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Re: CHOOSING A DOC

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Shirly,

Both of these Dr's have done a comparable number of surgeries (a

little more than 100). Dr. K is newer at the lap (just started), so

that could be a consideration if you want it done laprascopically.

Check if Dr. W has a " program fee " , Dr K's is $2000 (this is not

covered by insurance). Also, are they both in network?

Dr. K and his wife Dawn have been very helpful in swapping journal

papers with me for my " letter to Aetna " . They are both very kind.

They have setup a brand new wing in Delano with all single occupancy

rooms that are the size of double rooms. Dawn says that the hospital

has purchased all of the modern Bariatric equipment that Dr. K has

requested. Dr K's statistics are good, though he has not yet

published them.

I know less about Dr. Welker, but am anxious to find out. If he is

reponsive to my e-mail today than that will be a good sign. He has a

great reputation; however, one of the members on this list did die

after having surgery with Dr. W - I think it was a PE. He was a very

high risk patient.

I think that both of these suregons are top notch on patient care and

bedside manner, and have moderate experience.

If you are a revision or a super high risk patient then I think you

might want to consider more experienced suregons such as Anthone,

Rabkin, or Hess. If you are moderate risk then either of these

surgeons would make an excellent choice.

Read my posts on " The California Surgeons " a couple of weeks back. I

will update this post as soon as I learn more about Dr. Welker. Being

in Eugene he is practically in California, so I think a comparison

would be interesting.

Hull

> HELP ME DECIDE WHAT TO DO!!!!!!!!!!

>

> QUICKLY. Talk to me. I am trying to decide what to do. I have

narrowed my

> choice of surgeons down to two: Dr. Welker in Eugene, Oregon and Dr.

> Kisheshian in Delano, CA. I really need all the GOOD STUFF and the

BAD

> STUFF about both.

>

> I already have an appointment (I fly out on Thursday) with one but

the other

> seems like a good bet, also. Please let me know if you have

specifics. I

> already know they are both wonderful, nice men and talented

surgeons.

> Anything else???

> THANKS!

>

> ~Shirley in Arcata, CA

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> Anything else???

Hi Shirley:

I can't give you much info on either of the docs you're looking at,

BUT I have something you can use at your consultations to help

evaluate each one. It's my " Guide to Choosing a Surgeon, " which I'm

pasting in below. Just print a couple copies, take them along to the

consults, and ask each doc about each item.

HTH,

Tom

========================================

Many pre-ops are befuddled by the question of how to choose a

surgeon. To help out, I've written down my thoughts on the process I

went through to choose my surgeon. (Incidentally, my surgeon is Dr.

Anthone at the University of Southern California.) I've also

made sort of a form out of it. Feel free to use it as is, change it

in anyway you like, give it away, etc.

I hope you find this helpful.

Tom LaRussa

---------------------------------------

1. MEDICAL SCHOOL ATTENDED: ________________________________________

I look for docs who attended medical school either in the US or at a

well-respected school in western Europe or Australia/New Zealand.

Rationale: These are the best schools, and they therefore are

hardest to get into, and thus get the best students. (An argument

can be made for schools in former British Commonwealth countries, but

none of the surgeons I looked at attended such a school, so I didn't

have to deal with that issue.)

2. CHIEF RESIDENT?

YES NO (circle one)

I give preference to those surgeons who had been appointed as Chief

Resident during their residencies.

Rationale: Cream rises to the top. The chief resident is chosen by

the faculty as the best among that resident group. I want the best

working on me.

3. POST-RESIDENCY FELLOWSHIPS, ETC. ________________________________

_____________________________________________________________________

_____________________________________________________________________

Rationale: Again, the cream rises to the top, so winning a

competitive appointment to a post-residency fellowship is another big

plus. In particular, I like to see a surgical fellowship after the

residency because it indicates just that much more training and

practice under the eye of experts.

4. PROFESSIONAL CREDENTIALS

a. Is the surgeon certified by the American Board of Surgeons (or

its British equivalent)? <http://www.absurgery.org/home.html>

(NOTE: This is an absolute requirement! If the answer is NO, go no

further!)

YES NO (circle one)

Rationale: This is the basic, bottom line certification that

says, " You are now a surgeon. "

b. Is the surgeon a Fellow of the American College of Surgeons (or

one of the Royal Colleges of Surgeons in Commonwealth countries)?

<http://www.facs.org/index.html>

YES NO (circle one)

Rationale: Membership in the ACS, (denoted by the initials F.A.C.S.

after " MD " ), is voluntary, and requires recommendations from fellow

members, plus what amounts to an investigation of the surgeon's

practice history.

c. Is the surgeon a member of the American Society of Bariatric

Surgery?

YES NO (circle one)

Rationale: This is a professional/educational organization for

bariatric surgeons. If a bariatric surgeon were not a member, I

would certainly wonder why not. Don't they care about keeping up on

new developments?

5. SURGICAL PRACTICE Comments: _____________________________________

_____________________________________________________________________

_____________________________________________________________________

I prefer a surgeon who has practiced as a general surgeon for at

least a few years before starting to do bariatric surgery.

Rationale: I want a surgeon who is prepared to deal with any

eventuality, both in the OR and in the post-op period. I figure that

a few years practicing as a general surgeon gives them more exposure

to all the different kinds of problems that can crop up.

6. BARIATRIC PRACTICE

a. When, Where, and from Whom did they learn to perform the DS?

_____________________________________________________________________

_____________________________________________________________________

Rationale: I don't want a surgeon who learned how to do the DS by

watching a videotape. (NOTE: All of the DS surgeons I have ever

looked closely at learned the surgery from someone quite qualified to

teach it, so this isn't a big concern. On the other hand, this kind

of thing does on all the time in cosmetic surgery, so it's not out of

the question as more and more docs move into this field in the

future.)

b. How long has he/she been performing the DS? ____________________

Rationale: I don't want to be one of their early DS patients, while

they are still learning how to do the procedure really well.

c. How many of his/her patients have died? When and under what

circumstances?

_____________________________________________________________________

_____________________________________________________________________

Rationale: If the doc is uncomfortable giving me this information, I

would get worried about why he/she was uncomfortable.

7. RESEARCH AND OTHER STUDY OF OBESITY?

YES NO (circle one)

Comments: __________________________________________________________

_____________________________________________________________________

I look at whether the surgeon has researched/studied the root causes

of obesity, as well as whether the surgeon has studied the digestive

tract in detail.

Rationale: As much as possible, I'd like to have a surgeon who

understands what obesity is all about, and WHY the surgery works (or

does not work) and not just the technical aspects of how to

perform our surgery.

8. AWARDS/OTHER

_____________________________________________________________________

_____________________________________________________________________

I also give points if a surgeon has won awards for excellence, as

well as any other signs that the surgeon works very hard to continue

learning and improving as a surgeon.

Rationale: Awards for excellence are, hopefully, further indicia of

just that -- excellence. And, learning is a life-long process, not

just something one does once.

9. ACCESSIBILITY

_____________________________________________________________________

_____________________________________________________________________

Am I going to be able to get in touch with my doc in an emergency?

Also, when I go to an appointment, with whom do I meet, the surgeon

or some underling?

Rationale: The world's best nurse hasn't been to medical school, let

alone received advanced training in complex surgical techniques. I

want to know that the person in whose hands I have placed my life

with be there when I need him/her.

10. PERSONALITY

_____________________________________________________________________

Once I've found a truly excellent surgeon, it's time to consider

whether I can get along with this person. Truthfully though, if the

surgeon rated excellent in the categories above, I wouldn't reject

her based on personality unless he were really an ogre or completely

unapproachable.

11. OFFICE STAFF ___________________________________________________

Is the staff at least minimally competent in doing what they do,

i.e., pushing paper around and scheduling stuff.

Rationale: I'm not entrusting my health and safety to the office

staff, so who cares if they are morons and/or jerks as long as I get

my appointments when I need them?

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