Obesity as a disease: has the AMA resolution had an impact on how physicians view obesity?
Obesity as a disease: has the AMA resolution had an impact on how physicians view obesity?
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DOI：
10.1016/j.soard.2016.05.009
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发表时间：
2016-08
期刊：
影响因子：
--
通讯作者：
Voils CI
中科院分区：
文献类型：
--
作者：
Funk LM;Jolles SA;Voils CI
2013年，美国医学协会（AMA）通过了一项决议，将肥胖定性为一种疾病。目前尚不清楚初级保健医生（pcp）是否同意这一特征，以及他们的同意或不同意如何影响他们对肥胖患者的治疗。我们试图了解PCP对AMA肥胖决议的看法，以及它如何影响肥胖患者的管理。威斯康辛州的一个小型、中型和大型社区焦点小组与威斯康星州的pcp一起进行。pcp被问及他们是否认为肥胖是一种疾病，以及他们考虑了什么因素，包括美国医学会的决定。采用直接的内容分析方法对数据进行分析。开发了共识代码的分类，生成了编码摘要，并确定了具有代表性的引用。共进行了三个焦点小组，包括16名PCP参与者。并不是所有的pcp都知道AMA的决议。pcp对肥胖是否代表一种疾病持不同意见，主要集中在肥胖是一种风险因素而不是一种疾病。他们还讨论了将肥胖视为一种疾病如何影响医患关系、保险范围、医生报销和研究。美国医学协会的决议似乎没有对我们在威斯康辛州的焦点小组的PCP意见或管理实践产生重大影响。量化这些意见和做法在州和国家一级的普遍程度的后续调查将提供大量信息。
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. A small, medium, and large community in Wisconsin. 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 does 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.
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