Selecting a surgeon

I feel fortunate to live in an area with so many surgeons to chose from, but how to decide who to pick. I"ve gone to a couple of info session, gotten packets from others. Curious to hear about some things I should consider in making my decision. I of course have a list, but from the BTDT crew I might not have thought of some important factors. Thanks!

Hello,    There is a Bariatric Support Group Meeting  August 23rd 6:30-8:30 at the Rex Cancer Center Auditorium (Rex Hospital, Raleigh). They usually meet the 4th Thursday of the month.     My husband's surgeon was Dr. Enoch. Of course you can look at reviews from different people about their surgeon on this website.    You could talk to family or friends, maybe they have recommendations .     Another way to choose a surgeon to perform the weight loss surgery is through a doctor's referral. Your primary care physician can give you a referral. Referrals are also a good way in which to choose a surgeon.     You may be able to access websites of local doctors who perform operations of this type and be able to gain insightful information into the doctor, his practice and his procedural methods. Once a doctor, or doctors, is located, you can contact the office directly and find out whether or not they host seminars for the general public on the topic of weight loss surgery where the individual can receive more information.

 Dr. Enoch was wonderful. He's easy to talk to. He sincerely cares about his patients and my husband did not have any complications from his surgery. Anyway... I hope you find the surgeon that is right for you. A lot of things to consider (location, cost, insurance coverage and etc.)                           Take Care                      And God Bless                        Tanya Benajmin              

The questions I asked were in regards to their past performance.  I wanted a doctor with a less than one percent death rate and a very low complication rate.  It was important to me that he/she was experienced and had been doing this for years.  They will tell you their complication/death rates if you ask them.  I also asked, since both hospitals I considered were teaching hospitals, who will be doing the surgery.  It was important to me that my surgeon do it, not some resident.  They say that the "golden number" of surgeries that a doctor must have performed to decrease your chance of death is 100.  They must have done more than that. Bedside manner is less important to me, frankly I don't care if my surgeon is or is not a butthole.  I just want him to be competent.  For the record, Dr. Chapman isn't one, but  it was less of a concern to me. Good luck with your selection of surgeon. Take care. Ellen

don't assume that a "teaching hospital" teaches in every department. duke's WLS program only uses the named surgeons. i went with the program my insurance company said was a COE and had my pcp's recommendation. i trusted those 2 medical professional resources to know more about it than i did. it's their job.

if you're a nervous nellie, find someone you like. if you're not that sensitive, pick someone who has the right credentials. i only talked to my surgeon for about 3 minutes total -- that was fine with me. i'm sure she's a charming lady, but we're both busy people, yanno?

 

Sort of ... The named surgeons are in the "driver's seat" ... However, Duke, like other teaching hospitals does train experienced surgeons in the fine art of WLS surgery ... They get a new "crop" of "fellows" every year. These are not interns. These are seasoned surgeons in their own right that have decided to specialize in bariatrics.

You should always ask your surgeon who is assisting them and find out what their level of experience is.

bmc

My pcp who I really like wasn't helpful with the referral, he gave me one name, but admitted it was basically the only person he knew in the area who is doing it. I of course live online and know there are bunches of folks in our area. Like you I want the person w/the right stuff and don't care as much about the hand holding and warm fuzzies. I recognize that Dr. Pryor is at Duke. Can I ask you about there program?

dukewls.org

Dr. Kenneth Mitchell has a seminar in Raleigh on Monday night, I think at 7, at the embassy suites across from Crabtree.  Pinehurst Surgical  910-295-6831. They can give you all the details.   He was trained in Greenville with the pioneers of the bypass, but is only about an hour from Raleigh and it is a great facility designed especially for us "large" people.  It is not a teaching facility and is a very personal situation.  Lots of attention and TLC.  If you go to several seminars you will be able to make a well informed decision and one you will be pleased with

First, I agree with the assessment that Ellen had ... First you want to know that the surgeon is competent. That' they've been doing this for a long time. That they have a mortality rate under 1%. That they also have a low level of complications ... It's also really important that they have a comprehensive follow-on program and that they work with a facility that has a great deal of experience with WLS. Their are certain issues specific to the recovery of a WLS patient, that are different from other patients on a surgery ward. Also you want a facility that "accomodates" the needs of WLS, physically ... are their chairs, beds, showers set up for WLS patients.

I have to say that we are very lucky here in NC. There are a number of very good drs available. I know it may seem like a pain, but I would attend support groups and informational seminars on as many programs as possible. When you do this, you will find that different programs have different protocols. That doesn't necessarily mean one is right and the other is wrong ... They are just different. One of the things that I looked at where the shear volume each program had done ...

BTW ... A program that is a COE basically does a significant number of WLS, so that they have plenty of experience. They also must have what is considered a comprehensive program. Phsyc, Nutrition, Support, Exercise ....

Using a teaching program is not necessarily a bad thing, but I have tell you that none of the Dr.s do this surgery by themselves. They always have someone else who is assisting ... If you've ever seen Big Medicine, you know what I mean. At teaching facilities, experienced surgeons come into bariatric programs to obtain a "fellowship" in bariatric surgery. These a surgeons who have a great deal of surgical experience, including laparoscopic surgery ... however, they want to learn the nuances of WLS. So... with this in mind, you want to know who the second set of hands is ... what is their level of experience w/the surgery that you are going to have performed. I actually spoke with the "fellow" that was part of my surgical team.

My surgeon, Dr. DeMaria, was in charge ... My fellow, Dr. Rollar, was assisting. Dr. Rollar had a nice "bedside manner" ... Dr. DeMaria takes care of business and moves on.

While it would be hard to find a surgeon that has more experience than Dr. DeMaria, and he has wonderful "statistics" ... I should share that there was a "complication" ... Dr. DeMaria said it's the first time it's happened in over 1500 surgeries ... he nicked my colon during the first incision (the first incision is "blind" and the most dangerous) ... To Dr. DeMaria's credit, he was able to resect the colon and repair the damage laparoscopically ... normally, that is cause to convert to an open procedure. While I wish that there had never been an accident involving my colon, I'm glad that I have recovered well and without any complications. 

Personally, I have had issues with communications w/the Duke program in general and Dr. DeMaria specifically ... You can read my post for details. I think that counts as part of the "bedside manner" issues though ...

Go talk with Enochs, Moran, Mitchell, and Farrel (UNC Chapel Hill) ... I used a form so that I was sure to apples to apples information. I also made notes of differences ... For example, Duke is a "high volume" program w/COE certification ... UNC CH is a much "lower volume" program and didn't yet have COE designation the last time I checked. I honestly think that both a good programs. Both have pros and cons. ... as it will be with all programs.

Go to the American Society for Bariatric Surgeons ... www.asbs.org It provides a great deal of information.

Okay ... enough rambling ... Once you find a Dr. with an acceptable complication/mortality rate, then you need to look at how that Dr and their program suit your personal needs.

You will find that most of us are very happy with the program/Dr. we have chosen ... even if we have had complications that have required management. So you will just need to look at what's important to you and go from there.

Barbara, Thank you so much for your answer. I've considered many of the points you brought up, but you certainly introduced me to some other factors I need to consider be for making a final selection. I think it's such an important decision and I've so appreciated all that have taken the time to share their experiences with me, it's invaluable. Sabrina