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- May 28, 2011
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Does anyone have any experience with practicing full-time obesity medicine? I am specifically interested in the possibility of transitioning from primary care and what a model for that would look like. I graduated from an academic IM residency in the northeast four years ago, passed the ABIM exam, and have been practicing as a PCP since then.
I recently discovered that the ABOM exists as a stand alone board, which as of now is not yet recognized by the ABMS, but which has been increasing in popularity fairly quickly with I believe 1,000 or so applicants last year. I believe they are working through the process of applying for ABMS recognition, but who knows if or when that will happen. Given the prevalence of the condition, inadequate training for PCP's, growing pharmacotherapy options, and new research developments (genetics, microbiome, etc.), it wouldn't surprise me if they achieve ABMS recognition at some time in the future if fellowship availability increases. There are currently 10 obesity fellowship programs in the U.S., which exist at pretty well-respected academic institutions.
My main concern is the economics and job availability. There are occasional job postings for obesity medicine providers at multi-disciplinary weight loss clinics which usually include Bariatric Surgeons, Obesity Medicine Physicians, Dieticians, Psychologists, etc. However, these positions seem to be relatively few and far between. I don't believe my area has such a multi-disciplinary program for adults. As far as I know, the Bariatric groups in my area do not have IM/FM/Endo trained physicians with obesity medicine background on staff. I'm guessing it may not make financial sense for them to do so.
Edit:
I work for a large group and have thought of taking the idea of having an obesity medicine provider on staff to them, which would necessitate them creating the position. I think it could certainly provide value in terms of patient care, a referral option for the other PCP's without the time or interest to manage these patients, and in terms of improving quality measures. However, reimbursement is a major concern. I don't believe an IM trained physician with ABOM board certification can likely bill consult codes. Given that many payors are moving toward capitation, there would be little in the way of fee for service reimbursement. Primary care is basically getting paid for annuals, AWV's, and new patient visits.
I recently discovered that the ABOM exists as a stand alone board, which as of now is not yet recognized by the ABMS, but which has been increasing in popularity fairly quickly with I believe 1,000 or so applicants last year. I believe they are working through the process of applying for ABMS recognition, but who knows if or when that will happen. Given the prevalence of the condition, inadequate training for PCP's, growing pharmacotherapy options, and new research developments (genetics, microbiome, etc.), it wouldn't surprise me if they achieve ABMS recognition at some time in the future if fellowship availability increases. There are currently 10 obesity fellowship programs in the U.S., which exist at pretty well-respected academic institutions.
My main concern is the economics and job availability. There are occasional job postings for obesity medicine providers at multi-disciplinary weight loss clinics which usually include Bariatric Surgeons, Obesity Medicine Physicians, Dieticians, Psychologists, etc. However, these positions seem to be relatively few and far between. I don't believe my area has such a multi-disciplinary program for adults. As far as I know, the Bariatric groups in my area do not have IM/FM/Endo trained physicians with obesity medicine background on staff. I'm guessing it may not make financial sense for them to do so.
Edit:
I work for a large group and have thought of taking the idea of having an obesity medicine provider on staff to them, which would necessitate them creating the position. I think it could certainly provide value in terms of patient care, a referral option for the other PCP's without the time or interest to manage these patients, and in terms of improving quality measures. However, reimbursement is a major concern. I don't believe an IM trained physician with ABOM board certification can likely bill consult codes. Given that many payors are moving toward capitation, there would be little in the way of fee for service reimbursement. Primary care is basically getting paid for annuals, AWV's, and new patient visits.