Obesity ruling may have serious impact on patient’s health

The recent ruling requiring medical schemes that screen patients for joint replacement benefits to now fund the surgery regardless of the patient’s weight, fails to take into account the fact that patients should be ‘fit for surgery’ or else risk facing e

According to Graham Anderson, Principal Officer at Profmed, the medical scheme that caters exclusively for graduate professionals, patients who are obese should be entitled to surgery, but not at the expense of their health. “’Fit for surgery’ is a clinical protocol that enables a scheme to ensure that the patient has the least risk in terms of the procedure they will undergo. If the patient is not physically ready for surgery, then the risk of complications becomes exponentially higher.”

“Obesity is a co-morbidity – a condition that coexists with a primary disease – that may result in an increase in the level of treatment required, as well as a longer stay in hospital or complications during surgery. Whereas post-operatively the patient might have stayed in hospital for 24 hours before being discharged; a patient who is seriously obese runs the risk of collapsing during surgery, requiring a number of additional drugs and even being placed on a ventilator.”

Anderson says whether or not a patient is ‘fit for surgery’ is, however, not simply a matter of their weight. “There are a number of co-morbidities that affect whether a patient is ready for surgery, of which weight is just one. Excessive drinking or smoking, uncontrolled diabetes or asthma and high cholesterol, are all co-morbidities that can have a significantly detrimental effect on a patient during surgery.”

“It is critical for any patient who has an uncontrolled co-morbidity to get it under control before proceeding with an operation, particularly if the surgery is elective rather than an emergency. This may mean taking a few weeks to get their asthma; for example, to a more manageable level or losing some weight; but this could be the difference between a success and failure.”

“Patients should engage with their medical scheme to ascertain the reasons behind them implementing the fit for surgery protocol. Many schemes should be willing to pay for the member to see a health specialist for a period of time in order to ensure that their co-morbidity is under control before proceeding with a surgery.”

Anderson says it is in the best interest of the member, for the scheme to highlight the dangers upfront and to recommend that they improve their health before proceeding with surgery. “Often a scheme may not know what co-morbidities a patient has; but if they do then it is crucial that they advise the patient of what is in the best interests of their health, which may mean delaying the procedure.”

“Anyone who pays for medical cover should be entitled to any necessary surgery; but it is also extremely important that the member does not see this recent ruling as a reason to demand an operation – delaying a procedure can sometimes be in the best interest of the patient themselves,” concludes Anderson.