Dieting for dollars: Paying patients to lose weight
One way to get people to live healthier is to reward them for their efforts.
By Robert Kazel, amednews staff. June 28, 2004.
Trying to persuade patients to lose weight, stop smoking or improve their lifestyles in some other way? Don't just appeal to their common sense. Appeal to their wallets.
That's the decidedly pragmatic philosophy behind several initiatives now being sponsored by insurance companies, employers and at least one physician. The programs all share the assumption that patients can be motivated to break entrenched unhealthy habits if offered tangible rewards, including cash, discounts and rebates.
"The American way is money," says Joseph Chemplavil, MD, a cardiac endocrinologist in Hampton, Va. "I have no problem bribing [patients]."
For more than a year, Dr. Chemplavil has enrolled patients in a voluntary program, "Dollar for Pound," in which he pays them a dollar for each pound they take off. But if they gain a pound, they must pay him a buck. Accounts are settled every time patients come in for an appointment and weigh in. The successful ones remove cash from a jar on his desk, and those who have gained weight deposit money.
Dr. Chemplavil dreamed up the program in the fall of 2002, he says, when he shook the hand of an elderly patient who'd lost five pounds since her last visit. She joked that since she did all the work of taking off the weight, she should receive money, not just congratulations.
"It occurred to me maybe I should reward them," says Dr. Chemplavil, who sees many patients who are overweight or obese and have conditions such as hypertension, diabetes and high cholesterol.
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