I am a practicing family physician, and my clinic schedule is dominated by patients with complex health conditions that are not easily addressed in the routine physician-directed 15-minute office visit. This includes the sixty percent of my patients who are obese or overweight. My perception is that I routinely address weight as a health risk, but I have not assessed whether my actions support this perception. My sense is that although there is an occasional weight loss success story, I am not having much of an impact across my patient population which is reflected in my enthusiasm and approach to obese patients.
The literature confirms that primary care physicians such as me are not doing well in getting patients to lose weight. Obesity is a chronic illness where the social determinants of health have considerable impact. Sharing responsibility and resources for the management of this chronic illness has considerable promise. How do primary care clinicians and their practices find community resources to partner with in improving obesity rates in their communities?
The Bridge-Building Toolkit, developed by the Oregon Rural Practice-based Research Network and the Agency for Healthcare Research and Quality for primary care practices to manage obesity, provides tools and concepts that have been informed by the real world of six primary care practices in three rural Oregon communities. The toolkit moves patients from an individual practice-based "rope bridge" to the modern day suspension bridge that is able to support the traffic and weight of an entire population of patients at risk to reach effective community resources.
Lyle J. (L J) Fagnan, M.D.
Oregon Rural Practice-based Research Network
Oregon Health & Science University