Study finds Obvious Conclusion Good for Expensive Service

As part of my job I monitor a few sectors of the health industry to keep apprised of developments and potential new business opportunities. This is how I cam accross this.

TUESDAY, March 3 (HealthDay News) — The more obese a man, the greater his hormonal changes and the worse his sex life, a new study finds.

On the up side, the study’s authors found that gastric bypass surgery can help reverse those ills.

This was generated by a press release issued by the Endorcine Society — a trade group — so it’s not particularly surprising to see the study reveals the highly costly bariatric surgery to be a magic bullet when it might be a safe inference that normal, less profitable weight loss would have the same impact. But to expand beyond the basic absurdity of that paragraph, this is one of the reasons why comparitive effectiveness research is so important. As long as medical studies are funded and undertaken by those with the most to gain from positive outcomes — as is the status quo — it’s likely we’ll continue to spend roughly one third of health care dollars on ineffective treatments.

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5 Responses to “Study finds Obvious Conclusion Good for Expensive Service”

  1. Reid Says:

    Bariatric surgery is not well compensated for surgeons, and the patients are complete messes. Obese people bleed like stink, get pressure ulcers from being immobilized, have complications relating to clots e.g. (what killt kanye’s mom), not to mention a lot of them are diabetic, which is another whole can of worms in terms of perioperative headache.

    all told, medicare payments for bariatric surgery are dismal compared to someone say scoping a sore shoulder in a relatively healthy pitcher.

    the only surgeons that make this work financially are in factory esque bariatric practices with a shit ton of ancillary help, but you can make anything work with the right business sense. Basically what I’m trying to say, is that you’d be retarded to go into bariatrics for the money; or the patients, who tend to have unrealistic expectations to match their waist lines.

    So why do surgeons keep doing these? Well, it works for one. Not only do most patients lose an assload of weight. It is also one of the few viable “cures” for type II diabetes. And no, they have no idea how that works yet. People’s diabeetus often corrects before they’ve lost a pound.

  2. Reid Says:

    http://forums.studentdoctor.net/showthread.php?t=351127

    that’s a link to a reposted article from General Surgery News. It’s a bit exaggerated in that very few surgeons would have a bariatric practice that consists only of medicare patients (patients are over 65). But medicare essentially sets the trend for reimbursement across all insurance.

  3. Jon Says:

    Reid — thank you for adding actual knowledge to my mostly jejune conjecture. Anyway, in half-winging the post, I definitely come out looking less informed, but that wasn’t really the point I was going for.

    I don’t doubt that bariatric surgery is successful, my point was more that there many other less costly and risky ways to lose weight. Whatever the margins on bariatric surgery may be, they are certainly more than nothing. And more to the point, studies demonstrating that bariatric surgeries enhance sex life boosts the visibility and need for doctors who specialize in this sort of treatment. Of course, there is nothing really wrong with this, but so long as this sort of research is performed mostly by those with a vested interest, there will be less studies touting social marketing type interventions and other less costly, but perhaps similarly effective (in certain cases) treatments.

  4. Reid Says:

    yeah, I think there is more science in that study, and less marketing than you might imagine.

    Endocrinologists have long been trying to understand the link between having lots of fat and having higher levels of estrogen. They think this is why fat chicks don’t get osteoporosis as frequently as skinny chicks.

    Estrogens in men are inversley proportional to sex drive, and the Roux-en-Y gastric bypass surgery is particularly known to cause drastic hormonal changes e.g. eliminating diabetes as mentioned above. Someone put all this together and got a nice pub in Journal of Clinical Endocrinology & Metabolism.

    The Health article definitely frames the whole thing pretty stupidly. And I see where you are going with your point. I just think you used a bad example.

    go pick on drug eluting cardiac stents

  5. My Bad « Yes, Let’s Talk About This Says:

    […] Posted in Policy by Jon on March 10th, 2009 As some of you may have read, Med School student Reid absolutely eviscerates my point made in a post about bariatric surgery and comparitive effectiveness. Anyway, if I had […]


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