Not Gonna Believe This!

My husband’s surgeon told him today doctor’s are now getting fines imposed for operating on Diabetics, smokers, or the obese.

I’m too appalled to speak!

Where do you live?

There was a report of a man who was refused back surgery because he smoked. But if you read the story it is a little more complicated. These doctors are not refusing to operate, they are asking patients to make changes to enable a successful operation. And the medical profession seems to have come out clearly saying that it is unethical to refuse to treat patient who smokes. In the case of some surgeries, smoking, uncontrolled diabetes and obesity can pose serious complication risks and severely impede success. For instance if you don’t smoke and get a dental implant your chances of success I’ve seen quoted as higher than 90%. However if you smoke I’ve heard that your chances of success can drop below 50%. As a result, it is not surprising that a dentist would decline to give you an implant until you have stopped smoking and agree to not smoke while the implant heals. The consequences of a failed implant are worse than not getting an implant.

And for diabetes the same thing holds. If you have uncontrolled blood sugars surgery itself can become significantly more risky and you do not heal well with high blood sugars. In fact you have dramatically increased risk of very serious infections as high blood sugars feed infections.

I don’t think it is ethical for a doctor to refuse treatment and I suspect it is illegal to “fine” doctors for making medical choices to treat patients who smoke, have diabetes or are overweight. I think it is reasonable factor in smoking, diabetes and obesity when making a medical decision about surgery, and in particular when these factors dramatically affect outcomes.

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Excellent points. I agree bs needs to be in control to heal, etc. But it didn’t sound like that. Perhaps he misunderstood.

My mother was refused surgery for colon cancer because of dementia – and, as it turned out, the dementia was CAUSED BY THE TUMOR!

We found another doctor in another hospital who did the surgery and, aside from the tumor not having spread yet, her cognition improved. For a time, she was better mentally than she’d been in five years! My mother has since passed away from an unrelated heart attack, but her quality of life was vastly better post surgery than before. I only wish the tumor had been found sooner…

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Are we seeing an effect of value based health care initiatives called for by Obamacare. Value based heath care means simply that doctors that have the best outcomes receive reimbursement at the highest level. The idea is to encourage value not volume.

Seems like a good idea but a possible result is doctors denying service to patients likely to have poor outcomes so they can maintain their high value ratings.

With health care moving from individual practices to large clinic based services I suspect that the pressure being applied here is from clinic managers and insurance companies not a government agency.

Thas, so sorry that happened.

The Dr said it was Obamacare. Idk.

My point is, if they start playing god, we’re all doomed. Diabetics don’t choose to be diabetics.

IMO, 75% of deaths are caused by life style or bad decisions…in one way or another.

And science doesn’t know nearly as much as people trust they do.

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Could very well be… Back before it was a reality (when I was doing my MSHI), I predicted that we would see doctors refusing to treat the most ill patients in order to stack the deck regarding their “value.”

… There are times when I hate being right!

The answer will be that we’ll have to go to doctors that ONLY treat diabetics… Assuming any of those stay in business.

Wis

That’s just wrong!! I get that maybe sometimes you would be refused surgery because of your health and that should be. Surviving surgery of course is the most important thing! But just a blanket statement of fines being given smokers, diabetics, and the obese are what appalls me! Hopefully that is not the way it is going. I think your health needs to be judged first and foremost if you are fit and need the surgery.

I just had major surgery last summer on my shoulder after I fractured it to fix it right. The diabetes wasn’t an issue although I had good control, I had to have the surgery because of the type of fracture that happened. I healed great. I am basically in good health, I am overweight, T1 but no other issues at all.

They need to judge the individuals health not a blanket statement.

Thas, why do you think the tumor caused the dementia? because your mother’s cognitive ability improved afterwards? did you find out something about how that tumor would cause dementia?

Well… For one, her doctor believed it to be the case (He said that he has seen multiple patients whose dementia improved of was even 'cured" after colon cancer surgery). Yes, her cognitive ability started to improved almost immediately after the tumor was removed and did not go backward into decline from that point forward. It was slow progress, but after a few months, even her memory (that had been an issue somewhat longer than the dementia) started to improve.

The connection between brain function and the myriad of organisms in the intestines is becoming more clear. (For example this study Human gut microbiota: the links with dementia development - PMC - and many others.) It’s quite likely that the tumor was poisoning the environment in the colon, causing problems in the brain and, perhaps, other parts of her body. Once it was removed, things improved.

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@GenieInABottle, 100% of deaths are caused by the fact that death is inevitable. LOL.

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N’ that’s a fact! ;0)

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Brian, I’m not saying that, in some circumstances, delaying surgery to get-for example-hgba1c to an acceptable level to facilitate healing-isn’t a great idea-it is! I’m referring to outright refusing ‘just because’.

I see the possible mechanism and have heard a lot recently about the gut-brain connection.

I don’t think anyone would be refused an emergency surgery if blood sugar was not in line to the person smoked. That being said, I was told my hand surgeon would not do my finger trigger release until my A1C was under 8.0. At the time it was 8.1 and he wouldn’t budge, so I had to wait. It wasn’t life threatening but I couldn’t believe a .1 was going to make that much difference but he said, if he did .1 than it would be .2 etc. So we all waited. I get it because they want the best outcome but it is kind of scary where we maybe going with this. Because sometimes a person has no control over some things.