Guest guest Posted June 29, 2001 Report Share Posted June 29, 2001 Guess What I Just Learned About Dr. Pories? He's the President-Elect of the ASBS!! I thinks this is not good news at all. Especially if it is a fact that he is totally against the DS. Remember the unsubstantiated claim that the ASBS surgeons are going to be doing the DS less in the future? Well, perhaps this rumor somehow was based on Dr. Pories' POV. The sad thing is surgeons rarely change their POV due to inherent arrogance. Below is a letter I sent the Executive Director of the ASBS and her mind blowing reply. By the way, the fact that she forwarded my own email on to the insurance committee could possibly mean that there may be a way to put our own power together with that of the ASBS to fight insurance companies. Hi ann; The folks on the various lists have definitely been busy the last few days. Someone has come up with a letter from Dr. Pories dated March of this year, where he is using Dr. Hess' own report as proof that the BPD/DS is not considered to be safe or effective! Do you know this Dr. Pories? He is apparently a professor of surgery at Eastern Carolina University. The members of several groups are banding together with two purposes. One is to challenge Blue Cross which has started denying coverage for the DS on policies which cover Bariatric Surgery. I am part of this group. I have Blue Cross but am fortunate in that my coverage is through the Federal Government and 'rumor has it' that Federal Blue will still cover the DS because Medicare does. Another group is getting ready to take on their own State Legislatures. They are trying to get laws passed making it illegal for health insurance companies to exclude treatment for morbid obesity. I am personally interested in both efforts but my own background is insurance. I personally think that health insurance companies do not demonstrate an ethical model for private citizens to be dealing with. It has been very important to me to try and help each pre-op patient I can, but it's also been frustrating. I am hoping to devote myself to this full time after I've had a chance to recover from my own upcoming surgery on July 9. If there is any news or any way that the people I'm in touch with can support any efforts of ASBS will you please let me know? Most folks try to follow the news of your organization. Sincerely, Melinda on 6/29/01 9:51 AM, MalloryGN@... at MalloryGN@... wrote: Dear Melinda, I do know Dr. Pories. He is our president elect and will take office in June of next year. Is this letter posted somewhere? There are states that have enacted laws making it mandatory to cover bariatric surgery however in the case of Indiana, their requirements are so stringent that it is rare that anyone can \meet the criteria. I believe one of the things they require is that the person has documentation that they have been under a medically supervised diet for 18 months! I am forwarding your e-mail to the chair of our insurance committee. Sincerely, ann Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 29, 2001 Report Share Posted June 29, 2001 Gobo, You are the best - good for you for going after this the way you are. You are an inspiration! Blessings Dina in Aloha, OR Age 37/BMI 61 Waiting for my consult with Dr. Hoping my new insurance will cover it all.... Dr Pories & the ASBS Guess What I Just Learned About Dr. Pories? He's the President-Elect of the ASBS!! I thinks this is not good news at all. Especially if it is a fact that he is totally against the DS. Remember the unsubstantiated claim that the ASBS surgeons are going to be doing the DS less in the future? Well, perhaps this rumor somehow was based on Dr. Pories' POV. The sad thing is surgeons rarely change their POV due to inherent arrogance. Below is a letter I sent the Executive Director of the ASBS and her mind blowing reply. By the way, the fact that she forwarded my own email on to the insurance committee could possibly mean that there may be a way to put our own power together with that of the ASBS to fight insurance companies. Hi ann; The folks on the various lists have definitely been busy the last few days. Someone has come up with a letter from Dr. Pories dated March of this year, where he is using Dr. Hess' own report as proof that the BPD/DS is not considered to be safe or effective! Do you know this Dr. Pories? He is apparently a professor of surgery at Eastern Carolina University. The members of several groups are banding together with two purposes. One is to challenge Blue Cross which has started denying coverage for the DS on policies which cover Bariatric Surgery. I am part of this group. I have Blue Cross but am fortunate in that my coverage is through the Federal Government and 'rumor has it' that Federal Blue will still cover the DS because Medicare does. Another group is getting ready to take on their own State Legislatures. They are trying to get laws passed making it illegal for health insurance companies to exclude treatment for morbid obesity. I am personally interested in both efforts but my own background is insurance. I personally think that health insurance companies do not demonstrate an ethical model for private citizens to be dealing with. It has been very important to me to try and help each pre-op patient I can, but it's also been frustrating. I am hoping to devote myself to this full time after I've had a chance to recover from my own upcoming surgery on July 9. If there is any news or any way that the people I'm in touch with can support any efforts of ASBS will you please let me know? Most folks try to follow the news of your organization. Sincerely, Melinda on 6/29/01 9:51 AM, MalloryGN@... at MalloryGN@... wrote: Dear Melinda, I do know Dr. Pories. He is our president elect and will take office in June of next year. Is this letter posted somewhere? There are states that have enacted laws making it mandatory to cover bariatric surgery however in the case of Indiana, their requirements are so stringent that it is rare that anyone can \meet the criteria. I believe one of the things they require is that the person has documentation that they have been under a medically supervised diet for 18 months! I am forwarding your e-mail to the chair of our insurance committee. Sincerely, ann ---------------------------------------------------------------------- Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 29, 2001 Report Share Posted June 29, 2001 Why is this such a mind-blowing reply? ASBS is actively interested in the issue (I know since I am a member of the Insurance committee and I chair a subcommittee dealing with this very issue!) and they are working very hard at SCIENTIFICALLY addressing all bariatric surgery issues, including the DS. We've been working on it for several years. C'mon folks - let's not get carried away with who the enemy is here - it's not Dr. Pories - it's not ASBS - it's an absence of information used by deliberately ignorant insurers to deny access to something you want in an effort to direct you to something you don't want! THEY are the focus......take a deep breath now.....and keep focus. This is true. One thing our society has developed is the attitude that it's okay to be anorexic or bulemic but it's not okay to be fat. No one questions all the money spent on them for mental and physcial care which I'm sure adds up to far more than our surgery will. I find it rather absurd that insurance is allowed to pay their administrators huge salaries and bonuses, build beautiful expensive new buildings and then say they can't afford to pay for things. How do they justify the 500 a month it costs right now for my meds and the 110 for my therapy when after "I" pay for my surgery they will probably only have the therapy left for a time. It's so nice of me to pay for them to get the break. It also is terrible when I can get better coverage being on welfare than I can working and paying taxes. Something is very wrong here...and I'm not done fighting BC in Washington..I'm not going away yet...my dr said he'd help me but only if I keep fighting! So what has to be the first step to make the insurance see that this is not outdated, uncalled for or unneeded treatment, nor is it fair to do for one end of the spectrum and not the other.? ~~* AJ *~~ BMI 59 Surgery date 7/24/01 going self pay - Dr Baltasar Spain Check out the Bellingham Support for WLS WWW.lookin2bthin.homestead.com Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 29, 2001 Report Share Posted June 29, 2001 Why is this such a mind-blowing reply? ASBS is actively interested in the issue (I know since I am a member of the Insurance committee and I chair a subcommittee dealing with this very issue!) and they are working very hard at SCIENTIFICALLY addressing all bariatric surgery issues, including the DS. We've been working on it for several years. C'mon folks - let's not get carried away with who the enemy is here - it's not Dr. Pories - it's not ASBS - it's an absence of information used by deliberately ignorant insurers to deny access to something you want in an effort to direct you to something you don't want! THEY are the focus......take a deep breath now.....and keep focus. Walter Lindstrom, Jr., Esquire Obesity Law & Advocacy Center www.obesitylaw.com 2939 Alta View Drive, Suite O-360 San Diego, CA 92139 Tel: Fax: Dr Pories & the ASBS > Guess What I Just Learned About Dr. Pories? > He's the President-Elect of the ASBS!! > > I thinks this is not good news at all. Especially if it is a fact > that he is totally against the DS. Remember the unsubstantiated > claim that the ASBS surgeons are going to be doing the DS less > in the future? Well, perhaps this rumor somehow was based on > Dr. Pories' POV. > > The sad thing is surgeons rarely change their POV due to > inherent arrogance. Below is a letter I sent the Executive Director > of the ASBS and her mind blowing reply. > > By the way, the fact that she forwarded my own email on to the > insurance committee could possibly mean that there may be a > way to put our own power together with that of the ASBS to fight > insurance companies. > > Hi ann; > > The folks on the various lists have definitely been busy the last > few days. Someone has come up with a letter from Dr. Pories > dated March of this year, where he is using Dr. Hess' own report > as proof that the BPD/DS is not considered to be safe or > effective! > > Do you know this Dr. Pories? He is apparently a professor of > surgery at Eastern Carolina University. > > The members of several groups are banding together with two > purposes. One is to challenge Blue Cross which has started > denying coverage for the DS on policies which cover Bariatric > Surgery. I am part of this group. I have Blue Cross but am > fortunate in that my coverage is through the Federal Government > and 'rumor has it' that Federal Blue will still cover the DS > because Medicare does. > > Another group is getting ready to take on their own State > Legislatures. They are trying to get laws passed making it illegal > for health insurance companies to exclude treatment for morbid > obesity. > > I am personally interested in both efforts but my own background > is insurance. I personally think that health insurance companies > do not demonstrate an ethical model for private citizens to be > dealing with. It has been very important to me to try and help > each pre-op patient I can, but it's also been frustrating. I am > hoping to devote myself to this full time after I've had a chance to > recover from my own upcoming surgery on July 9. > > If there is any news or any way that the people I'm in touch with > can support any efforts of ASBS will you please let me know? > Most folks try to follow the news of your organization. > > Sincerely, > Melinda > > > on 6/29/01 9:51 AM, MalloryGN@... at MalloryGN@... > wrote: > > Dear Melinda, > > I do know Dr. Pories. He is our president elect and will take > office in June of next year. Is this letter posted somewhere? > > There are states that have enacted laws making it mandatory to > cover bariatric surgery however in the case of Indiana, their > requirements are so stringent that it is rare that anyone can > \meet the criteria. I believe one of the things they require is that > the person has documentation that they have been under a > medically supervised diet for 18 months! > > I am forwarding your e-mail to the chair of our insurance > committee. > > Sincerely, > > ann > > > > ---------------------------------------------------------------------- > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 29, 2001 Report Share Posted June 29, 2001 Dear Group, I agree with Walter's point. It is the insurance industries misuse of information that is the most agregious. I do wonder if Dr. Pories stops to ponder how profound the impact of just a few of his words are. FYI, I have read the Aetna policy bulliten very carefully and it seems to echo Dr. Witgrove's website almost (but not quite) verbatum. I think we all know how much weight he carries as well. Interestingly, Dr. Witgrove (and associate) have done 400 BPD procedures in the past (no BPD/DS). There main concern seems to be regarding patient compliance with followups. In their own study on Lap RNY they only had an 80% followup rate (rather abysmal I would say). I belive that a patients motiviation for followup should be part of the patient selection criteria for BPD/DS. A patient that is not able or willing to keep vigilint on nutrition would suffer greatly. I think those of us who regularly monitor this group have proven that we are motivated enough to qualify for BPD/DS. I can imagine others out there who shouldn't be treated with it. BUT - patient selection criteria is vastly different from determination as to if a procedure is experimental. I don't see any such declaration from Dr. Wittgrove. It seems the insurance companies have taken a bit of a leap (and Dr. Pories has- perhaps unwittingly - helped them along). Hull > > > > Dear Melinda, > > > > I do know Dr. Pories. He is our president elect and will take > > office in June of next year. Is this letter posted somewhere? > > > > There are states that have enacted laws making it mandatory to > > cover bariatric surgery however in the case of Indiana, their > > requirements are so stringent that it is rare that anyone can > > \meet the criteria. I believe one of the things they require is that > > the person has documentation that they have been under a > > medically supervised diet for 18 months! > > > > I am forwarding your e-mail to the chair of our insurance > > committee. > > > > Sincerely, > > > > ann > > > > > > > > ------------------------------------------------------------------ ---- > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 29, 2001 Report Share Posted June 29, 2001 Walter; I am so glad to know that you are on the Insurance Committee. It's good to know that one of our heros is there trying to get what's best for all. However, I am sorry if I misled you about pointing fingers at enemies. I don't for a second consider the ASBS to be our enemy. On the contrary, I think of them as championing our cause. The mind blower was discovering that a man who is patently against the BPD/DS will head up the ASBS. My concern is that this organization will have at the helm, someone who doesn't appear to be open-minded or objective. My reaction is that this is sort of like having a fox voted president of the hen house. My impression is that he will not favor any activities in support of this particular surgery. regards, gobo > > > > Dear Melinda, > > > > I do know Dr. Pories. He is our president elect and will take > > office in June of next year. Is this letter posted somewhere? > > > > There are states that have enacted laws making it mandatory to > > cover bariatric surgery however in the case of Indiana, their > > requirements are so stringent that it is rare that anyone can > > \meet the criteria. I believe one of the things they require is that > > the person has documentation that they have been under a > > medically supervised diet for 18 months! > > > > I am forwarding your e-mail to the chair of our insurance > > committee. > > > > Sincerely, > > > > ann > > > > > > > > ---------------------------------------------- ------------------------ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 30, 2001 Report Share Posted June 30, 2001 Gobo: Your fear is completely misplaced. Dr. Pories is a well-respected scientist who is very interested in studying, indexing and documenting proven results. He is the leader in setting up a national registry for bariatric surgery, hopefully funded by NIH, which will allow tracking of results based on, among other things, procedure type. Do not think for a moment that he isn't interested in this being a " better mousetrap " .....he is interested in proving scientifically that it is (or is not) an equal (or better) and safe way to do bariatric surgery. Walter Lindstrom, Jr., Esquire Obesity Law & Advocacy Center www.obesitylaw.com 2939 Alta View Drive, Suite O-360 San Diego, CA 92139 Tel: Fax: Re: Dr Pories & the ASBS > Walter; > > I am so glad to know that you are on the Insurance Committee. > It's good to know that one of our heros is there trying to get > what's best for all. > > However, I am sorry if I misled you about pointing fingers at > enemies. I don't for a second consider the ASBS to be our > enemy. On the contrary, I think of them as championing our > cause. > > The mind blower was discovering that a man who is patently > against the BPD/DS will head up the ASBS. My concern is that > this organization will have at the helm, someone who doesn't > appear to be open-minded or objective. My reaction is that this is > sort of like having a fox voted president of the hen house. > > My impression is that he will not favor any activities in support of > this particular surgery. > > regards, > gobo > > > > > > > > Dear Melinda, > > > > > > I do know Dr. Pories. He is our president elect and will take > > > office in June of next year. Is this letter posted somewhere? > > > > > > There are states that have enacted laws making it mandatory > to > > > cover bariatric surgery however in the case of Indiana, their > > > requirements are so stringent that it is rare that anyone can > > > \meet the criteria. I believe one of the things they require is > that > > > the person has documentation that they have been under a > > > medically supervised diet for 18 months! > > > > > > I am forwarding your e-mail to the chair of our insurance > > > committee. > > > > > > Sincerely, > > > > > > ann > > > > > > > > > > > > ---------------------------------------------- > ------------------------ > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted June 30, 2001 Report Share Posted June 30, 2001 Walter; Thanks for setting me straight. gobo > Gobo: Your fear is completely misplaced. Dr. Pories is a well-respected > scientist who is very interested in studying, indexing and documenting > proven results. He is the leader in setting up a national registry for > bariatric surgery, hopefully funded by NIH, which will allow tracking of > results based on, among other things, procedure type. Do not think for a > moment that he isn't interested in this being a " better mousetrap " .....he is > interested in proving scientifically that it is (or is not) an equal (or > better) and safe way to do bariatric surgery. > Walter Lindstrom, Jr., Esquire > Obesity Law & Advocacy Center > www.obesitylaw.com > 2939 Alta View Drive, Suite O-360 > San Diego, CA 92139 > Tel: > Fax: > Re: Dr Pories & the ASBS > > > > Walter; > > > > I am so glad to know that you are on the Insurance Committee. > > It's good to know that one of our heros is there trying to get > > what's best for all. > > > > However, I am sorry if I misled you about pointing fingers at > > enemies. I don't for a second consider the ASBS to be our > > enemy. On the contrary, I think of them as championing our > > cause. > > > > The mind blower was discovering that a man who is patently > > against the BPD/DS will head up the ASBS. My concern is that > > this organization will have at the helm, someone who doesn't > > appear to be open-minded or objective. My reaction is that this is > > sort of like having a fox voted president of the hen house. > > > > My impression is that he will not favor any activities in support of > > this particular surgery. > > > > regards, > > gobo > > Quote Link to comment Share on other sites More sharing options...
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