Re: supporting fulltime bariatric nutritionists

[Guest guest]

Calire-

I work full time soley bariatric surgery at out facility. We do an

average of 200 surgeries (band and bypass) each year between 2

surgeons. I see all pts pre-op to determine if they are a candidate

for surgery, and I see them at every f/u along with the surgeons. I

do an education in-house right after surgery and I co-lead a once

monthly support group. It think that you could definitely justify a

full-time position. Good luck!

>

> I am looking for assistance in seeking a request to support the

need for my

> dept. hiring me fulltime.

>

> Currently, I am 20 hours FTE for a facilty that does over 300 WLS

per year.

> I think there are many other bariatric sites out there that support

a FT RD

> for less or equivalent surgeries per year. If you are at one of

those,

> please let me know how many hours you work (and if you have more

than one

> RD) in comparison to the # of surgeries your facility does. BTW,

we are a

> Centers of Excellence, so if anyone knows that this is mandated for

a COE,

> please let me know.

>

> I know many sites required a pre-surgical individual consult with

the RD -

> we only require it if insurance does, otherwise we only require a

group

> presentation that they are mandated to do after their surgery is

scheduled,

> three-four weeks prior to surgery. Is there any research out there

that

> supports my suggestion that all pts see me individually prior to

surgery,

> that can improve their outcome post-surgery? Are there any other

thoughts

> re: supporting me on this idea, as obviously this would increase my

needed

> hours.

>

> *Some other ways I plan to support my need for more hours are the

following*:

> to be more available for the 3 bariatric surgeons pts in f/u and

for more

> referrals from other surgeons; to initiate and become involved in

more

> bariatric research; develop more nutrition info. on our website; to

do

> inservices for staff; to become more involved with being present at

support

> groups and f/u of pt calls/emails.

>

> - if anyone can think of anything else I could add to my case - I

would

> greatly appreciate your ideas!

>

> Many thanks in advance,

>

> LeBrun, MPH,RD

> Washington, DC

> 202.741.2422

>

[Guest guest]

We do 500 surgeries per year and have two full time dietitians, we also have psych, medical and physical therapists and dietitians see about twice the volume of other clinicians and MORE than pay for themselves (I have been working as dietitian and manager for the last couple months so I have looked at the numbers) I actually believe that COE does require nutrition pre-op although I don't know if they specify groups/individual but if you plan to do f/u and support groups and what not then you will need to be full time. Good luck.

Laschkewitsch RD LDDietitian, Legacy Obesity Institute(503) 413-8135

-----Original Message-----From: [mailto: ]On Behalf Of bradshawmsSent: Friday, June 06, 2008 12:43 PM Subject: Re: supporting fulltime bariatric nutritionists

Calire-I work full time soley bariatric surgery at out facility. We do an average of 200 surgeries (band and bypass) each year between 2 surgeons. I see all pts pre-op to determine if they are a candidate for surgery, and I see them at every f/u along with the surgeons. I do an education in-house right after surgery and I co-lead a once monthly support group. It think that you could definitely justify a full-time position. Good luck!>> I am looking for assistance in seeking a request to support the need for my> dept. hiring me fulltime.> > Currently, I am 20 hours FTE for a facilty that does over 300 WLS per year.> I think there are many other bariatric sites out there that support a FT RD> for less or equivalent surgeries per year. If you are at one of those,> please let me know how many hours you work (and if you have more than one> RD) in comparison to the # of surgeries your facility does. BTW, we are a> Centers of Excellence, so if anyone knows that this is mandated for a COE,> please let me know.> > I know many sites required a pre-surgical individual consult with the RD -> we only require it if insurance does, otherwise we only require a group> presentation that they are mandated to do after their surgery is scheduled,> three-four weeks prior to surgery. Is there any research out there that> supports my suggestion that all pts see me individually prior to surgery,> that can improve their outcome post-surgery? Are there any other thoughts> re: supporting me on this idea, as obviously this would increase my needed> hours.> > *Some other ways I plan to support my need for more hours are the following*:> to be more available for the 3 bariatric surgeons pts in f/u and for more> referrals from other surgeons; to initiate and become involved in more> bariatric research; develop more nutrition info. on our website; to do> inservices for staff; to become more involved with being present at support> groups and f/u of pt calls/emails.> > - if anyone can think of anything else I could add to my case - I would> greatly appreciate your ideas!> > Many thanks in advance,> > LeBrun, MPH,RD> Washington, DC> 202.741.2422>

[Guest guest]

We do 300-400 surgeries per year with one

surgeon. I saw all pre-op pts for an initial consult (~ 45 min) then more

appts if needed (~30 min). All approved candidates then return for a 2hr

pre-op class about 2-3 wks prior to surgery. I also assist with our 2 support

groups each month. I also manage our in-house supplement store. With just the

revenue from seeing pts pre-op/post-op I bring in over double what I cost our

business. Then of course the store brings in extra revenue to help fund other

projects. We also have an exercise physiologist and counselor on staff

full-time. It definitely can be sustained from the practice, and in my opinion,

is necessary to really help change the patients’ lifestyles.

K. Mackie, MS, RD, LDN

Southeast Bariatrics, P.A.

2300-A Randolph Road

Charlotte, NC 28207

(704) 347-4144 x 214

hmackie@...

www.southeastbariatrics.com

From:

[mailto: ]

On Behalf Of Laschkwitsch,

:LPH Obes Inst

Sent: Friday, June 06, 2008 4:22

PM

Subject: RE:

Re: supporting fulltime bariatric nutritionists

We do 500 surgeries per year and have two

full time dietitians, we also have psych, medical and physical therapists and

dietitians see about twice the volume of other clinicians and MORE than pay for

themselves (I have been working as dietitian and manager for the last

couple months so I have looked at the numbers) I actually believe

that COE does require nutrition pre-op although I don't know if they specify

groups/individual but if you plan to do f/u and support groups and what not

then you will need to be full time. Good luck.

Laschkewitsch RD LD

Dietitian, Legacy Obesity Institute

(503) 413-8135

Re: supporting fulltime bariatric nutritionists

Calire-

I work full time soley bariatric surgery at out facility. We do an

average of 200 surgeries (band and bypass) each year between 2

surgeons. I see all pts pre-op to determine if they are a candidate

for surgery, and I see them at every f/u along with the surgeons. I

do an education in-house right after surgery and I co-lead a once

monthly support group. It think that you could definitely justify a

full-time position. Good luck!

>

> I am looking for assistance in seeking a request to support the

need for my

> dept. hiring me fulltime.

>

> Currently, I am 20 hours FTE for a facilty that does over 300 WLS

per year.

> I think there are many other bariatric sites out there that support

a FT RD

> for less or equivalent surgeries per year. If you are at one of

those,

> please let me know how many hours you work (and if you have more

than one

> RD) in comparison to the # of surgeries your facility does. BTW,

we are a

> Centers of Excellence, so if anyone knows that this is mandated for

a COE,

> please let me know.

>

> I know many sites required a pre-surgical individual consult with

the RD -

> we only require it if insurance does, otherwise we only require a

group

> presentation that they are mandated to do after their surgery is

scheduled,

> three-four weeks prior to surgery. Is there any research out there

that

> supports my suggestion that all pts see me individually prior to

surgery,

> that can improve their outcome post-surgery? Are there any other

thoughts

> re: supporting me on this idea, as obviously this would increase my

needed

> hours.

>

> *Some other ways I plan to support my need for more hours are the

following*:

> to be more available for the 3 bariatric surgeons pts in f/u and

for more

> referrals from other surgeons; to initiate and become involved in

more

> bariatric research; develop more nutrition info. on our website; to

do

> inservices for staff; to become more involved with being present at

support

> groups and f/u of pt calls/emails.

>

> - if anyone can think of anything else I could add to my case - I

would

> greatly appreciate your ideas!

>

> Many thanks in advance,

>

> LeBrun, MPH,RD

> Washington, DC

> 202.741.2422

>

[Guest guest]

Would you mind sharing whether you file insurance for classes and

seeing pts one on one or does the pt self pay. I also understand some

surgeons or hospitals charge an education fee at the time of surgery .

I understand that the store would also provide funds . Thanks for any

info.

Helen Ramsey RD,LD,CDE

> >

> > I am looking for assistance in seeking a request to support the

> need for my

> > dept. hiring me fulltime.

> >

> > Currently, I am 20 hours FTE for a facilty that does over 300 WLS

> per year.

> > I think there are many other bariatric sites out there that support

> a FT RD

> > for less or equivalent surgeries per year. If you are at one of

> those,

> > please let me know how many hours you work (and if you have more

> than one

> > RD) in comparison to the # of surgeries your facility does. BTW,

> we are a

> > Centers of Excellence, so if anyone knows that this is mandated for

> a COE,

> > please let me know.

> >

> > I know many sites required a pre-surgical individual consult with

> the RD -

> > we only require it if insurance does, otherwise we only require a

> group

> > presentation that they are mandated to do after their surgery is

> scheduled,

> > three-four weeks prior to surgery. Is there any research out there

> that

> > supports my suggestion that all pts see me individually prior to

> surgery,

> > that can improve their outcome post-surgery? Are there any other

> thoughts

> > re: supporting me on this idea, as obviously this would increase my

> needed

> > hours.

> >

> > *Some other ways I plan to support my need for more hours are the

> following*:

> > to be more available for the 3 bariatric surgeons pts in f/u and

> for more

> > referrals from other surgeons; to initiate and become involved in

> more

> > bariatric research; develop more nutrition info. on our website; to

> do

> > inservices for staff; to become more involved with being present at

> support

> > groups and f/u of pt calls/emails.

> >

> > - if anyone can think of anything else I could add to my case - I

> would

> > greatly appreciate your ideas!

> >

> > Many thanks in advance,

> >

> > LeBrun, MPH,RD

> > Washington, DC

> > 202.741.2422

> >

>

[Guest guest]

Based on what I've heard from everybody, it sounds like most bariatric programs have a mandatory individual nutrition assessment before approval for surgery, then at least followed -up with a mandatory pre-surgical group (3-4 weeks prior to surgery) where you would discuss both the bariatric pre and post-surgical diets. So this is what I'm thinking of proposing necessary to bring me on fulltime and the charges acrude from these appear to more than pay my salary. For those of you willing to share charges for both individual and group visits with the RD, please email or call me individually.

To answer Helen's question: We bill insurance (after calling the co. to make sure it's a covered bene for each pt.) only for the individual RD visits. We have the pt pay out-of-pocket for the pre-surgical nutrition group (but will certainly supply them the paperwork for them to seek reimb.) and we charge enough to cover the cost of 2 nutrition f/u's in this fee, to easily wrap that visit with the f/u MD visit and to not have to charge the pt more after surgery, when they're less willing to pay.

Are there any other formats (that would include more necessary RD appts.) out there that people are willing to share with me or any other ways I can add my services to create more income?

thanks,

Washington,DC

202.741.2422

On 6/11/08, helenramsey49 <rdrone@...> wrote:

Would you mind sharing whether you file insurance for classes andseeing pts one on one or does the pt self pay. I also understand somesurgeons or hospitals charge an education fee at the time of surgery .

I understand that the store would also provide funds . Thanks for anyinfo.Helen Ramsey RD,LD,CDE> >> > I am looking for assistance in seeking a request to support the> need for my> > dept. hiring me fulltime.> >> > Currently, I am 20 hours FTE for a facilty that does over 300 WLS

> per year.> > I think there are many other bariatric sites out there that support> a FT RD> > for less or equivalent surgeries per year. If you are at one of> those,> > please let me know how many hours you work (and if you have more

> than one> > RD) in comparison to the # of surgeries your facility does. BTW,> we are a> > Centers of Excellence, so if anyone knows that this is mandated for> a COE,> > please let me know.

> >> > I know many sites required a pre-surgical individual consult with> the RD -> > we only require it if insurance does, otherwise we only require a> group> > presentation that they are mandated to do after their surgery is

> scheduled,> > three-four weeks prior to surgery. Is there any research out there> that> > supports my suggestion that all pts see me individually prior to> surgery,> > that can improve their outcome post-surgery? Are there any other

> thoughts> > re: supporting me on this idea, as obviously this would increase my> needed> > hours.> >> > *Some other ways I plan to support my need for more hours are the

> following*:> > to be more available for the 3 bariatric surgeons pts in f/u and> for more> > referrals from other surgeons; to initiate and become involved in> more> > bariatric research; develop more nutrition info. on our website; to

> do> > inservices for staff; to become more involved with being present at> support> > groups and f/u of pt calls/emails.> >> > - if anyone can think of anything else I could add to my case - I

> would> > greatly appreciate your ideas!> >> > Many thanks in advance,> >> > LeBrun, MPH,RD> > Washington, DC> > 202.741.2422> >

>

[Guest guest]

,

Thanks so much for your response - I really appreciate it. I apologize for my delayed response! thanks again,

On 6/6/08, Laschkwitsch, :LPH Obes Inst <KLaschke@...> wrote:

We do 500 surgeries per year and have two full time dietitians, we also have psych, medical and physical therapists and dietitians see about twice the volume of other clinicians and MORE than pay for themselves (I have been working as dietitian and manager for the last couple months so I have looked at the numbers) I actually believe that COE does require nutrition pre-op although I don't know if they specify groups/individual but if you plan to do f/u and support groups and what not then you will need to be full time. Good luck.

Laschkewitsch RD LDDietitian, Legacy Obesity Institute(503) 413-8135

-----Original Message-----From: [mailto: ]On Behalf Of bradshawms

Sent: Friday, June 06, 2008 12:43 PM Subject: Re: supporting fulltime bariatric nutritionists

Calire-I work full time soley bariatric surgery at out facility. We do an average of 200 surgeries (band and bypass) each year between 2 surgeons. I see all pts pre-op to determine if they are a candidate

for surgery, and I see them at every f/u along with the surgeons. I do an education in-house right after surgery and I co-lead a once monthly support group. It think that you could definitely justify a full-time position. Good luck!

>> I am looking for assistance in seeking a request to support the

need for my> dept. hiring me fulltime.> > Currently, I am 20 hours FTE for a facilty that does over 300 WLS per year.> I think there are many other bariatric sites out there that support

a FT RD> for less or equivalent surgeries per year. If you are at one of those,> please let me know how many hours you work (and if you have more than one> RD) in comparison to the # of surgeries your facility does. BTW,

we are a> Centers of Excellence, so if anyone knows that this is mandated for a COE,> please let me know.> > I know many sites required a pre-surgical individual consult with the RD -

> we only require it if insurance does, otherwise we only require a group> presentation that they are mandated to do after their surgery is scheduled,> three-four weeks prior to surgery. Is there any research out there

that> supports my suggestion that all pts see me individually prior to surgery,> that can improve their outcome post-surgery? Are there any other thoughts> re: supporting me on this idea, as obviously this would increase my

needed> hours.> > *Some other ways I plan to support my need for more hours are the following*:> to be more available for the 3 bariatric surgeons pts in f/u and for more> referrals from other surgeons; to initiate and become involved in

more> bariatric research; develop more nutrition info. on our website; to do> inservices for staff; to become more involved with being present at support> groups and f/u of pt calls/emails.

> > - if anyone can think of anything else I could add to my case - I would> greatly appreciate your ideas!> > Many thanks in advance,> > LeBrun, MPH,RD> Washington, DC

> 202.741.2422>

[Guest guest]

, I really appreciate your response to my question - your imput was very valuable. i apologize for my delayed response.. would you mind telling me if you have a program fee that covers the cost of all your aftercare (other than surgeon f/u) for your allied health and what that fee is per pt.?

thanks again,

On Fri, Jun 6, 2008 at 4:48 PM, Kennedy <hmackie@...> wrote:

We do 300-400 surgeries per year with one surgeon. I saw all pre-op pts for an initial consult (~ 45 min) then more appts if needed (~30 min). All approved candidates then return for a 2hr pre-op class about 2-3 wks prior to surgery. I also assist with our 2 support groups each month. I also manage our in-house supplement store. With just the revenue from seeing pts pre-op/post-op I bring in over double what I cost our business. Then of course the store brings in extra revenue to help fund other projects. We also have an exercise physiologist and counselor on staff full-time. It definitely can be sustained from the practice, and in my opinion, is necessary to really help change the patients' lifestyles.

K. Mackie, MS, RD, LDN

Southeast Bariatrics, P.A.

2300-A Randolph Road

Charlotte, NC 28207

(704) 347-4144 x 214

hmackie@...

www.southeastbariatrics.com

From: [mailto: ] On Behalf Of Laschkwitsch, :LPH Obes Inst

Sent: Friday, June 06, 2008 4:22 PM

Subject: RE: Re: supporting fulltime bariatric nutritionists

We do 500 surgeries per year and have two full time dietitians, we also have psych, medical and physical therapists and dietitians see about twice the volume of other clinicians and MORE than pay for themselves (I have been working as dietitian and manager for the last couple months so I have looked at the numbers) I actually believe that COE does require nutrition pre-op although I don't know if they specify groups/individual but if you plan to do f/u and support groups and what not then you will need to be full time. Good luck.

Laschkewitsch RD LDDietitian, Legacy Obesity Institute(503) 413-8135

Re: supporting fulltime bariatric nutritionists

Calire-I work full time soley bariatric surgery at out facility. We do an average of 200 surgeries (band and bypass) each year between 2

surgeons. I see all pts pre-op to determine if they are a candidate for surgery, and I see them at every f/u along with the surgeons. I do an education in-house right after surgery and I co-lead a once monthly support group. It think that you could definitely justify a

full-time position. Good luck!

>> I am looking for assistance in seeking a request to support the need for my> dept. hiring me fulltime.> > Currently, I am 20 hours FTE for a facilty that does over 300 WLS per year.

> I think there are many other bariatric sites out there that support a FT RD> for less or equivalent surgeries per year. If you are at one of those,> please let me know how many hours you work (and if you have more

than one> RD) in comparison to the # of surgeries your facility does. BTW, we are a> Centers of Excellence, so if anyone knows that this is mandated for a COE,> please let me know.>

> I know many sites required a pre-surgical individual consult with the RD -> we only require it if insurance does, otherwise we only require a group> presentation that they are mandated to do after their surgery is

scheduled,> three-four weeks prior to surgery. Is there any research out there that> supports my suggestion that all pts see me individually prior to surgery,> that can improve their outcome post-surgery? Are there any other

thoughts> re: supporting me on this idea, as obviously this would increase my needed> hours.> > *Some other ways I plan to support my need for more hours are the following*:> to be more available for the 3 bariatric surgeons pts in f/u and

for more> referrals from other surgeons; to initiate and become involved in more> bariatric research; develop more nutrition info. on our website; to do> inservices for staff; to become more involved with being present at

support> groups and f/u of pt calls/emails.> > - if anyone can think of anything else I could add to my case - I would> greatly appreciate your ideas!> > Many thanks in advance,

> > LeBrun, MPH,RD> Washington, DC> 202.741.2422>

[Guest guest]

, i really appreciate your response to my question below - sorry for the delayed response. do you mind sharing with me if you have a program fee for the pt to defray some of your allied health aftercare (like your f/u's with the pt.) and what that fee is? Where in VA are you - Are you at UVA?

thanks,

On Fri, Jun 6, 2008 at 3:42 PM, bradshawms <msb5d@...> wrote:

Calire-I work full time soley bariatric surgery at out facility. We do an average of 200 surgeries (band and bypass) each year between 2 surgeons. I see all pts pre-op to determine if they are a candidate

for surgery, and I see them at every f/u along with the surgeons. I do an education in-house right after surgery and I co-lead a once monthly support group. It think that you could definitely justify a full-time position. Good luck!

>> I am looking for assistance in seeking a request to support the need for my> dept. hiring me fulltime.> > Currently, I am 20 hours FTE for a facilty that does over 300 WLS

per year.> I think there are many other bariatric sites out there that support a FT RD> for less or equivalent surgeries per year. If you are at one of those,> please let me know how many hours you work (and if you have more

than one> RD) in comparison to the # of surgeries your facility does. BTW, we are a> Centers of Excellence, so if anyone knows that this is mandated for a COE,> please let me know.>

> I know many sites required a pre-surgical individual consult with the RD -> we only require it if insurance does, otherwise we only require a group> presentation that they are mandated to do after their surgery is

scheduled,> three-four weeks prior to surgery. Is there any research out there that> supports my suggestion that all pts see me individually prior to surgery,> that can improve their outcome post-surgery? Are there any other

thoughts> re: supporting me on this idea, as obviously this would increase my needed> hours.> > *Some other ways I plan to support my need for more hours are the following*:> to be more available for the 3 bariatric surgeons pts in f/u and

for more> referrals from other surgeons; to initiate and become involved in more> bariatric research; develop more nutrition info. on our website; to do> inservices for staff; to become more involved with being present at

support> groups and f/u of pt calls/emails.> > - if anyone can think of anything else I could add to my case - I would> greatly appreciate your ideas!> > Many thanks in advance,

> > LeBrun, MPH,RD> Washington, DC> 202.741.2422>

[Guest guest]

-

We do not have a program fee. I'm not exactly sure where my salary

comes from....either revenue from the surgeries or just budgeted

through the dept of surgery. And I am at UVA.

> > >

> > > I am looking for assistance in seeking a request to support the

> > need for my

> > > dept. hiring me fulltime.

> > >

> > > Currently, I am 20 hours FTE for a facilty that does over 300

WLS

> > per year.

> > > I think there are many other bariatric sites out there that

support

> > a FT RD

> > > for less or equivalent surgeries per year. If you are at one of

> > those,

> > > please let me know how many hours you work (and if you have more

> > than one

> > > RD) in comparison to the # of surgeries your facility does. BTW,

> > we are a

> > > Centers of Excellence, so if anyone knows that this is mandated

for

> > a COE,

> > > please let me know.

> > >

> > > I know many sites required a pre-surgical individual consult

with

> > the RD -

> > > we only require it if insurance does, otherwise we only require

a

> > group

> > > presentation that they are mandated to do after their surgery is

> > scheduled,

> > > three-four weeks prior to surgery. Is there any research out

there

> > that

> > > supports my suggestion that all pts see me individually prior to

> > surgery,

> > > that can improve their outcome post-surgery? Are there any other

> > thoughts

> > > re: supporting me on this idea, as obviously this would

increase my

> > needed

> > > hours.

> > >

> > > *Some other ways I plan to support my need for more hours are

the

> > following*:

> > > to be more available for the 3 bariatric surgeons pts in f/u and

> > for more

> > > referrals from other surgeons; to initiate and become involved

in

> > more

> > > bariatric research; develop more nutrition info. on our

website; to

> > do

> > > inservices for staff; to become more involved with being

present at

> > support

> > > groups and f/u of pt calls/emails.

> > >

> > > - if anyone can think of anything else I could add to my case -

I

> > would

> > > greatly appreciate your ideas!

> > >

> > > Many thanks in advance,

> > >

> > > LeBrun, MPH,RD

> > > Washington, DC

> > > 202.741.2422

> > >

> >

> >

> >

>