Risk Management and Obesity

If you work in the medical field you are probably familiar with the phrase Risk Management. Outside of caring for the patients, risk management is perhaps the most important issue facing a medical practice today. In recent years, American’s of all ages have gotten heavier and health care professionals around the country seem to be struggling with obesity related risks. Managing these risks properly may prove to be the key in keeping a successful practice free of lawsuits.

Obesity can affect a medical practice in a number of ways. In order to protect itself from potential litigation, a medical practice needs to focus risk management efforts on creating a safe environment for patients of all sizes. The first step is creating awareness in the office. Talking to employees about the obesity epidemic is a good start. Statistics show that two out of three patients are obese and that number is expected to rise in the future. Encourage everyone working at the office to lead by example and cut down on their own unhealthy habits. Making sure the staff is trained in the correct methods for moving obese patients in the case of an emergency is also important.

Ask members of the staff to check for a maximum weight rating on all of the exam tables and waiting room furniture. Obese patients sometimes have limited mobility and may walk with the assistance of canes or walkers so thoroughly examine carpeting and other flooring in the office for signs of wear. Make sure that any loose wires or electrical cables are safely covered so as not to become a tripping hazard. If wheelchairs are present in the office, make sure that they are in proper working order and check for a maximum weight rating. Taking these steps will dramatically reduce risks in the office. Helping obese patients lose weight quickly and safely should also be a focus for risk management. The longer a patient is obese, the more at risk they are for developing other illnesses. Obesity has already been linked to osteoarthritis, type II diabetes, sleep apnea, certain types of cancer and a variety of other ailments.

Doctors everywhere know that do-it-yourself dieting and fad products do not work for the vast majority of their obese patients. Impressive new methods have been developed within the medical community to address the needs of millions of overweight American’s. Physicians are communicating with their obese patients about the scientific options for weight loss. The sheer number of options can be overwhelming and each has pros and cons associated with it. They range from meal planning with a dietitian and a customized exercise regimen with a personal trainer to prescription appetite suppressants or bariatric surgery. One of the more appealing options has come in the form of a comprehensive program offered by Smart for Life Weight Management Centers.

The Smart for Life Weight Management Program was developed and is administered by physicians. It has proven successful for thousands of patients because it focuses on helping them to change their eating habits for life. Instead of focusing only on weight loss, Smart for Life has added a weight maintenance portion for patients who reach their goal weight. By addressing the downfalls of other weight loss approaches, the Smart for Life team feels they have come up with a winning combination that will appeal to the masses.

Smart for Life has discovered the six most common reasons a person will fail on a diet. Many weight loss systems over the years have addressed one or more of these issues but Smart for Life is the first to have developed a system that addresses them all. A person might fail due to the following reasons:

1.) They are not losing weight fast enough to stay motivated

2.) They are too hungry to stay compliant with their nutrition plan

3.) They are not monitored on a regular basis and therefore do not feel accountable for their progress

4.) The nutrition plan they have been given is not convenient

5.) Their individual risk factors are not continually monitored by a medical professional.

6.) They are not including long term lifestyle change as a priority.

The Smart for Life Weight Management Program was designed to deal specifically with each of these items. Patients on the program see an average weight loss of twelve to fifteen pounds per month which helps them to stay motivated. To control hunger through the day, a patient will eat six specially formulated organic cookies. Each cookie is full of nutrients, amino acids and, fiber to naturally suppress hunger while supplying the body with the protein and healthy fats it needs to maintain energy. Going with an organic formula means that the cookies have a higher nutrient content, more protein and, no pesticides or chemicals. The dinner meal consists of six to eight ounces of healthy protein (some patients will consume additional protein during the day depending on their gender and unique nutritional needs) and two cups of vegetables.

Another aspect that is crucial to the program’s success is accountability. Each patient receives a one-on-one consultation with a physician, nurse practitioner or physicians assistant before starting. The consultation includes analysis of blood work BMI and an EKG. Appropriate long term and short term goals are also discussed. Most patients will also be put on vitamin and mineral supplements to ensure proper nutrition.

Accountability does not end there. Each week the patient comes in to have their weight, pulse and, blood pressure monitored. Every fourth week, the patient meets with one of the providers to discuss their progress. This cycle continues until the patient gets close to a healthy BMI. At that point, their caloric intake is increased and their exercise routine enhanced. Patients are weened off of the organic cookies and encouraged to continue eating six small healthy meals during the day. As part of weight maintenance, patients still come in to have their vital signs checked on a regular basis.

The cookies are a convenient meal form because they require little to no planning. A single package contains all six cookies needed for the day. Offered in a growing variety of flavors these cookies provide a safe and healthy alternative to prescription based appetite suppressants. With an average weight loss of twelve to fifteen pounds per month the Smart for Life Weight Management Program is comparable to bariatric surgeries without the associated health risks and co-morbidity rates.

From a risk management point of view, it makes sense for doctors, nurses and physicians assistants to refer their patients to programs like Smart for Life. Practitioners also need to make sure that they are adequately documenting their recommendations in these situations. There have been cases recently where doctors have been found at fault for not helping their obese patients to lose weight. In the case of Lawrence Smith’s family vs Doctor Franklin Price, a Cleveland internist, a jury leveled a $3.5 million judgment against Dr. Price for not doing enough to keep Lawrence Smith from developing coronary heart disease which led to a fatal heart attack. Through documenting appropriately medical professionals can avoid future accusations of “not doing enough to help” their obese patients.

Programs like Smart for Life can further lower the risk to primary care physicians, family practice physicians and OB/GYN practices by helping patients to lose weight before they develop weight related illnesses. More importantly, a program like Smart for Life helps patients keep excess weight from coming back which lowers longer term risks.