Ultimately, our study shows that obesity significantly increases the odds of experiencing a postoperative complication after undergoing medically indicated, elective breast surgery. Our findings have important implications for plastic surgeons in terms of appropriate patient selection and counseling. These results also may be applicable to surgeons who perform other elective procedures in the obese population.
Earlier this year, I opined on a story involving OB/GYNS in the State of Florida. Specifically these OB/GYNS were refusing as a group to see obese patients claiming they were an increased risk to the practice. I defended the doctors arguing that obese patients constituted an increased liability and limiting liability was basic to business. I repeated this viewpoint on Fox and Friends a few days later (as they were kind of enough to invite me on.) My closing comment was that this was a liability issue and doctors should be allowed to shield themselves as if they were in any other business from uncompensated liability.
Interesting enough is this article in Plastic and Reconstructive Surgery that supports my position quite a bit. It finds that obese patients are a higher risk population to the tune of 11.8 times more risky.
The study article goes on:
Our study demonstrates the need for quality and payment decisions to account for obesity given the increased rate of complications in this select population. Failure to do so can result in discrimination against obese patients when evaluating surgical candidates who may lower quality scores and reimbursements, or inappropriately penalizing physicians who continue to provide care to this population. Instead, surgeons who operate on obese patients should have an adjusted payment for the increased likelihood of complications in this population.
So the author suggests considering obese patients as higher risk and compensating the surgeons for that risk. Well I wonder who suggested that?
John Di Saia MD