Saving dollars, saving lives
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CHARLESTON, W.Va. -- About 10 years ago, George Farley was packing on pounds as he moved from project to project as an electrician for the city of Charleston. "If you'd seen me in my hoodie back then, it looked like I was pregnant," he said.
"Back then, I took two pills, a blood pressure pill and another pill because my heart was skipping," said Farley, 50. "I just thought, well, if you have a problem, you take pills. It didn't occur to me to fix it by exercise or what I ate.
"Hey, I come out of the construction field," he said, laughing. "We eat fast food and get heavy, and we don't worry about it. I'm serious!"
With high blood sugar, cholesterol and blood pressure, Farley -- now city construction manager -- was a prime candidate for diabetes.
But then in 2007, the city started requiring insured employees to get health risk screenings so they could catch diabetes and heart problems before they happened.
"They sent you back color-coded screening reports, green, yellow and red," Farley said. "Mine looked like a fire alarm."
"It was a real wakeup call," he said. "Doctors had told me this stuff before, but I'd never seen it right there in front of me, on paper, in color, one thing after another. All that red really hit me. I mean, my wife, she works for the city too, and she got back all green."
That really bothered him, he said. Then his teenage daughter really
got his attention. "She told me my weight embarrassed her. You know, teenagers tell it like it is."
He signed up for a checkup at the city's new health clinic in the ballpark building on Morris Street.
Any city employee can visit that clinic on work time at no cost. It has its own bloodwork lab.
"We wanted to make it as convenient as possible to take care of yourself," said City Manager David Molgaard. "This is about prevention. And if people are healthier, the city saves money. Everyone wins."
About 1,200 employees use the clinic, said Maria Jones, city claims manager. "A lot of our employees have no other doctor," she said. "The clinic is their medical home. Matter of fact, it's my medical home. I'm that satisfied with it."
"We schedule appointments far apart enough that people aren't rushed, and we can accommodate walk-ins," Molgaard said. "We want people to have time to talk about what's going on and find out what they can do about it."
Farley talked "a long time" during his first visit with David Miller, the physician's assistant who operates the clinic. They talked about what could happen if Farley kept gaining weight ("not a pretty picture") and how he could prevent it.
"He didn't just hand me a pill," Farley said. "He explains what you can do for yourself, without medication, if you do this, this, and this."
On Miller's advice, Farley changed his diet and started working out at the gym the city installed in the city building. The gym is part of the wellness plan. So are lunchtime zumba and yoga sessions.
Farley also joined a Weight Watchers group meeting in city hall. "The guys on the construction crew harassed me about that at first. Even my wife, she said, 'George, isn't Weight Watchers for women?'"
He lost 60 pounds in six months. "The guys saw that, and they quit teasing me," he said. "Some of them started coming too. They said, if George can go to Weight Watchers, we can too."
More important, Farley's blood pressure and cholesterol fell into normal range. He dropped his triglycerides from 179 to 81. So he figures the city saves money on him. "I don't take those two pills anymore, so Dave Molgaard doesn't have to pay for that anymore, and my knee trouble disappeared after I lost weight."
Farley gets a 24 percent discount on his insurance because he goes to the clinic at least once a year. Employees with one to three risk factors must visit the clinic twice a year. If they have 4 or more factors, they visit four times a year.
He pays $168.83 a month for family insurance. If he wasn't betting health risk assessments, he'd pay about $40 a month more.
As construction supervisor, he knows the clinic saves down time. "I have about 20 people working under me. Instead of taking off half a day for a doctor's appointment, they go to the clinic, and they're back in maybe an hour. There's a lot less absenteeism since we started this."
Over the summer, the city's Weight Watcher group took a break. Farley gained back some pounds. In November, when he got his color-coded report, he had a red bar: his weight. "So there's that wakeup call again," he said. "What I've learned is, you can't say, well, I took off the weight, so now I can go back to my old ways."
He went to the clinic and got a pep talk from Miller. "So now I'm bringing meat and fruit for lunch again, no bread, no doughnuts," he said. "Going to take the weight back off."
His daughter's working small jobs with him in the evenings now. "Life's good," he said. "No way am I going back to the shape I was in before."
"The Shape We're In" has been supported by a Dennis A. Hunt Fund for Health Journalism fellowship, administered by the California Endowment Health Journalism Fellowships at the University of Southern California's Annenberg School for Communication and Journalism.
Tips from David Miller: "I like to keep it simple."
"A patient can get overwhelmed if you make a bunch of suggestions at once, so I like to keep it simple. There are five things that help people, no matter what's going on with them, whether they have diabetes, heart disease, arthritis or what.
• Try to eat three to five smaller meals a day instead of three big ones. Don't skip breakfast.
• Increase your exercise. Walk, swim, whatever.
• Quit smoking.
• Reduce stress.
• Have a positive mental outlook on your goals.
"You tailor it to the person. We talk about what kind of exercise they like and how they can fit it into their lives. We discuss their food preferences and portion size and what they like to eat. We talk about ways the person can weave stress reduction into their life."
"We concentrate on one or two of those things at first. Then when they come back, we take on about another one."
Physician's assistant David Miller, who staffs the City of Charleston's health clinic, run by HealthStat