Primary health care providers' roles and responsibilities: A qualitative exploration of ‘ who does what ’ in the treatment and management of persons affected by obesity.

Obesity is now considered a national epidemic. Guidelines to manage persons who are overweight or affected by obesity are available but rarely relevant and applicable to primary care clinicians’ expertise. A qualitative descriptive narrative approach was used to identify challenges of primary care professionals in regard to the management of obesity. A literature review was conducted and input from experts was integrated with findings from interviews with Primary-Care Physicians, Physician Assistants, Nurse Practitioners, and Patient Advocates. Transcripts were coded using a thematic analysis approach. Two main challenges, associated with communication among the primary care team and with patients, emerged: (1) a lack of interprofessional integration and; (2) challenges in conceptualizing obesity as a chronic condition, contributing to lack of proactivity and communication in treating and managing persons who are overweight or affected by obesity. A causal factor is the dearth of standardized procedures, applicable at a primary care level. Lack of systematic procedures for the communication with, and management of, persons who are overweight or affected by obesity, and of clearly delineated roles of each primary care team member can undermine continuous care, and can contribute to a sense of disempowerment for both providers and the patients. Both would, thus, benefit from standardized clinical protocols. Behavioral training to the primary care team would also facilitate the communication with at-risk patients and would provide guidance to address the psychological and behavioral aspects of being overweight or affected by obesity in order to facilitate lifestyle changes.