pgg

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Hmm, using an objective measure of self-abuse and self-inflicted disease to delay or deny routine elective surgery paid for by the public.

I think I like it.
 

Wiscoblue

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It's coming to a hospital near you in a couple of years when bundled payments become the norm. Hospitals are going to have to start turning patients away if they are high risk. One joint gone bad takes away the profit from 10 joints. It's just not going to be worthwhile taking on the obese diabetic smoker for total knee or hip replacement.


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HalO'Thane

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Isn't this the same type of health care model that the makers of Obamacare are trying to emulate?
 
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ChiDO

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https://www.msn.com/en-gb/news/uknews/obese-patients-and-smokers-banned-from-all-routine-operations-by-hospital-in-most-severe-rationing-ever/ar-AAiqkz6

The UK must be running low on 7" spinal needles. I'm just wondering how the obese are expected to lose weight if they have a bum hip/knee?
Most recent data shows (and confirms prior research) that your bad knee/hip is not preventing you from losing weight. Most TKA/THA patients gain weight. http://www.ncbi.nlm.nih.gov/pubmed/26718776

Some academic centers here in the US are starting to implement a strict 40 BMI cutoff for arthroplasty. This will become the norm with bundled payments. Over the course of my residency, I've seen average BMI in our studies creep from 31-32 to 34-35
 

BLADEMDA

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Most recent data shows (and confirms prior research) that your bad knee/hip is not preventing you from losing weight. Most TKA/THA patients gain weight. http://www.ncbi.nlm.nih.gov/pubmed/26718776

Some academic centers here in the US are starting to implement a strict 40 BMI cutoff for arthroplasty. This will become the norm with bundled payments. Over the course of my residency, I've seen average BMI in our studies creep from 31-32 to 34-35
That would be great to see a BMI limit of 40. I'd say the norm for me is a BMI of 35 right now.
 

BLADEMDA

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The majority of subjects gain weight after surgery and this cannot be attributed to the effects of aging. Weight gain after TKA should be treated as an independent concern and management of orthopedic impairments will not result in weight loss. Post-operative care should include access to nutrition or weight management professionals in addition to medical and physical therapy services.

http://www.ncbi.nlm.nih.gov/pubmed/20060949
 

Mad Jack

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The future looks bright, comrades, and it's coming soon to a hospital near you once Hillary has her way!
 

Psai

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Most recent data shows (and confirms prior research) that your bad knee/hip is not preventing you from losing weight. Most TKA/THA patients gain weight. http://www.ncbi.nlm.nih.gov/pubmed/26718776

Some academic centers here in the US are starting to implement a strict 40 BMI cutoff for arthroplasty. This will become the norm with bundled payments. Over the course of my residency, I've seen average BMI in our studies creep from 31-32 to 34-35
Should cut it off at 30
 

SaltyDog

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No surgery for smokers and/or BMI>30? That means nobody on Medicaid will ever get elective surgeries... wait oh I get it
I'm not quite sure what it says about a society when the poorest are also the fattest??
 

BLADEMDA

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I'm not quite sure what it says about a society when the poorest are also the fattest??
It says we have a lot of cheap, high fat, high caloric foods readily available. The fact is "healthy food" is more expensive than the processed crap the low income people prefer to consume.
So, besides the poor diet the low income bracket is lees likely to exercise on a regular basis:

This results in the medicaid triad:


1. Poor diet
2. Lack of exercise
3. Less educated, lower compliance
 

BLADEMDA

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BLADEMDA

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Ronin786

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A BMI of 30 is quite the strict goal. I would say 5-10% of my patients would qualify.