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.
“Difficult” patient-physician encounters have roots in uncertainty about individuals’ trustworthiness, clinicians’ skills and training, and medical science.
AMA J Ethics. 2017; 19(4):391-398. doi:
10.1001/journalofethics.2017.19.4.mhst1-1704.
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 Patient Protection and Affordable Care Act's provisions will drive up premiums, increase unemployment, and spend money the government doesn't have.
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.
The future success of the Affordable Care Act depends on doctors' willingness to take the lead in identifying reforms that will lead to high-quality, cost-effective health care.
This month, Virtual Mentor spoke with Dr. Alex Ding and Mr. Jordan VanLare, a fourth-year medical student at Columbia University College of Physicians and Surgeons, about their impressions of health reform and how it will impact the medical practice environment they will soon enter.
A discussion of the ethical issues raised by a patient’s request for off-label, prophylactic bariatric surgery to prevent diabetes mellitus type 2 (DM type 2).