Metabolic Patient Care By Committee: A New Paradigm?


Fri Apr 15 10:00:00 CDT 2016
Eric Jakel, MBA
Director of Provider Solutions, Minimally Invasive Therapies Group, Medtronic

How the oncology care center approach can help address obesity-related chronic disease


A common approach to treating cancer is increasingly being used to address obesity and metabolic disorders — with promising results.


It’s called care by committee. And it can have a significant impact on short and long-term clinical and economic outcomes.


The timing is right, too. As healthcare trends toward “population health” and “accountable care” models — with a greater emphasis on value over volume — we’re seeing a shift from episodic care delivery to a comprehensive disease-state approach.


Indeed, doctors Walter J. Pories, M.D., and Konstantinos Spaniolas, M.D., recently co-authored an insightful editorial on this very subject. It was published in the January 2016 issue of The Bariatric Times.


Care by Committee


In the cancer center model, the physicians note, multispecialty care teams review cases on an individual patient basis. A multidisciplinary tumor board for a lung cancer diagnosis, for example, could have representation from:


  • Thoracic surgery
  • Interventional pulmonology
  • Radiation and medical oncology
  • Radiology


A variety of ancillary care providers and care navigators would round out this patient-centric collaboration. And these professionals create a treatment plan through consensus, each providing their perspective of the patient’s condition.


The Metabolic Care Team


An obesity medicine specialist and bariatric surgeon could anchor the care team, with core support from:


  • Dietician/nutritionist
  • Behavioral health specialist
  • Exercise physiologist
  • Patient engagement specialists


And depending on a patient’s comorbidity profile, the treatment-delivery team could also include:


  • Endocrinologist
  • Cardiologist
  • Hepatologist
  • Nephrologist
  • Gastroenterologist
  • OB/GYN


A variety of patient profiles may be addressed through this model — from those needing purely dietary and behavioral intervention, to those who would benefit from the sustainability and durability of a bariatric surgical procedure.


A Perfect Fit


Clinical evidence already suggests the less time that passes between diagnosis and intervention, the greater the impact on a patient’s obesity-related comorbidities. And obesity — along with its related conditions — continues to impact an increasing percentage of the population.


Regardless of the type of weight-loss intervention, patient engagement and behavioral changes are critical to sustain long-term weight-loss success. And that’s exactly why the care by committee model may, in fact, be a new paradigm in healthcare delivery for obesity and metabolic disorders.


Eric Jakel, MBA, is director of Provider Solutions in the Minimally Invasive Therapies Group of Medtronic.