Posted on 5.12.10 by Ronald Fong, MD 

Recently, I received two mailings regarding treatment of obesity.  One was an invitation to a pharmaceutical company-sponsored program discussing the role of the primary care physician in treating obesity.  The speaker is a physician who "consult[s] in the art, science and business of bariatric medicine" as per his website.  The other was an application to be a referral physician for a bariatric surgery clinic and increase practice income "by more than $20,000 per month without waiting for third party reimbursement." 

Has the role of family physicians in the treatment of obesity been reduced to the "business of bariatric medicine" and to a bounty of increasing "practice income by more than $20,000 per month?"  Are we resigned to contribute and benefit financially from the increasing number of bariatric surgeries performed with each passing year?  If so, we are committing a grave disservice to our patients by discarding the mantle of advocacy? 

The current legislative climate is beckoning for innovations to improve health care delivery at more efficient costs.  Scavenging profit from failed policies or vacated leadership is not consistent with the core values of family medicine. Our discipline resides in departments of family and community medicine.  We need to prioritize the "comity" in "community" to address the obesity epidemic.  This is an opportunity for family physicians to demonstrate our virtues.  We believe in treating the entire family, not isolating ourselves to an individual or to an organ system.  We believe that strong social interactions are a powerful determinant in improving our patients' health.  We believe that any viable health care system must have an active public health component.  We believe that the treatment of obesity involves seeking and maintaining partnerships with parents, spouses, and communities.

The obesity epidemic serves as a calling for family physicians to assume leadership and navigation.  We have an opportunity to reverse the current payment structure which values procedures over prevention, invasiveness over interaction, and production over productivity.  We need to segue from the examination room and surgical suites into city planning commissions, school boards, and public hearings.  While others extract dollars, family physicians are obligated to do no harm and to pursue the common good.  Our panels are not based on ability to pay.  Rather, our neighbors are our patients we have yet to meet and we can serve them without a consent form or a bill.