Re: Question about Surgeons

[Guest guest]

Hi ,

> >

> Hi- This question is going to be strange, because I am sure most

> post-ops generally feel the surgeon they went to was the best, but I

> was just wondering who is considered the best DS surgeon in the

> United States?

I don't think the question is strange at all, I only wish there could be some

way of answering it. As you yourself say - most people feel their surgeon was

the best, and that's a good thing, because it shows that there are a lot of

highly qualified surgeons out there who are doing so much to help people

transform their lives.

>

> Also, how do I tract down the surgical record for a surgeon. Like

> how many, if any, deaths they have had. Where they went to college

> and got their residency? How long have they performed DS surgery and

> how many patients have they had. If they perform Lap, how many?

> Questions like these. I appreciate any information you are willing

> to provide.

Most people who decide to go for BPD/DS settle in with the " family " at the

duodenalswitch site, but there is a lot of useful information at

www.obesityhelp.com, especially in terms of getting information about doctors.

You can search for a specific doctor and see all the comments that his or her

patients have written about their experience - many BPD/DSers also write in.

Besides reading people's personal experiences, you'll find lots of info on each

doctor's page including the procedures performed, the types of insurance that

people have used, contact information, and a link to the medical boards in the

doctor's state. I'm not sure if each state board discloses the same type of

information, but I'm sure they're similar.

At the state boards' websites, you can probably get basic info about specific

surgeons - license, date first licensed, perhaps info re professional training,

address. You will also be able to see if there was ever any action taken to

discipline the doctor - in other words, claims to the state board that resulted

in some action. Even if you find such information, though, it may not give you

many details - but knowing that it exists may spur you to seek additional

information. obesityhelp.com has a library filled with many different categories

of extremely helpful information, even if it's not totally up-to-date re the

specifics of BPD/DS (and that's an understatement).

Many doctors post their CVs on their own websites. In other cases, the hospital

may have a page with the doctor's CV. A lot of doctors run support groups,

similar to this - many of them here at yahoo. I know that Dr. Welker has a group

at yahoo, and I'm sure others do as well. I'm subscribed to Dr. Gagner's group,

but I get the feeling that no one likes to leave " home " (this group right

here!!) - because all I ever get from them is announcements of support group

meetings. Other doctors run support groups from their own websites. Many doctors

also run chat rooms from their websites. This will give you a great deal of

highly valuable anecdotal evidence; it's not the same as a report with

scientific authority, but listening to a lot of information can certainly give

you a sense of what's going on, help you formulate certain questions or issues

you want to clarify, etc.

Many doctors have published authoritative reports about their experience with

BPD/DS. For example, Dr. Hess' report covers the first 440 patients in the first

8 years that the procedure was done in his practice. His report gives

information on complications, mortality, etc. in that group of patients. There

are a lot of reports right at the duodenalswitch site - with direct links to

some individual reports, and then a link to a collection of studies found at the

PubMed site (65 reports, out of which 30+ are reports of procedures similar in

form to Dr. Hess' report; the others are studies that were done on other aspects

of BPD/DS, such as post-surgical nutritional profiles, psychological aspects of

post-op life, etc.). You can also go to PubMed and do a keyword search to find

other reports and abstracts. All of this will give you a lot of information

about a whole lot of surgeons who are doing BPD/DS - the year they began doing

the procedure, the number of patients (as of the date of the study),

effectiveness short and long term, complications short and long term, mortality,

etc.

You can read professional peer-reviewed publications, and check out websites of

professional associations such as the ASBS and the IFSO. One place to get great

information is www.amedeo.com. This is a free service (sponsored by a bunch of

pharmaceutical firms) that updates you once a week on any articles that were

published in the area you select. I checked off about 8 or 10 journals, general

and specifically about obesity, such as Lancet, New England Journal of Medicine,

Obesity Surgery, etc. - there are many more and it's very well categorized - and

each week I get an email with links to articles and abstracts published that

week. I don't see too much mention of this service, and I don't remember how I

found it, but I think it's a superb resource, because it's one-stop coverage of

all the professional journals available online.

I'm sure there are a lot of terrific doctors who are not as Internet-savvy as

others, and unfortunately in this day and age it may mean that the information

about them is not as readily available and within reach. So if you hear about a

doctor who may not have a lot of information on the 'net, don't rule her out

just because she isn't all over cyberspace. I'm sure that there are enough ways

to adequately evaluate the qualities of any doctor, but to tell you the truth, I

wouldn't be quite sure as to how it could be done as easily as with those

doctors who have information online. It's a shame, really, because they didn't

go to med school to learn how to run a website, so that isn't what we should use

to as a measure of their quality, but nowadays it's a real disadvantage not to

be online, especially in this area of practice.

All of these things are going to give you a volume of information as thick as a

New York City telephone book. Armed with this - you start asking the doctors

themselves. When you go for a consult, be forthright about every single issue

that concerns you. I may be naive, but I give people the benefit of the doubt:

unless they prove otherwise, I believe that people - surgeons or normal human

beings - conduct themselves with personal integrity and honesty in their

dealings with me, whether on a professional or personal basis. Still, whatever

they tell you, you can substantiate independently if you feel it's required.

From your question, I will assume that you will narrow the list down to the more

prominent surgeons, and in that case it will be even easier because there is

more extensive information available (which is not to say that the less

prominent surgeons are any less qualified, or that a limited amount of online

information about a doctor says anything at all about his skills as a

physician).

Be sure that you're drawing a line between information that is authoritative,

and information that is anecdotal. Both are very valuable types of information,

but they are very different, and the difference is crucial. I'm sure you realize

why. The authoritative information is the kind you will find in sources such as

studies published in places that impose certain standards of publication (like

peer-reviewed journals), or official governmental websites, officially published

data, and of course the hospitals and doctors' websites provide reliable

information that is certainly authoritative for that particular physician (you

may not agree with her procedure or way of doing things, but if she is the one

reporting it to you, you can rely on the fact that she is presenting her own

view accurately). The rest is anecdotal and subjective, whether the anecdote is

being related by a senior reporter for the New York Times, a superstar news

anchor doing a national TV story on obesity surgery, or one person describing

what happened on the day of her surgery.

I am learning this these days, as some acquaintances dig up all kinds of

articles from who knows where, and expect me to defend my decision based on

hearsay and gossip and a reporter's subjectivity. At some point I drew a line

and decided that I'm not going to debate issues based on the information in a

newspaper article, and I think there's even something offensive in assuming that

I would make such a critical decision - or back out of it - based on today's

newspaper or last night's TV news. I say " acquaintances " because everyone who

knows me well knows I have been devouring authoritative information for the past

few months, and they would never challenge me based on something read in a

newspaper article. You should also remember that the media, by nature, will seek

to report on controversial issues. That is an important and valuable function,

even when reporting on WLS, but by definition it means that resulted in

horrendous complications is more likely to be highlighted in the news than a

case that resulted in a person " simply " regaining good health and vitality and

happiness.

>

> Because BC/BS seems to be so difficult lately, I am trying to prepare

> myself for possibly doing this self-pay...

This is the kind of information you really should verify in terms of your own,

specific situation. Your health condition and your specific insurance policy are

the things that determine whether you will get coverage. If you qualify, I don't

see any reason why you shouldn't get coverage. I am saying this based on a

conversation I had yesterday (reported it onlist) with the insurance coordinator

for one of the leading doctors. He said that the determining factor (besides the

question of your medical condition) is whether your insurance policy has an

exclusion for this surgery for morbid obesity. Please bear in mind that

" obesity " is not the same medical condition as " morbid obesity " . Some policies

have an exclusion for surgery for " obesity " or for obesity surgery for cosmetic

reasons - but they do not exclude surgery for " morbid obesity " if the surgeon

proves that it is medically necessary. Each policy's wording must be carefully

reviewed. Before anything else, you have to be very cautious in learning your

specific policy's provisions.

HTH

Aviva

[Guest guest]

Aviva- Thank you so much for your insight and answers into my

questions. The time you spent offering such a well thought out and

informative response is vastly appreciated. You have given me much

food for thought. I have gone to many of the sites you mentioned,

but a couple of them are new to me, so I look forward to continuing

my research of surgeons. You mentioned not taking anecdotal

information on BC/BS and you are correct, I had fallen into the habit

of believing that if others were being denied insurance, I too would

be as well. I have looked into my policy and the wording does

suggest that I may have problems, but I need to remember that it will

be decided on a case by case basis. Thank you. As far as sugeons go

though, I agree that authoratative information is much more

important, but I was just trying to narrow my options if possible.

Thank you again for all the time you took to help me.

Take care,