NR 717 CCN Patient Suffering from Obesity Discussion

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Consider a time when there was an issue related to healthcare policy in your local, regional, or national community. If you pursued an opportunity to address the issue, describe the results. If you did not follow the opportunity, explain the reasons.

Access to care for patients suffering from obesity is an identifiable health inequity (Hampl et al., 2023). This is a multifactorial issue. One issue is that weight stigma and bias are common at the provider level. Blaming and shaming the patient with obesity does little to start the dialogue for healthy discussion regarding the health issues that excess weight causes (Cohen & Shikora, 2020). Bias and open discrimination lead to the provider and caregivers’ commonly held beliefs that patients with obesity lack self-control and do not wish to live a healthy life (Cohen & Shikora, 2020). Healthcare providers can address complex comorbidities that accompany obesity. Speaking directly to patients concerning weight-related issues is a skill that needs development to be effective. Successful communication between patients and healthcare providers requires trust and understanding. Sensitivity training, patient transfer, and mobilization training are standards for team members to undergo and show proficiency to ensure compassionate care is delivered to understand the burden of patients with obesity (Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program [MBSAQIP], 2019).

I speak with groups of physicians about once a week to present our service line and what it offers to the system. I have added a “frequently asked questions” portion to the end of the presentation. I have included two questions that I made up. The questions address weight bias at the provider level. I phrase the questions from the provider angle, but the answer is geared towards a teaching moment that gives the patient voice center stage. At times it is not well received. I believe it may be the most essential part of the presentation. One of the surgeons I work with tells me that even if it only reaches one provider, I have accomplished a goal that day. I believe this advocates for my patients at the local/system level.

Propose an area of your political competency that needs further development and action you could take to become more politically competent to impact your selected population.

Another issue of access to care for the patient suffering from obesity is that obesity services are considered elective. The inconsistent coverage in commercial, state, and federal policies creates a significant barrier to evidence-based treatment plans for patients suffering from obesity (Hampl et al., 2023). Obesity services must be a covered benefit on all health insurance plans for the prevention and treatment plans to be available to all individuals equally. As a leader, it is essential to educate staff on supporting patients with inconsistent insurance coverage for obesity services. Maintaining a database of lower-cost or free community services for patients to participate in, supporting elected officials who have alignment with obesity services as a chronic disease, treating and supporting patients who suffer from obesity with respect, and recognizing and acknowledging obesity as a chronic disease are ways to create an atmosphere of care and understanding within the healthcare organization as a leader.

In our administrative meetings, our practice regularly discusses access to care issues with leaders in the organization who can make a difference for patients by discussing and negotiating insurance benefit changes through other employers, legislators, insurance companies, patient advocacy groups, and our employee’s health insurance plans. The access to care regarding prior authorization of obesity services to our full-risk insurance population is authorized by our system and based on standards of care set by our providers.

References

Cohen, R., & Shikora, S. (2020). Fighting weight bias and obesity stigma: A call for action. Obesity Surgery, 30(5), 1623-1624. https://doi.org/10.1007/s11695-020-04525-0

Hampl, S. E., Hassink, S. G., Skinner, A. C., Armstrong, S. C., Barlow, S. E., Bolling, C. F., Avila Edwards, K. C., Eneli, I., Hamre, R., Joseph, M. M., Lunsford, D., Mendonca, E., Michalsky, M. P., Mirza, N., Ochoa, E. R., Sharifi, M., Staiano, A. E., Weedn, A. E., Flinn, S. K., Okechukwu, K. (2023). Clinical practice guideline for the evaluation and treatment of children and adolescents with obesity. Pediatrics, 151(2), 1–100. https://doi.org/10.1542/peds.2022-060640

Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. (2019). Optimal resources for metabolic and bariatric surgery: 2019 standards revised. https://www.facs.org/quality-programs/accreditation-and-verification/metabolic-and-bariatric-surgery-accreditation-and-quality-improvement-program/