As the healthcare climate in America continues to change, it becomes more important for the private practitioner to increase revenue streams for their office or clinic.  One very important revenue stream that every practitioner can incorporate into their practice is dietary consulting and providing nutritional products for their patients.  The manner in which the private practice healthcare provider includes nutritional advice into their practice will determine the success of expanding into the nutritional field.

The sad fact of the matter is that most medical schools, and consequently most medical doctors, place very little importance on nutrition and healthy eating.  To complicate the matter is the government’s inadequate attempt to educate private citizens on nutritional matters through the food pyramid and now the new ‘my plate’ guidelines.  I don’t intend to make this article a nutritional seminar, but the government’s guidelines only concern macronutrients: carbohydrates, proteins, fats, calories, and fiber; and have no information about nutrition. Most Americans think that as long as they follow these guidelines they are eating healthy.  This is far from the truth.  This is a great opportunity for the private practitioner to become a ‘doctor’-“teacher” in Latin, and not just a physician.

I have written several articles concerning incorporating alternative healthcare practitioners into your practice to increase revenue and patient referrals.  This trend is increasing nationwide and is gaining momentum.  This looks like a fad that is here to stay just like that internet thing.

I strongly urge you, as a leader in the healthcare field,  to learn about and include alternative healthcare practitioners in your team of healthcare providers.  You can distinguish yourself from your competition by giving your patients the option of alternative healthcare.  Most medical doctors still do not include these options in their healthcare treatment. According to a new report by QuantiaMD, more than one-third (37 percent) of physicians reported they rarely or never ask patients about their use of complementary or alternative medicine, and 39 percent of physicians said they rarely ask about their spiritual beliefs.

As the obesity problem in America grows, an alarmingly significant increase in childhood obesity has become a large part of the problem. According to recently released figures from the Center for Disease Control (CDC):

There is a prevailing viewpoint in the medical feild, and society in general, that obesity is a problem that is beyond our control.  Everywhere you turn there is a new study that blames America’s obesity problem on some external factor.

• Former FDA Commissioner David A. Kessler argues that modern food is addictive.
• Recently, in the Journal of Health Economics, University of Illinois researchers join a long list of analysts who blame urban sprawl for obesity.
• Former Carter administration advisor Amitai Etzioni argued that it’s so hard for Americans to keep weight off that adults should simply give up and focus attention on the young instead.
• A recently released Ohio study, using mice, suggests “fine-particulate air pollution” could be causing a rise in obesity rates.

Let’s use the definition of alcoholism provided by the AMA approved by the Boards of Directors of the National Council on Alcoholism and Drug Dependence, Inc. (February 3, 1990) and the American Society of Addiction Medicine (February 25, 1990).:

“Alcoholism is a primary, chronic disease with genetic, psychosocial, and environmental factors influencing its development and manifestations. The disease is often progressive and fatal. It is characterized by continuous or periodic: impaired control over drinking, preoccupation with the drug alcohol, use of alcohol despite adverse consequences, and distortions in thinking, most notably denial."

Can you substitute the word ‘obesity’ for ‘alcoholism’ and ‘eating’ for ‘drinking’ and still make to definition accurate?  Most patients dealing with obesity and healthcare professionals treating obesity would clearly answer the question with a resounding ‘YES’.

No matter how you look at it, the cost of the ever increasing obesity epidemic in America is huge.  From the extra expense incurred by Medicare recipients, to the increased costs for private insurers, to the higher costs for hospitals and emergency services, the cost of overweight Americans is growing out of proportion.  What are the numbers associated with the obesity in America?

Keeping in mind that if you torture statistics enough they will tell you anything; let’s look at some numbers that the government has released concerning the cost of obesity to the American pocketbook.

The following is taken directly from the Center for Disease Control (CDC) website:

Obesity is common, serious and costly.

• About one-third of U.S. adults (33.8%) are obese.

• No state has met the nation's Healthy People 2010 goal to lower obesity prevalence to 15%. The number of states with an obesity prevalence of 30% or more has increased to 12 states in 2010. In 2009, nine states had obesity rates of 30% or more.In 2000, no state had an obesity prevalence of 30% or more.

• Obesity-related conditions include heart disease, stroke, type 2 diabetes and certain types of cancer, some of the leading causes of death.

• In 2008, medical costs associated with obesity were estimated at $147 billion; the medical costs paid by third-party payers for people who are obese were $1,429 higher than those of normal weight.

Being able to charge patients $600 to $5,000 per year for more personalized medical care and limiting the number of total patients for which you are responsible, sounds like a very good deal for any doctor. But taking the proper steps required to make the transition from a traditional medical practice to a concierge medical (CM) practice may be daunting.

The first concern that you need to resolve is why you are considering switching to a concierge practice in the first place.  If you are contemplating the switch to a CM practice so that you can make more money with less effort or so that you can avoid insurance hassles then your practice most likely will struggle to prosper.  As with any endeavor, your motivation should be to pursue your passion; in this case it may be to spend more time with patients or to return to better doctor-patient relationships.  It will take time and effort to transition to a CM practice, so you may be disappointed if money is your primary motivation.

Concierge Medicine (CM) is a concept where patients pay an annual fee, similar to a retainer fee that attorneys receive, that allows the payee constant access to their personal physician.  The fee can range from $1000 to $15000 per year, but averages $1500-1800 per patient.  For this fee the patient receives 24/7 access to their personal physician, priority scheduling, and maybe discounts on routine and preventative screenings.  It sounds like a good deal for the patient, but what are the advantages and disadvantages for the doctor?

How would you like to have every patient in your practice pay you $1,500 to $2,000 per year, in addition to your normal fees, just for the privilege of getting a same day appointment when they call?  Sound too good to be true?  Welcome to the world of Concierge Medicine (CM). This type of healthcare delivery is also referred to as membership medicine, concierge health care, cash only practice, direct care, direct primary care, and direct practice medicine.

What exactly is Concierge Medicine?  According to the American Academy of Private Physicians (AAPP), the national association of physicians who provide “concierge medicine,” defined as a ‘fee-for-service, and other forms of health care delivery characterized by a direct, financial relationship between private physicians and their patients.’ This movement will forever change American health care by restoring the doctor-patient relationship of times past --private doctors unencumbered by insurance company policies, provider-network constraints, and the misaligned incentives that have infected our health care system.