How Far Will You Travel for Obesity Treatment?Wednesday, March 26, 2008
One consequence of the rapid increase in obesity is that the vast majority of Canadians cannot rely on local facilities or expertise for obesity treatments. As a result, patients often have to travel long distances or even across borders to seek obesity treatments.
For example, our program has over 300 patients from other provinces awaiting assessment and hoping for treatment.
This throws up a number of logistical but also practical issues: how do you provide cross-border management for a chronic disease?
It is one thing to fly across the country to consult an expert for a diagnosis of a rare condition or a one-time specialized procedure. But what do you do for a common condition that requires on-going lifelong management? How do you provide education, counseling, monitoring and support across 1000s of kilometers?
Sure there are telephones, internet and telehealth but this does not entirely replace the need to actually see and examine a patient face-to-face.
Remember, obesity is a complex and heterogeneous condition – patients may require 10s of visits with a whole array of health professionals to determine the best treatment plan. Successful obesity management requires continued intervention and monitoring to keep the patient in remission. Early signs of relapse need to be recognized and dealt with to prevent weight regain. Surgical patients need band readjustments, dietary counseling and psychological support.
Much of this is theoretically possible across distances with modern communication technologies but in reality often impractical and inefficient.
On the other hand, how do you refuse to see patients who are clearly in dire straits for whom no local help is available or forthcoming any time soon?
Frankly, I see no alternative to rapidly ramping up obesity care across Canada – this will take both time and resources but most of all a change in attitude: ignoring obesity is no longer an option – limiting efforts to prevention is not helping the millions already struggling with this condition.