Successful bariatric surgery requires planning, prep

Bariatric surgery can be one of the tools internists recommend to help combat obesity in their patients, but there are many things to consider before, during, and after a referral for the procedure, according to experts. Right up front, it's important to develop a good patient-physician relationship to make it easier to discuss potential surgery and its pros and cons. Internists also should make sure that comorbid conditions are stabilized before surgery to the extent possible; that medications, especially those that can exacerbate weight gain, are managed appropriately; and that patients are prepared to keep the weight off. In our story this month, staff writer Mollie Durkin delves into the many issues surrounding bariatric surgery, including a review of the procedures available and which are most commonly performed now.

Location matters in health care, and the area in which patients live can often impact their health as well as their overall life expectancy. Our story in this issue focuses specifically on physicians who practice in lower-income urban areas and the types of external factors that could be affecting their patients' well-being. Read more on ways to determine whether concerns about environment, finances, or safety could be derailing patients' efforts at staying healthy, as well as some public health initiatives that could help.

Speaking of public health, hepatitis C virus (HCV) infection may be even more pervasive than reported, according to a story from the American Public Health Association's (APHA) annual meeting, held in Chicago in December. Read about how death certificates may not tell the whole story where HCV is concerned, as well as ways the CDC proposes to try to curb the epidemic. Another story from the APHA meeting looks at how a transitions-of-care clinic at Rush University Medical Center in Chicago, staffed by primary care clinicians, tackled and appears to have at least partially affected hospital readmissions. Finally in conference coverage, read an in-depth feature from the University of San Francisco's annual Management of the Hospitalized Patient conference, held in San Francisco in October, discussing why several practices common to palliative care may be doing patients more harm than good.

We wish all of our readers a happy and healthy 2016. Let us know what you'd like to read about this year by e-mailing us.

Sincerely,

Jennifer Kearney-Strouse