sunday has an insurance company that will pay me 32 dollars for seeing them.  Why would I ruin my Sunday and come up to the office for this?” This is NOT why I went to Medical School , went through a grueling residency and risked much by opening my own practice for…to allow an insurance company to devalue my worth.  I started finding myself unhappy going to work and I had never experienced that before.

In 1995 I made a bold decision: I decided to drop participation with any and all insurance companies.  This was way before the advent of the “Concierge Medicine” concept of getting patients to pay a yearly membership fee.  I sent letters to all of my patients, conducted nighttime “town hall” meetings to explain how this would work and why patients should be willing to pay me upfront my fees as opposed to 10 dollar co-pays.  Over the ensuing weeks I had hundreds and hundreds of request for record transfers.  Scary!!!  I was forced to close one of my offices and terminate the Physicians who were working with me.

I spent the next several years going back to my roots of marketing...lectures, health fairs and providing the very best and most attentive medicine I could muster.  And it worked!  I had a significant number of patients stay in my practice and started getting return patients who ventured out to managed care doctors and found that they were being treated poorly.  They realized it was worth their money to come back and receive the empathetic, caring and attentive treatment our clinic provided.

I found myself also being so much happier because I was able to spend more time with each patient and was not forced to run from room to room.  I also had happier employees who were not inundated with managed care paperwork.  Even more importantly, I was able to focus on “wellness” as opposed to quickly throwing people on medications to treat disease states.  When you have more time to be with patients, you start realizing how if you can help their detrimental lifestyle issues…weight control, smoking, lack of exercise, etc.  You can truly make a huge difference.  Then in the year 1998 I became interested in something that would change my professional life dramatically.

Serotonin imbalance is linked to depression, anxiety, migraine headaches, chronic fatigue, irritable bowel syndrome, PMS symptoms, eating disorders and carbohydrate cravings.  This neurotransmitter, which is present in very small amounts in the body and brain, can have so many clinical effects because there are a number of different serotonin receptors which are involved in the aforementioned clinical entities.  We, as Physicians, prescribe many medications which work indirectly via serotonin mechanisms: selective transport carrier inhibitors, serotonin receptor agonists and antagonists.  Question:  Why can’t we provide direct serotonin supplementation?  Precursors such as 5-HTP and tryptophan are on the market, why not direct serotonin?

Over the next 2 years I performed extensive research on this subject which culminated in the development and patenting (US Patent Number 6,017,946) of the first oral serotonin supplement.  As we were performing safety and efficacy studies we noticed a substantial lowering of carbohydrate cravings.  As Physicians, we all know that helping people lose weight is never based alone on using “pills”.  Therefore, I wrote a protocol for a weight loss program that utilized our patented serotonin formula, a very safe dosage of an FDA-approved anorectic, a dietary plan based on “real” food and weekly visits for behavioral modification.  I wrote this as a 12-week program.  We also utilize an incredible GE Inbody device that measures body fat composition, lean muscle mass and body water content.  Patients love the feedback they get as they are losing weight.

First, I posted signs in my own waiting room saying “New Weight Loss Program-Ask Dr. Posner.”  Within 8 weeks I had 60 of my own patients wanting to start!  Our results were very impressive and we quickly saw that our protocol was very safe and effective.  The average weight loss in our 12-week protocol was 30 pounds in females and 40 pounds in males.  If people had more weight to lose they could stay for more than one session. 

I then expanded the marketing beyond my own practice. First, newspaper ads (this is way back when people read newspapers!) and television ads.  Our phones started ringing off the hook!  We were seeing many new patients who would also see our Internal Medicine signs and ask if they could also be our medical patients.

In 8 years, we have built the largest Medically Supervised Weight Loss Program in the Washington, D.C. area.  We have helped over 10,000 patients lose weight effectively and safely.  From a professional standpoint, it is amazing to help so many people become healthier and happier.  Our program has allowed people to come off of their diabetic, blood pressure, cholesterol and antidepressant medications.  Seeing confidence and self-esteem levels rise exponentially in these patients is truly rewarding as a Physician.

Financially, incorporating weight loss into my practice has resulted in our building of a 1.2 million dollar a year business which has taken off any pressure from having to make lots of money on the medical side.  Americans are spending over 55 BILLION dollars a year on weight loss efforts and Physicians, who are BEST positioned to help patients lose weight, are seeing little-none of this income. 

YOUR patients are in fact spending money to lose weight, but unless you have a formal program in place, they are spending this money elsewhere.  Who is better able to help your patients lose weight, you or Jennie Craig?

In the next issue, we will discuss why it is so important, from both a medical perspective and a financial perspective, that you, as a Primary Care Physician become PROACTIVE in helping your patients lose weight.  Not only are you helping them incredibly from a medical point of view, but you can dramatically change your personal income and wealth.