The Tough Questions vs. The Right Questions

From epicvelocity.wordpress.com

Which is more difficult?  Asking the "Tough" questions, or asking the "Right" questions?

A case could be made for either, actually.

I would define the "Tough" questions as the type of question that implies intellectual pursuit; and the "Right" questions as those that need to be asked, and usually on the basis of a deeper understanding of the actual issues at hand.

Such is the case with an editorial recently published in the ACS Surgery News, by Dr. Bruce Schirmer, an ACS Fellow from the University of Virginia Health Sciences Center in Charlottesville.

In his editorial, he detailed an excellent point in regard to the "cost effectiveness" of Bariatric Surgery vs. other surgical procedures.  It followed another published report on the topic of an article recently published in JAMA that detailed the cost benefit to patients from Bariatric Surgery to an insurance company, vs. obese that didn't have the procedures.  It ends up by saying that more study is needed to measure the true benefit of bariatric surgeries, and look beyond just the financial aspects of short and longer-term benefit.

Why all the fuss about measuring the cost-effectiveness in regard to Bariatric Surgery, whereby other types of surgery and surgical procedures (i.e. joint replacements, hernia repairs, cataract surgeries, lung resections for Ca) seem to rarely undergo such investigation?

Thought-provoking point.  I am not sure that similar scrutiny in regard to other types of surgery could easily be justified by a strict dollars and cents (sense?) evaluation either.

There is certainly something more to the benefit of the procedures, including Bariatric surgical procedures, than just the measure of cost-effectiveness.  Most especially for metabolic and bariatric surgeries, quality of life is difficult to measure on a purely monetary scale.  That would include mental health, and improvement in sense of patient well-being, productivity, happiness, a deeper satisfaction in living, as well as an actionable concrete momentum to make other needed changes in their lives that heretofore they have been unable to actuate .  We have all seen these effects in our post-surgical patients, and if you ask them to 'count the ways' they are quick to detail many of them.

Or, more jermain to health care, is the fact that bariatric surgeries do save lives... and what's that worth?

There certainly are financial benefits to both patient and insurer as well, but not likely not as great as some of the other "touchy-feely" characteristics I attempted to detail above.

And, as Dr. Schirmer further puts forth, is it possible that weight loss surgical procedures are under repeated examination and criticism due to a "societal bias against obesity as being a byproduct of character flaws"?  Maybe.

As much as I am not a fan of the "victim mentality", or conspiracy theories, I guess that type of question does have merit, and would be likely more under the "right" side than the "tough" side.

Or do I have it reversed?

And, by the way, Happy New Year, and here's to more of both the Tough and Right questions, and  even some of their attendant answers over the next year!

(If you are under 21, please don't look at the following picture)

From letspour.com