Dr. O'Toole's Blog

I recently engaged with fellow eating disorder treatment providers in an online discussion about the biological basis of anorexia nervosa.

The answer is, without a doubt, a resounding Yes. Whatever the collective merits of the Patient Protection and Affordable Care Act, signed into law by President Obama on March 23, its impact on eating disorder treatment for children and young adults promises to be highly significant, and overwhelmingly positive. [For the record, Kartini Clinic has been a vocal proponent of healthcare reform; we don't think this Act will solve every problem - in fact it may cause some of its own - but on balance we believe it to be an essential first step towards much needed comprehensive reform.

DSM-V: A Rose by any other name...

Anyone with any experience - personal or professional - of eating disorders will know the lengths individuals or families often have to go to get proper treatment. I speak on a daily basis to families battling insurance companies and/or employers (in the cases of "self-funded" in insurance plans). And even if some coverage for treatment is forthcoming, maintaining adequate treatment until remission is gained is often more difficult.

From the world of public health and the campaign against tuberculosis comes critical information relevant to our patients with eating disorders.  As many of you know, we have found the use of Olanzepine (Zyprexa) very helpful in the early part of treatment for anorexia nervosa in children, adolescents and young adults.  Obviously, anything worth doing is also worth doing correctly.  After all, it is dangerous (not to mention ineffective) for a child’s blood levels of a medication to gyrate up and down wildly because they sometimes “forget” or their parents “forget” or because

I can’t keep quiet about it.  All over this country we are talking about the outrageous cost of medical care, trying to tease out the reasons medical care seems to be more expensive in the U.S. than elsewhere in the world.  I am sure there is not “one answer” or “one reason” for these escalating costs, but rather many reasons across all fields of medicine.  So let me confine my comments to my field: eating disorders.

I often have to counsel families to appeal denied claims, especially from mental health insurers who are hired by larger health plans to "administer" mental health benefits. In my experience they are there to deny claims, rather than coordinate care, facilitate access to treatment, or assist families to select appropriate providers (other than those providers who are contracted with that insurer). That would actually be useful.