Andrea Nederveld1, Phoutdavone Phimphasone-Brady2, Lauri Connelly3, Laurie Fitzpatrick4, Jodi Summers Holtrop3. 1. Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA. Andrea.Nederveld@cuanschutz.edu. 2. Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO, USA. 3. Department of Family Medicine, University of Colorado School of Medicine, Aurora, CO, USA. 4. Department of Obstetrics and Gynecology, Michigan State University, East Lansing, MI, USA.
Abstract
BACKGROUND: Obesity is of epidemic proportion in the USA but most people with obesity do not receive treatment. OBJECTIVE: To explore the experience of providing obesity management among primary care clinicians and their team members involved with weight loss in primary care practices. The study's focus was on examining the use of the Medicare payment code for intensive behavioral therapy for obesity (IBT), but other obesity management services and payment mechanisms were also studied. DESIGN/PARTICIPANTS: We conducted 85 interviews of clinicians (physician, advanced practice clinicians, registered dietitian, or other) practicing in primary care practices. Interviews gathered information about treatment approach to obesity, barriers, and facilitators to providing obesity care including the handling of billing and reimbursement (especially use of the IBT code), personal beliefs about the appropriateness of primary care providing weight loss services, and recommendations for improving weight management in primary care practice. The analysis was conducted using a grounded theory hermeneutic editing approach and the constant comparative method. KEY RESULTS: Seventy-five interviews were included in this analysis. We identified three primary themes: (1) clinicians and staff involved in obesity management in primary care believe that addressing obesity is an essential part of primary care services, (2) because providing obesity care can be challenging, many practices opt out of treatment, and (3) despite the challenges, many clinicians and others find treating obesity feasible, satisfying, and worthwhile. CONCLUSIONS: Treating obesity in primary care settings poses several challenges but can also be very satisfying and rewarding. To improve the ability of clinicians and practice members to treat obesity, important changes in payment, education, and work processes are necessary.
BACKGROUND: Obesity is of epidemic proportion in the USA but most people with obesity do not receive treatment. OBJECTIVE: To explore the experience of providing obesity management among primary care clinicians and their team members involved with weight loss in primary care practices. The study's focus was on examining the use of the Medicare payment code for intensive behavioral therapy for obesity (IBT), but other obesity management services and payment mechanisms were also studied. DESIGN/PARTICIPANTS: We conducted 85 interviews of clinicians (physician, advanced practice clinicians, registered dietitian, or other) practicing in primary care practices. Interviews gathered information about treatment approach to obesity, barriers, and facilitators to providing obesity care including the handling of billing and reimbursement (especially use of the IBT code), personal beliefs about the appropriateness of primary care providing weight loss services, and recommendations for improving weight management in primary care practice. The analysis was conducted using a grounded theory hermeneutic editing approach and the constant comparative method. KEY RESULTS: Seventy-five interviews were included in this analysis. We identified three primary themes: (1) clinicians and staff involved in obesity management in primary care believe that addressing obesity is an essential part of primary care services, (2) because providing obesity care can be challenging, many practices opt out of treatment, and (3) despite the challenges, many clinicians and others find treating obesity feasible, satisfying, and worthwhile. CONCLUSIONS: Treating obesity in primary care settings poses several challenges but can also be very satisfying and rewarding. To improve the ability of clinicians and practice members to treat obesity, important changes in payment, education, and work processes are necessary.
Authors: William H Dietz; Louise A Baur; Kevin Hall; Rebecca M Puhl; Elsie M Taveras; Ricardo Uauy; Peter Kopelman Journal: Lancet Date: 2015-02-19 Impact factor: 79.321
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Authors: Sean Iwamoto; David Saxon; Adam Tsai; Erin Leister; Rebecca Speer; Hilde Heyn; Elizabeth Kealey; Elizabeth Juarez-Colunga; Kimberly Gudzune; Sara Bleich; Jeanne Clark; Daniel Bessesen Journal: Obesity (Silver Spring) Date: 2018-09-26 Impact factor: 5.002