The use of coded patient data for reimbursement purposes can tempt clinicians to exaggerate the severity of the patient's condition, skewing the accuracy of the data and interfering with clinical decision support and research.
At Geisinger Health System, the experience has been that good care can lead to lower costs, but replicating its success might be difficult given its unique history and demographic situation.
Karen Uhlenhuth, Angira Patel, MD, and John Lantos, MD
A statin drug will not give a 10-year-old a high level of energy, the freedom to interact with peers without fear of being bullied, or a generally happy outlook on life.
All of us who are pursuing solutions to the obesity epidemic face clinical, ethical, and regulatory challenges. First among them is the significant role of individual lifestyle and behavior choices in causing obesity.
Lawrence J. Cheskin, MD, Scott Kahan, MD, MPH, and Gail Geller, ScD, MHS
Many health professionals harbor negative biases toward individuals who are obese. Cultivating an awareness of our own biases is the best way to avoid acting on them.
The guidelines for patients’ eligibility for bariatric surgery have not changed since 1991, although recent data suggest there may be indications for broadening application of the surgery.
The rationale for policy intervention to reduce obesity rates appears compelling. Justification for intervening in the case of children is particularly strong, and precedent suggests that society will more readily accept appropriate restrictions to youth behavior.
The adoption of the accountable care organization model means that coordination of care will greatly improve, doctors will end up taking a much more active role in preventive care, and access will have to increase dramatically, perhaps with office-hour changes to accommodate patients' schedules.