LOL! I vote for *****
The place I was looking into first for the band was not a COE but they said they wanted to apply for it, but hadn't actually done enough surgeries to qualify yet. They only did bands. So needless to say I went somewhere else once I decided I did not want the band.

My surgeon can wax eloquent on this subject! IMNSHO he, and others who function like he does, are the real "centers of excellence," not these surgery mills.

 The hospital where I want to have surgery is a center of excellence- but Magee in Pittsburgh is highly rated in every area of care for woman and bariatrics.  All the reviews- in person and online that I've had of Magee have been great.  There may be some truths to the centers of excellence being in an alliance in which the two entities can benefit but it might not mean that it's a bad thing across the board.  I don't get the impression about the hospital I've chosen is a surgery mill but if I find out later that it is I'll definitely share that.

As someone else posted not ALL CoE's are evil and not all bad doctors only work at CoE's. Not all CoE's are "SURGERY MILLS"

And I don't know how you got that I said otherwise from my post, but OK.  I never said that all surgeons who operate at COEs are evil - hell, my own surgeon has an affiliation with at least one COE for patients who must use them.  And the hospitals themselves are making a deal with the devil and being forced to accept crappy reimbursement rates in exchange for a steady flow of patients, which has both ups and downs - they can therefore afford bariatric beds, for example.  There certainly is something to be said for having a bariatric ward and team of professionals (nurses, anesthesiologists, hospital dieticians) who know what they are doing.  It is the PRESUMPTION that the COE means something POSITIVE and designed that is for the patients' benefit that I particularly object to.

I might have gotten that impression in your first post where your wrote

So, basically, "Bariatric Center of Excellence" = SURGERY MILL

and said

"And to work with the insurance company to keep costs low - often at the expense of the patient."

Then listed how they do this.

They limit access to surgeons who cooperate accept their low reimbursement rates.
They limit time in the hospital post-op.
They limit access to second opinions.
They set requirements that are for the purpose of saving the insurance company money, such as pre-op mandatory weight loss requirements, which often discourage people into dropping out.
They limit access of the patient to their surgeons post-op, making them go through non-MD gatekeepers.

and then this

This initiative was a CONSPIRACY (and possibly even an anti-trust problem) between the insurance companies and the upper echelons of the ASBS.  The net effect was to make it even more difficult for patients to get access to lower volume procedures such as the DS, and to steer patients into RNY and band mill operations rather than surgeons who had their own individual lower volume practices.

Some where in all that,  I got the that impression and reading it again, Hmm I still get that same impression. All of that stuff sounds pretty EVIL to me.


 

Opinions are like bellybuttons, dude. Maybe you should consider not being quite such a pain in the ass.

I didn't really post any opinions in this thread I responded to her opinions. All I said was not all CoE's are evil and that IS a fact, not all of them are, do you disagree?

My problem with this thread if someone new who is looking to research WLS and comes up on this thread are going to be led into believing, OMG I have to avoid CoE's and any doctor alligned with one.. That isn't true. To me CoE or not is unimportant, it is all about the surgeon. I researched my surgeon, I spoke to numerous patients, I met him, I felt comfortable that he knew what was talking about and what he was doing. Case closed, yeah he is CoE but that didn't enter into it. Might not have been the purpose of the thread, again I have no clue what the point of it was, but look at from the point of view of someone new to this, We are scared enough about stuff to now have to worry about the evil CoE's, doctors and insurance companies conspiring againist us. You all are well done the road from your surgeries, maybe you can't relate,  I  AM a newbie and I still have that point of view and I am reading this post though newbie eyes.

What actually IS evil about COEs is that some insurance companies only pay for WLS when done at a COE, thereby limiting patient choice. You said yourself "CoE or not is unimportant, it is all about the surgeon." And that's what it SHOULD be about, but it's NOT when insurance companies insist on a COE.

The way the COE designation is marketed implies that any surgeon NOT associated with a COE is inferior/shady/evil/not to be trusted.  It also gives sometimes false confidence that a surgeon who is associated must therefore be superior/trustworthy/godlike.

"It also gives sometimes false confidence that a surgeon who is associated must therefore be superior/trustworthy/godlike."

This is my big objection. I see people posting statements such as "well MY surgeon/hospital is a COE" as if that means they are one of the top programs in the country. Well they can't ALL be the top program in the country when more than half of the programs have that designation.

So, to me, it's really is more like when you see the bumper stickers on the car that say "MY CHILD was ________" and you know that every kid in the school gets that award before the year is out because your kids go to that school and every year they get that award once and it's usually for something like "caring about others." LOL