3 Finding Ways around Managed Care: Part I
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Dynamic Chiropractic – May 19, 1997, Vol. 15, Issue 11

Finding Ways around Managed Care: Part I

By Stephen R. Seater
A recent article in The Wall Street Journal described how medical physicians are finding ways to keep their incomes growing in spite of managed care. This particular article described the enormous growth of diet pill clinics nationwide. The new "pill mills," as critics call them, dispense the hot-selling Redux to patients wishing to lose weight. Made by American Home Products Corporation, Redux is based on dexfenfluramine, and phenfen, a combination of two other obesity drugs, phentermine and fenfluramine. These drugs were originally intended only for people who were 20 to 30 percent heavier than ideal weight. The drug combination can have devastating effects, including pulmonary hypertension. The new pill mills, however, maximize patient turnover while providing little or no contact with physicians. Many of these weight loss centers play down the risks involved while promising permanent weight loss.

"There are plenty of pill mills out there, handing out medications like cheap Halloween candy," says Dr. Michael Myers, an obesity specialist in Los Alamitos, California. "Lots of physicians have suddenly become experts in obesity." Experts say the pill mills are providing the biggest gold rush in the weight loss business in 30 years. These clinics offer a highly profitable cash business to MDs hurt by managed care. "I've never seen a vehicle like this for seeing large numbers of patients. You may be talking about the next billionaire," says Dr. Fred Garcia, owner of Slim and Slimmer Medical Associates in Newport Beach, California.

Last year, sales of the three drugs topped $400 million, and about three quarters of that went to American Home Products. The company says that doctors only prescribe the drugs for people who are obese. However, visits to various pill mills show that is not so. People who are far from obese, but who want to be model thin are given the drugs just for the asking. Furthermore, claims that patients will lose weight permanently are, of course, false. "It's totally unethical to promise permanent weight loss," says Dr. Richard Joseph of the American Society of Bariatric Physicians.

I mention the diet pill mills only because the weight loss market is huge and growing. Keep in mind that there are millions of Americans who want to live healthier lives, control their weight, etc., but who do not want to rely on dangerous drugs. In his prophetic study, "The New Millennium Chiropractor," trends analyst Gerald Celente talks about the huge weight management market that is developing for professionals who employ safe and natural methods to help people manage their weight. And remember, even though most of this market consists of people who want to lose weight, some people want to gain weight, such as certain kinds of athletes, bodybuilders, etc., without taking steroids and other unsafe drugs.

Getting back to weight loss, many experts believe that neither diets nor drugs really work well in keeping weight off people. Many overweight individuals eat to excess due to stress. Many are also very sedentary individuals. However, weight loss plans that incorporate stress management, exercise, and modified diets are said to be successful, at least for some people. Even so, there are many who still have a difficult time keeping excess weight off.

Chitosan is a polysaccharide derived from chitin, which is found in the exoskeletons of crustaceans. It holds great promise for helping people to lose weight. Chitosan is a completely safe and natural substance. Studies have shown it to be biocompatible and biodegradable. It differs from other natural fibers in that is has a positive charge. Because fat molecules have a negative charge, they are attracted to chitosan. Since chitosan is not digestible, it contributes no calories.

According to an article Paul Rosch, MD, wrote in the Health and Stress Newsletter (#2, 1997), chitosan is able to attract up to four times its weight in fat. The resulting combination is then passed out of the body. Chitosan does not interfere with the absorption of protein and carbohydrates, nor does it appear to interfere with the uptake of fat soluble vitamins. People taking chitosan for a period of four weeks lost an average of 14 pounds without changing their diets. Chitosan also lowered blood pressure in the above group.

Information on chitosan is readily available on the Internet. Just type in the word chitosan in any search engine to get the addresses of numerous web sites to access. DaVinci Labs recently introduced a chitosan product that contains sodium ascorbate and rice bran. For more information, call (802) 878-5508.

Weight management is an expanding market. Natural approaches to weight management make up a growing segment of the overall market and offer chiropractors a means of circumventing managed care. The chiropractic physician, with training in diagnostic procedures, nutrition, and exercise, is the ideal professional to offer natural approaches to weight loss and weight gain. Vitamin and herb counseling should also be a part of this equation. With their background in nutrition, it would not take much for chiropractors to also become knowledgeable about herbs. The market for nutritional and herbal supplements is exploding and is projected to keep growing into the next century.

In my next article, I will present another important market for chiropractors in which managed care is not a factor.

Stephen R. Seater, CAE
Arlington, Virginia

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