It’s 5:56pm. You just finished notes on your last patient of the day and you have about 90 seconds before you’re ready to head out and do rounds. Glancing at your desk (if you’re lucky enough to still have one) a piece of mail on top of the rapidly growing stack catches your eye.

On the envelope in big red letters it says... “What your patients with BMI ? 30 said about your efforts to help them achieve healthy weight.” Upon closer examination it’s from your largest private payor.

“Hmmm…. what’s this?” Well it looks like some insurance companies are beginning to take obesity more seriously. They want to know how their policy holders’ needs for healthy weight assistance is being managed. What they noticed is that some providers’ BMI performance is better than others and they are hoping to get some insights on why.

So… even though this fictional scenario may not have happened to you (yet), how do you think you would fare in such a survey?

Do Your Performance Metrics Need a Boost?

Improving performance in BMI, hypertension, hyperglycemia, lipid profiles and patient satisfaction is increasingly important, but prescription drugs are unlikely to produce the incremental improvements that will put you in the top tier of performance.

Here are 5 realistic steps to move the needle on your metabolic performance rating.

Step 1. Implement a BMI Self-Assessment Tool

Weight is a sensitive subject. You may not even be 100 percent comfortable with your own. You already have most of the information you need to identify high-risk patients. What you don’t have is a convenient way to identify patients who are open to help or a way to get more patients interested in the first place.

Why not give patients a handout when they’re brought to the exam room, which allows them to assess themselves by finding their BMI on a chart? This single piece of paper can also provide information on health risks correlated to BMI while directing patients to your resources for help.

Step 2. Leverage Motivational Interviewing Basics

As a consultant helping doctors address obesity, I’m an advocate of expanding your skills to handle conversations about weight. But I’m also a realist who aims to provide advice everyone can implement regardless of their capacity for, or interest in taking on new skill sets.

Motivational Interviewing is a complex skill to master, however the basics can be learned in 5 minutes for more productive interactions with patients.

The first goal is getting permission to discuss a sensitive subject. I don’t know about you, but straight up asking “is it ok if we talk about weight” is not exactly an awkward-free segue (especially if your own weight could be viewed as less than ideal).

This is where the BMI self-assessment sheet comes in handy. The patient is already holding it. All you need to say is “What questions can I answer about the BMI assessment page?”

If they want to talk about it, they will. If not, the answer will be “no questions”, in which case you respectfully move on. If their medical conditions are affected by weight, that’s another opportunity to bring up the BMI assessment and educate them on their risk factors. “Overweight” or “obesity” doesn’t have to be mentioned, it’s about objective health markers and the patient’s interest level in improving them through weight loss.

Step 3. Use Educational Tools

Conveniently, your BMI assessment sheet doubles as the first education tool. List health consequences correlated to elevated BMI and benefits of even moderate weight loss. A well-researched and designed brochure laying out the consequences of high BMI could be handed out as part of these discussions.

Additional information can be programed into your EHR to print out on a visit summary. Include your web page with educational content and useful links like www.obesityaction.org.

An eye-catching poster on weight-related health consequences can increase awareness and draw patients into more conversations. Put one in every room.

Be sure all of your educational tools use “patient-first” language and do not objectify patients with stereotypes. This will increase trust and lead to better conversations.

Five pound fat replicas can be good conversation starters. Patients are surprised how much volume 5 pounds of fat takes up!

Step 4. Offer Resources

There’s no shortage of choices when it comes to weight loss. I suggest vetting out 3 well-qualified options for your patients.

One of the best ways to provide value is to partner with another provider who specializes in weight loss to conduct regular workshops and support groups at your office. Qualify the service by doing a pilot with your own staff who should get a nice discount. Pay attention to their communication process for medical approvals, monitoring and progress reporting. You need confidence that you will remain in control of your patient. Often doctors refer to a service and never hear back. A provider that communicates systematically with your office is a great asset.

Another possibility is to integrate a comprehensive weight loss service into your practice. With the right kind of support from a weight loss model specialized for medical professionals, weight loss can be a successful ancillary business that generates cash revenue.

Step 5. Follow Up With Triggers for Change

Only a small number of patients are ready to take on a weight loss journey at any given time. The key is to implement systematic follow up strategies that educate patients and remind them to get help. With consistent follow up through email lists, social media and targeted letter campaigns, you can increase participation in your weight loss resources.

Focus your messages on providing education and inviting patients to utilize your resources, but avoid obesity stereotypes. Studies show that marketing efforts perceived as stigmatizing or shaming are ineffective and could actually deter patients from getting help.

Tim Buist is an independent medical practice consultant based in Orlando, FL, with 17 years of experience in the pharmaceutical, medical device, clinical trial and wellness industries. He founded www.myweightclinic.com and www.weightlossintegration.com and works with 50+ Florida weight loss clinics who utilize a leading model for healthcare professionals. Contact tim@weightlossintegation.com