A team-centered, patient-centered approach to obesity management

September 20, 2022

4 minute read


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Obesity is a complex disease with a multifactorial etiology. Multidisciplinary care is an optimal way to help patients achieve short-term success, maintain long-term weight loss, and prevent obesity-related complications.

In the United States, 41.9% of the population is affected by obesity. With a wide range of associated physical and mental complications such as diabetes, hypertension, depression and anxiety, obesity must be treated by an interdisciplinary team working together to create a comprehensive patient-focused plan.

PC0822Shetye_Chart_01_WEB

Source: Bharti Shetye, MD

What is multidisciplinary care?

A multidisciplinary approach involves a team of healthcare professionals who use their expertise and work together to provide high quality patient care. For example, in a bariatric center of excellence, this team might include a bariatric surgeon, obesity medicine specialist, registered dietitian, psychiatrist or psychotherapist, and a non-medical team including an insurance coordinator, a bariatric coordinator, nursing staff and office staff.

Studies show that patients receive better quality care when a group of medical experts work together. Maximizing the skill set of multiple providers complements and improves the overall quality of care when managing a multifaceted condition like obesity.

How can providers implement a multidisciplinary approach?

The first step is to diagnose the etiologies of the patient. Obesity presents differently in each patient depending on their comorbidities and health factors. It is therefore essential to create a basic understanding of the underlying conditions of the patient to know how to move forward with treatment.

When working with multiple healthcare professionals, sharing an accurate and detailed patient medical history is paramount to providing the highest quality care. For example, when treating a patient with an eating disorder, collaboration between the dietician, psychiatrist/psychotherapist and obesity management specialist is beneficial in determining the etiology, which leads to a well-developed treatment plan.

For providers and practices wishing to lay the foundation for successful multidisciplinary care, there are several steps to follow:

  1. People-Ffirst of all ILanguage: The whole team, from doctors to reception staff, must be trained in people’s first language (PFL). The PFL puts the person before the condition, thus using an expression like “obese person” instead of “obese person”. Obese patients often face weight biases, so professionals should use empathetic language in all conversations with them.
  2. Bariatric Ffurniture: The clinic should have specific amenities for bariatric patients, such as chairs, doors, elevators, bioimpedance scales, blood pressure cuffs, and gowns.
  3. Forms and Consents: Make sure the office has all the necessary forms regarding procedures and consents (eg, if the office distributes controlled substances, know the state rules regarding distribution).
  4. Hospital titles: Verify that the office is properly accredited for bariatric surgery with the hospital.
  5. Center of Excellence Protocols and Policies: If the office is pursuing a Bariatric Center of Excellence designation, access the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database for protocols and policies.

What are the benefits of multidisciplinary care?

Multidisciplinary care has many advantages for both the patient and the healthcare team. Creating an integrated, patient-focused treatment plan can lead to a more effective and efficient process for everyone involved.

Potential patient benefits include:

  • access to a comprehensive list of medical experts familiar with the patient’s medical history;
  • faster diagnosis and treatment timeline through real-time collaboration between providers;
  • better outcomes through a multidisciplinary approach of physicians and providers offering their expertise on the patient’s condition; and
  • better patient satisfaction.

Healthcare professionals are also seeing the benefits, including:

  • improved communication and collaboration between care teams and providers;
  • a more efficient treatment process and schedule;
  • deeper relationships between physicians, providers and staff; and
  • reduction of redundancies or delays during the treatment process.

Here is an excellent illustration of how this care strategy works for a patient preparing for bariatric surgery. Instead of navigating between multiple providers and treatment protocols, the patient can benefit from a “one stop shop” process:

  1. Patient meets with Bariatric Coordinator to understand insurance requirements.
  2. The coordinator works with the insurance company for approval and pre-authorization.
  3. The patient meets with an obesity medicine specialist for an accurate history and diagnosis, which will then inform the plan of care.
  4. The team works with a dietitian to optimize nutritional plans and learn about nutritional needs before and after bariatric surgery.
  5. A psychiatrist engages with the patient to provide advice and expertise on the mental and emotional aspects of bariatric surgery (this step is often insurance mandated).
  6. A bariatric surgeon educates the patient on the pros and cons of the procedure and formulates a treatment plan.
  7. The entire team works with the patient for short and long term success and prevention of complications.

Although multidisciplinary care has many advantages, it is not without its challenges. To avoid communication barriers or duplication, it is important to clearly define the role of each supplier within the team early in the process.

Understanding how and when team members will communicate with the patient is crucial to the long-term success of a multidisciplinary approach and will help alleviate confusion or duplication throughout treatment.

Resources to get started

The Obesity Medicine Association (OMA) has resources and networking opportunities to help providers improve and evolve their practices. As the largest clinical obesity organization in the United States, the OMA is comprised of more than 4,000 physicians, nurse practitioners, physician assistants, and other healthcare providers dedicated to prevention, treatment, and prevention. reversal of obesity disease. To learn more, join the OMA and access a wide range of resources.

Reference:

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