Weight Control, Tobacco Use Increasingly Part of the Patient-Family Physician Conversation
FOR IMMEDIATE RELEASE: Monday, June 1, 2014
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WASHINGTON, DC — Patients in family physician offices are increasingly likely to be counseled about tobacco use and weight control, but financial barriers continue to hinder universal assessments.
Those are the findings of research summarized in “Winnable Battles: Family Physicians Play an Essential Role in Addressing Tobacco Use and Obesity,” a one-pager published in the June issue of American Family Physician.
The conclusions stem from analysis of data from the National Ambulatory Medical Care Survey and show 76 percent of family physicians screened for tobacco use in 2010, up from 66 percent in 2006, and 60 percent screened for diet, exercise or weight problems in 2010, up from 53 percent in 2006.
The data show family physicians are increasingly following U.S. Public Health Service recommendations to discuss tobacco use and weight control at every patient visit, according to Joseph Nichols, MD, MPH, lead researcher who conducted the analysis with the Robert Graham Center for Policy Studies in Family Medicine and Primary care.
“Family physicians are on the frontline of the obesity epidemic and ending tobacco use,” Nichols said. “Evidence shows that even brief interventions of three minutes or less within a routine office visit can help patients toward behavior changes. Patients are rarely persuaded to adopt radical behavior change within one visit. Because family physicians have a long-term relationship with our patients, we have the chance to revisit the issue with each visit. But only with universal screening can a physician offer every patient effective treatment.”
Despite research demonstrating the serious health risks associated with tobacco use and obesity, universal screening has yet to materialize. Part of the barrier is likely the inadequate compensation for tobacco screening, counseling and treatment. Medicare, for example, compensates for tobacco cessation counseling only for patients who already have a health issue associated with tobacco use. Moreover, it pays $12.19 to compensate for tobacco counseling lasting up to 10 minutes.
The Affordable Care Act has improved incentives to compensate for the extra time and coordination with community resources required by screening, counseling and treatment of obesity and tobacco use. Additional incentives likely would enable more family physicians to provide universal screening.
“It’s our responsibility as family physicians to raise awareness of the seriousness of obesity and tobacco use,” Nichols said. “Family physicians need to take advantage of the existing incentives to help patients. When existing incentives are not enough to enable us to provide screening, counseling and treatment services to every patient who needs them, it’s our responsibility to advocate for expansion.”
About the Robert Graham Center
The Robert Graham Center for Policy Studies in Family Medicine and Primary Care works to improve individual and population health by enhancing the delivery of primary care. The Center staff generates and analyzes evidence that brings a family medicine and primary care perspective to health policy deliberations at local, state, and national levels.
Founded in 1999, the Robert Graham Center is an independent research unit affiliated with the American Academy of Family Physicians (AAFP). The information and opinions contained in research from the Center do not necessarily reflect the views or policy of the AAFP.