142nd APHA Annual Meeting and Exposition

Annual Meeting Recordings are now available for purchase

Wisconsin physician survey on diagnosis and treatment of obesity

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014 : 1:30 PM - 1:50 PM

George Morris III, MD , Zilber School of Public Health, University of Wisconsin -Milwukee, Milwaukee, WI
David Nelson, PhD, MS , Dept. of Family and Community Medicine, Medical College of Wisconsin, Milwaukee, WI
Kayla Chapman , Medical College of Wisconsin, Milwaukee, WI
Jennifer Fink, MS , Aurora Research Institute, Aurora Health Care, Milwaukee, WI
Obesity is an expensive and substantially under-managed condition.  The literature suggests that obesity is not always addressed during a patient visit and is infrequently documented in the patient’s problem list (PL) despite screening and interventional recommendations.  The literature supports that physician interest and referral has a positive effect on weight reduction strategies.  We conducted a cross sectional email solicitation of Wisconsin physicians to complete a survey on their knowledge, perceptions, and practices regarding obesity.  Survey questions included obesity causes, definition, frequency, documentation and barriers to documentation, available consultation time, treatments used and barriers to treatment, and training in obesity management. From over 12,000 e-mails sent from the Wisconsin Medical Society, 590 responses were obtained.  Primary care physicians represented 61% of all respondents, and EMRs were used in 94% of their practices.  Over 90% of respondents accurately identified obesity causes such as diet and activity level.  Family support, lack of knowledge about nutrition, depression, and stress were recognized as obesity causes by over 80% of respondents.  Eighty one percent of respondents identified a BMI of >30 as obese, and 71% of respondents correctly identified that 21-50% of the population is obese.  Physicians reported documentation failure of obesity in the PL for a variety of reasons including treatment unavailability, lack of reimbursement, expense, and lack of effectiveness.  Embarrassment discussing obesity and patient factors were reported by 19% of respondents, and 15% reported failing to document obesity due to lack of pertinence to the visit.  Time spent readdressing obesity at subsequent patient visits was limited to 6 minutes or less for 77% of respondents.  Referrals were most commonly made to dietitians and bariatric surgeons, but only 12% of respondents reported always or sometimes making referrals. Only 14% of respondents were optimistic about sustained weight loss, and only 7% believe they have been successful at treating obesity.  Training in obesity management was reported to have occurred in 6% of medical school experiences and in 10% of respondent’s residency training.  The effectiveness of physician obesity interventions may be improved by several steps.  Training in obesity management during medical school and residency may improve patient outcomes.  The majority of respondents stated they would be interested in receiving training in obesity management, and the majority also reported lacking sufficient tools to assist in obesity management.  Reducing the barriers to documentation and treatment could improve the rate of referral and enhance success in obesity management.

Learning Areas:

Chronic disease management and prevention
Implementation of health education strategies, interventions and programs
Planning of health education strategies, interventions, and programs

Learning Objectives:
Identify the knowledge base, diagnosis, and barriers to placing Obesity in a Problem list and to intervention

Keyword(s): Obesity, Health Assessment

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I participated in the creation and have analyzed the content of the results. I was assisted by The Wisconsin Medical Society and no commercial produces are used.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.