Funk Luke M, Jolles Sally A, Voils Corrine I
William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin; Department of Surgery, Wisconsin Surgical Outcomes Research Program (WiSOR), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
William S. Middleton Memorial Veterans Hospital, Madison, Wisconsin; Department of Surgery, Wisconsin Surgical Outcomes Research Program (WiSOR), University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
Surg Obes Relat Dis. 2016 Aug;12(7):1431-1435. doi: 10.1016/j.soard.2016.05.009. Epub 2016 May 11.
In 2013, the American Medical Association (AMA) passed a resolution characterizing obesity as a disease. It is unclear whether primary care physicians (PCPs) agree with this characterization and how their agreement or lack thereof affects their treatment of patients with obesity.
We sought to understand PCP opinions about the AMA obesity resolution and how it has affected management of patients with obesity.
Small, medium, and large communities in Wisconsin METHODS: Focus groups were conducted with PCPs in Wisconsin. PCPs were asked whether they considered obesity a disease and what they factored into this consideration, including the AMA decision. A directed approach to content analysis was used to analyze the data. A taxonomy of consensus codes was developed, coding summaries were generated, and representative quotes were identified.
Three focus groups comprising a total of 16 PCP participants were conducted. Not all PCPs were aware of the AMA resolution. PCPs held divergent opinions on whether obesity represented a disease, primarily focusing their considerations on obesity as a risk factor versus a disease. They also discussed how considering obesity as a disease affects the patient-doctor relationship, insurance coverage, physician reimbursement, and research.
The AMA resolution did not appear to have made a significant impact on PCP opinions or management practices in our focus groups in Wisconsin. Follow-up surveys that quantify the prevalance of these opinions and practices at the state and national levels would be highly informative.
2013年,美国医学协会(AMA)通过了一项决议,将肥胖界定为一种疾病。目前尚不清楚初级保健医生(PCP)是否认同这一定义,以及他们的认同与否如何影响其对肥胖患者的治疗。
我们试图了解初级保健医生对美国医学协会肥胖决议的看法,以及该决议如何影响肥胖患者的管理。
威斯康星州的小型、中型和大型社区
对威斯康星州的初级保健医生进行了焦点小组访谈。询问初级保健医生他们是否认为肥胖是一种疾病,以及他们在做出这一判断时考虑了哪些因素,包括美国医学协会的决定。采用定向内容分析法对数据进行分析。制定了共识编码分类法,生成了编码摘要,并确定了代表性引述。
共进行了三个焦点小组访谈,共有16名初级保健医生参与。并非所有初级保健医生都知晓美国医学协会的决议。初级保健医生对肥胖是否为一种疾病存在不同意见,主要将他们的考量集中在肥胖是一个风险因素还是一种疾病上。他们还讨论了将肥胖视为一种疾病如何影响医患关系、保险覆盖范围、医生报销和研究。
在美国医学协会的决议似乎并未对我们在威斯康星州的焦点小组中的初级保健医生的意见或管理实践产生重大影响。在州和国家层面量化这些意见和实践的后续调查将提供丰富信息。