Sales Driven Marketing LLC

Physician Sells
Weight-Loss Center
Approach to His Peers

Doctors Get Training,
Advertising and Use
Of Business's Brand

By HEATHER WON TESORIERO
March 13, 2007; Page B8

When Michael Kaplan was a practicing internist, he grew weary of seeing patients suffering from a roster of conditions that all stemmed from being overweight. He also grew weary of fighting insurance companies for reimbursement.

Seeking to solve both problems at once, Dr. Kaplan got board certified in bariatric medicine, the treatment of obesity, and made it the sole focus of his practice. Patients were attracted to the idea of having their weight loss supervised by a physician. And Dr. Kaplan's business did better because patients mostly paid for his services out of pocket. Eventually, he opened three Center for Medical Weight Loss locations on New York's Long Island.

PROFITS AND LOSS

•  What's New: A doctor who made bariatrics the focus of his practice and started a weight-loss center is now selling the plan to other physicians.
 
•  The Details: Doctors attend a seminar, get advertising, an exclusive territory in which to operate and use of the center's name.
 
•  The Skeptics: While applauding the medical guidance in weight loss, some critics wonder if participating doctors get enough training.
 

Now, sensing growing demand from both patients and doctors, Dr. Kaplan is marketing and selling the approach to other primary-care doctors. The goal, he says, is to give doctors a program that "allows us to compete with the commercial world" of weight-loss plans.

Exclusive Territory

For an initial fee of $16,995, internists in Dr. Kaplan's venture get a two-day seminar in New York, where they learn the science behind bariatrics and get suggestions on how to structure their centers. They also get an exclusive territory in which to operate under the center's brand. For an additional monthly membership fee of $3,095, Dr. Kaplan's center will advertise -- on print, radio and online -- in that designated area. And any calls to the center's national toll-free number, 1-800-MD-BE-THIN, are automatically routed to participating doctors in the callers' geographic location based on ZIP Codes.

The doctors then basically create their own Center for Medical Weight Loss within their practice, where they see their primary-care patients and then carve out hours to see new weight-loss patients. Since Dr. Kaplan launched his venture in September, 60 centers have opened in 10 states.

But some critics question whether seminars like Dr. Kaplan's are sufficient training for doctors. "I completely agree that you get the best outcomes when you get a physician to individualize the patients' care," says Mary Vernon, president of the American Society of Bariatric Physicians. "What I'm not sure about is whether you can learn that in two days."

Dr. Kaplan says participating doctors must be board certified in primary care. They are encouraged, but not required, to be board certified in bariatrics. To become board certified, a doctor has to have a minimum of 50 hours of American Medical Association-approved continuing medical education courses in obesity. A doctor must then pass written and oral exams and have an onsite review by the bariatrics board to demonstrate that he or she has treated a group of bariatric patients for at least a year. A doctor needs to get recertified every five years.

Dr. Kaplan's program aims to get the percentage of body fat as low as possible and to help people take off pounds without losing muscle mass. Patients are typically put on low-calorie diets of shakes and nutrition bars and, in some cases, prescription appetite suppressants. As they approach their goal weight, they are eased back onto food. Dr. Kaplan says patients initially have weekly appointments and then often taper off, depending on their progress. There's a big emphasis on counseling patients on behavior modification and lifestyle changes.

Dr. Kaplan says his medical approach sets his program apart from businesses like Weight Watchers, Jenny Craig or L.A. Weight Loss. "I'm trying to set the world straight that this is a disease, and doctors should be managing diseases," he says. "I don't know of any diseases being managed by people with no medical background."

The centers aim to treat people who are seeking both cosmetic and medical weight loss. But the doctors are not bariatric surgeons. Dr. Kaplan says he refers patients who have lost and regained 100 pounds more than once in the past five years to surgeons. In its advertising, the center touts 21 pounds off in four weeks as the average loss of customers.

Dr. Vernon says it's possible to lose that in four weeks in a healthy manner, but it depends on how much weight, and particularly, body fat the patient needs to lose altogether.

Americans spend $46 billion a year on consumer weight-loss products, programs and diet aid, according to a 2005 Marketdata Enterprises study. And some people who have tried other commercial programs say they don't mind paying for medically guided weight loss.

Elissa Rizzo, 29, a kindergarten teacher from Bellport, N.Y., says she had tried Weight Watchers, Jenny Craig and the South Beach Diet. She lost some weight on all the programs but the results never lasted. Dr. Kaplan put Ms. Rizzo on a low-calorie diet, which involved a strict regime of shakes and bars sold by the center. Since last August, she has lost 43 pounds. Ms. Rizzo says she's now four pounds away from her goal weight of 150 pounds. She spends about $500 a month for her visits and the food substitutes.

"I would've spent the money on food anyway," she says. "Losing the weight was a first priority. I didn't mind spending the money on health."

Dr. Kaplan says Ms. Rizzo is more likely to keep weight off with his plan because he treats weight as a chronic illness that must be monitored long term.

Patient costs vary by doctor. Dr. Kaplan's practices charge $19 for an initial consultation. And fees for a weight-loss program range from $75 to $640 a month -- and could be more depending on the patients' needs. Dr. Kaplan says he suggests prices, but the doctors are free to set their own. For $640 a month at Dr. Kaplan's centers, a patient gets a weekly weigh-in, food and counseling.

Daily Calls

Pamela Fennewald, an internist in Gurnee, Ill., signed on with Dr. Kaplan last November after receiving a direct-mail solicitation from his center. "There are a lot of very dubious diets and weight-loss recommendations out there that have no foundation in any kind of medical reality," she says.

Since opening her center, Dr. Fennewald says she gets an average of five calls per day and sees six to 10 new patients per week. She is considering partnering with another physician to take on some of the load, adding that it's still too soon to know if her center will be profitable.

Dr. Kaplan says that of the 60 doctors who signed on, two have left -- one because Dr. Kaplan didn't deem him appropriate and the other due to a lack of business.

He says 10 new sites open each month and estimates that will jump to 25 by the end of 2007. Dr. Kaplan discourages doctors from selling the program to pre-existing patients. "Those patients are used to having insurance cover their treatment," he says. "It'll be hard for them to make the adjustment to paying out of pocket.

He estimates that doctors who join his operations will earn $100,000 to $300,000 a year from their weight-loss business, and believes that if they do weight loss full time, they'll earn more. He projects that his own offices will earn $1.8 million this year, or 10 times the average internist's salary of $183,840 according to a 2006 survey of the American Medical Group Association.

"We're trying to do 100 calls per month per doctor," he says. "We've had as many as 400 and as few as 50." Call reports are emailed to doctors daily.