Met surgeon, not sure of his practice, need your thoughts

[InterplanetJanet 0]

I just met with the surgeon yesterday. I loved the surgeon, but wasn't wild about the bariatric coordinator or the office in general. I guess I wanted to just "talk it out" a bit here to see if my concern are valid or if I'm just not being realisitic in expectations.

First, I am likely going to get the sleeve. All of their materials said lap-band and gatric bypass. Like, all the forms I had to sign referred to the band and the RNY. I know the sleeve is a newer procedure, but it really turned me off that they hadn't updated their forms to include all the surgeries they offer.

Second, before my appointment they had me call my insurance company and find out what they cover - and fill out of form explaining coverage. I had no problem with this, and I think every patient should take responsibility for knowing what is covered by their insurance plan. I got the name of a rep who said I needed 6 months of diets - and it would have to be documented. I asked her if receipts from a meal delivery diet service would suffice and she said "yes". So I collected receipts and put together this tidy little 6-months of diet "proof" that I thought might work. Well, the coordinator wouldn't even take it and said that I needed to fax that to the insurance company myself. Is that normal? I don't mind doing some legwork, but I thought that the submission would ultimately come from my doctor's office.

Now, I really connected with the surgeon and I think he would be great. But, I am not totally sure that this place is the right place for me.

There is another surgeon that is a bit closer to me. He has a very active support group (which he attends himself), a great hospital, etc. This could be a "grass is always greener" situation.

My husband thinks I should go check out this other place. I feel bad, like I'm jerking around this first surgeon to go to this first appointment and then change my mind about him -- but, really, I don't think he'll be up at night worrying about it. LOL!

The monthly support groups for surgeon A are about 1 1/2 hour drive for me. Monthly support groups (acutally happen twice monthly) for surgeon B are 50 minutes away.

I guess I just need some help in thinking this all out. Would you be turned off by the forms not being updated to include the sleeve, or is that just being petty and silly? Is it unusal for the patient to need to fax the insurance info in themselves, or is that typical?

Thanks for any thoughts, and for reading all this rambling.

[KristeyK 3]

Go try the other office. You could LOVE the surgeon AND his staff, or it could be the same as the first surgeon's office. Trust me, you want to feel comfortable with his staff, since you'll be dealing with them more often at the beginning than your doctor. (Frankly, I am just as picky about front office staff as I am the Dr. Having a good staff shows me that the Dr. cares about my experience all the way around...kwim?)

Good luck!

[InterplanetJanet 0]

Go try the other office. You could LOVE the surgeon AND his staff, or it could be the same as the first surgeon's office. Trust me, you want to feel comfortable with his staff, since you'll be dealing with them more often at the beginning than your doctor. (Frankly, I am just as picky about front office staff as I am the Dr. Having a good staff shows me that the Dr. cares about my experience all the way around...kwim?)

Good luck!

Thank you very much for your response! I have been thinking and obsessing on this all night. I agree that the office staff is just as important as the surgeon in many ways. I think being active in the support group is going to be a major part of my post-op life - I know I will need and want the support and companionship.

It could be a case of "the grass is always greener" or just simply cold feet... but, I think you are right. I should just check out the other surgeon.

I think part of my hesitation in checking out the other surgeon is that I feel like I've already started the journey with the other place and like I'd be betraying some imagined loyalty to them. Ridiculous, I know. I think it's part of some sort of low self esteem desire to please others. In truth, I don't think they would care or even notice if I never came back! LOL! I'm just one patient in a sea of hundreds that they work with.

I may have to pay out of pocket because i don't know if my insurance would be too pleased with having to pay TWICE for a surgical consult. But that would be money well spent if I can feel more confident in my decision.

Thanks for listening to me ramble and think through all of this.

I am curious to know what others have experienced with submitting their own insurance and if it's common for paperwork from a surgeon's office to say "gastric bypass and banding" everywhere with no mention of the sleeve.

Thanks again.

[mnbsleeve 87]

I agree with your husband and with Kristey above. I would DEFINITELY check out the other MD! Your first loyalty is with yourself and your health. Like Kristey said, you'll be having to deal with the staff alot. Should somethinge ever come up, which most likely it won't, you could frankly say that you were uncomfortable at the level of response and treatment. I think the surgeon would be glad to know if his staff is causing him to loose patients. Remember: this is a very HOT business right now. It's hard to say this but it's the truth. Lots of money is being made with sleeves. This is our health and our lives and no one has as much invested in it. Insurances, doctors, etc, when push comes to shove they mind thier stores. Sorry to be so practical here. I did not use my insurance so avoid the hassles. I was fortunate to be able to do this (cleaned us out though :-) ) But I was treated like royalty the whole time. Staff "worked for me" as it should be. Good doctors are not threatened by patient's self advocacy and second opinons! In fact, they expect it and hold us to it!!!

I hope this helps. Pay for the other consult if you have to. So worth it in the end if it reasures whatever decision you make. Hope you get some zzzzz's :-)

[ILKrista 36]

I would probably consult the other surgeon. It is your health, and you want to be sure you are getting what it best for you. That being said, my surgeon's office also hadn't updated most of their stuff to include the sleeve when I first went in because the sleeve had only been approved my the main insurance companies in our area for about 2 months. I also found the surgeon to be a bit... pompous. However, I feel like he did a great job. The thing about having to submit stuff to the insurance yourself would be what would probably put me off. I would check out the other place & see if they will take care of that for you & how comfortable you feel with them. Good luck with your decision!

[longer-life 139]

My first conversation phone conversation with the insurance coordinator left me a bit uneasy as well. I felt EXACTLY the way you are feeling now . A long phone call with the "office manager" (forgot her title) solved all that. She was fantastic and a VSG patient herself. I feel good about my initial decision and will stay.

You might want to try that AND also go to the other doctor as the others have said. Let your insurance be unhappy. They just need to pay! :-)

Best wishes!

[SeattleSue 25]

Forget the "I feel bad..." Nope. You are shopping for a life altering procedure. You need to feel good and confident with your choice, because even after you've met it, made it, slept in it, etc., you will be as married to it as you are to your hubby! Just sayin' The sleeve is PERMANENT. Not like "permanent" as it refers to a level 3 hair color...but permanent as in, forever!

[FloraBama Girl 116]

I started with a program here in Orlando. I loved the surgeon, but the rest of the program and staff turned me off. When I talked to Melissa the program director at US Bariatrics it was like I was home. The difference between the 2 programs was like night and day. I would recommend anyone not comfortable with the whole program to look into other programs. Your success depends on a lot people not just the surgeon.

[SKCUNNINGHAM 298]

Definately see the second surgeon. You have ZERO COMITTMENT to the first surgeon at this point. So you went on a "coke date" (to use a term from my high school years) - you haven't committed to marry the guy! I'm sure he and his staff have ZERO COMITTMENT to you at this time. They must have many people come in and do what you did - never to be seen again.

One of the most important factors to consider when selecting a surgeon is their experience in performing the sleeve (not other WLS surgeries), and the experience of the hospital where the surgery is done is taking care of a sleeve patient. If surgeon #1 hasn't had the initiative to update his website or his forms, he is new to this sleeve game. Run the other direction! This is way more important than buying a house - would you buy one from a builder of condos who just started building free standing houses? Would you buy a car from an airplane manufacturer?

Here's info that supports you want an experience sleeve surgeon.

http://healthengine.com.au/article/sleeve-gastrectomy.html

This article quotes " The mortality rate in gastric sleeve is 1:500 and it lies between the gastric band, which is the safest, and the laparoscopic gastric bypass, which carries the highest risk."

From something I was reading this week on another forum - surgeons who perform 100 or more sleeves per year have lower risk rates. Hospitals that perform over 150 sleeves per year have lower risk rates.

If you are considering a surgeon, ask how many procedures he/she has performed in a year, and how many he/she has performed in total. Then ask the same two questions about how many of his patients died. This will give you an idea where your surgeon is versus the norms. Also ask about the hospital you will have the surgery performed in - how many procedures do they do a year?

Don't be hesitant about being a questioning, "pushy" consumer of medical services. WLS surgery is a hot field now - a good experienced surgeon should have no problems or concerns with sharing this information.

Good luck in your surgeon selection!

[MelissaAnd 3]

I would definetly go and see the second surgeon. It's easy to feel bad when you have started the process with one doctor and then switch. However, it is your ultimate choice and the first doctor wont loose any sleep if you don't choose him. The support group distance is important, at least for me, especially in the beginning. You will have lots of questions and will want to be close to your group.

You will have more contact with the office staff then the doctor so it is actually more important, at least to me, that I felt good with the office staff of my surgeon. The staff at my surgeon's office did everything for me! I didn't have to contact insurance for myself. They did it all for me.

Good luck and remember to do what you feel is best! Whatever the decision is, you will love the sleeve!

[klus263 9]

Do not feel bad about checking out another office. Most of your dealing with an office will be with the office staff and not the doctor. No way you should be submitted anything directly to your insurance for a precertification. This should be coming all from the doctor's office as supporting documentation for approval for the surgery. My husband had to switch doctors in the middle of his 6 month diet due to company guideline changes. The insurance company paid for the second consult. My doctor's office did not have their information updated on paper but they had all the information regarding the procedures included the insurance companies that were approving it. My doctor actually recommended it over the band which is what I was first looking at as he knew my insurance and changed and was now covering it before I even did. Good Luck

[feedyoureye 3,087]

..... All of their materials said lap-band and gatric bypass. Like, all the forms I had to sign referred to the band and the RNY. I know the sleeve is a newer procedure, but it really turned me off that they hadn't updated their forms to include all the surgeries they offer.

I guess I just need some help in thinking this all out. Would you be turned off by the forms not being updated to include the sleeve, or is that just being petty and silly? Is it unusal for the patient to need to fax the insurance info in themselves, or is that typical?

The Center I went to had NO mention of the sleeve on their web site, their group meetings or any of the teaching documents or information forms. My Doc (who is the head of the Bariatric unit at a local teaching University Med center) told me that in our state (California) the main insurance companies did not include the sleeve in their options until recently. Back East it has been accepted for longer. It kind of bugs me too, but hopefully that will change soon.

[Lissa 2,631]

I agree with the others, visit other offices and make sure YOU are comfortable with the surgeon and his staff. You are putting YOUR life in their hands, so it should be the most capable, caring, competent hands you can find. I visited several surgeons before I chose mine (Dr Domkowski, Sebastian, FL) and I feel like I made the right choice. I was sleeved on Tuesday.

[InterplanetJanet 0]

Oh, thank you everyone for your generous and understanding responses!! I feel so much better for having read them. I especially appreciate the reassurances and reminders that the office really has no commitment to me so I shouldn't feel bad about "shopping around".

This other office (2nd surgeon) has a seminar coming up next weekend. I registered for that online.

There more I've thought about my interactions with the bariatric coordinator at the 1st surgeon's office, the more I thought that this is NOT the woman I want to turn to with all my questions and concerns. We just didn't click - and I'm usually the type that likes almost everyone I meet. Plus she made it very clear that I would need to handle insurance myself, faxing stuff over and making calls and whatnot. AND she even started talking about how I can't blame them if I don't lose weight (?? it was a pretty weird random statement ??) and that patients need to understand that they must drink Protein drinks and not blame her if they taste bad or they don't like them. I didn't disagree with what she was saying, but it was the fact that she was bringing up these things out of the blue and rather defensively. It gave met he impression that she'd had a lot of trouble with some patients or something. Again, just a turn off personality-wise. So the more I thought about her, and how her role would be central in my dealings with that office, the more I realized that I really owed it to myself to check out this other surgeon.

Thank you all again for taking the time to respond and for being so understanding!!

[Sassygirl06 962]

i never have to deal with the docs office. all of the work is done by my coordinator. she even makes my appointments. i would try the other office though so that you can weigh all your options, also it helps that the b office is closer. i think it is great to be involved with the insurance that way you wont have any surprizes at the end. i didnt have to do that either thanks to the coordinator. she got all of my stuff together and filed everything. i ended up not having to pay a dime for my surgery. i was in shock!

hope you find what you are looking for in the other office. good luck!