Seminars at Hospitals in Pittsburgh; St. Margaret, Magee, Allegheny General

[Band_Groupie 3]

I’m a little obsessive compulsive and usually over research anything I’m doing (as you’ll see by the length of this, sorry). I’ve been toying with the idea of LB for awhile, but didn’t start researching this until Sept. So I signed up for informational seminars at 3 different Pittsburgh Hospitals. They’re all about the same distance from me (Cranberry) 40-50 min. and they all had what I considered to be equally (between the 3) good and a few bad reviews and information about them online. I thought I’d share my (and DH went to the first 2) perspective here in case anyone else starting off in Pittsburgh could benefit…again, this is just what I think.

UPMC St. Margaret (Pittsburgh Bariatrics)-

---Pre-Seminar: I read a lot of great things about Dr. Quinlan there and he was even voted best bariatric Dr. by Pittsburgh Magazine one year (my Urologist also knows him and said he’s a great guy. I wasn’t planning to go there but I wanted to go to at least one smaller program and this one fit the bill as they have 2 Drs. and have a good reputation (other staff and pre/post care is as important to me as the Dr. since Lap is ongoing visits). Other staff also had a great reputation. It sounded great to me- small/personal and good rep. I called and signed up for the seminar in Cranberry (local hotel mtg. room), they later cancelled from lack of sign up, so they rescheduled me for one at the hospital at the end of Oct. (Peggy-on phone was very nice). I still thought I’d like this group best from what I’d read.

---Seminar: Unfortunately they couldn’t tell me ahead of time who would give the seminar and I did not end up with Dr. Quinlan; Dr. Means gave the seminar (more about that later). It had by far the most attendees of any of the 3 seminars I went to—huge meeting room (so much for small and personal). They started with one of their nutritionists giving an overview. There was a sheet addressing the diet that’s required by each insurance co. and some sample forms to use (and they gave me my insurance co’s. requirements). They have nutritionists and exercise physiologists on staff as well as monthly support group meetings. Then she mentions the “program fee” sheet. They have a $395 program fee that is not covered by anyone’s insurance and is mandatory for everyone (covers meetings with nutr., exercise, support) even if you don’t ever use any of this. At this point she got bombarded by insurance questions she couldn’t answer specifics about (just generalities) and people all around me were buzzing about having to pay the program fee. Trust me, I was thinking, I have no idea, but it’s possible that I’ll be paying around the same out-of-pocket insurance overages no matter where I go and why would they start off with negatives? We were given a self pay sheet that had all the financials broken down (BTW self-pay for LB is a total of $19,895. just for the portion in the hospital, no pre or post testing and they never mentioned fill costs). Then Dr. Means came and gave the slide show on Gastric Bypass and LB. This is probably a personal thing, but I found his approach very abrasive (he was very arrogant and talked down to people…my husband thought the same- and his Dad’s a Dr.). Part of that was probably that he definitely came across as anti-LB (people around me thought so too). At one point he said “If you’ve got Diabetes you’re going to have a tough time convincing ME to give you a LB!” I don’t have full blown diabetes, but the way he said this even rubbed me the wrong way (I’ll jump ahead and say the other 2 hospital also got the point across that those with bigger health problems should probably look at Bypass, but they said this more collaboratively). I wanted to ask insurance questions, as my main worry was- would I get approved, but it was evident I wasn’t going to get a specific answer as there wasn’t an insurance person there. Many (I’d say most) of the questions to the Dr. were also about insurance (since they didn’t answer them), and it was too big of a group to address each person’s specific situation. I asked a general question or two about the procedure. We all filled out our forms, took home packets of what we were to fill out IF we were accepted into their program and were told they would call us. I have yet to receive a call…I’ll have to say I didn’t have my hypertension diagnosis then, so they probably didn’t think I was a good candidate, but don’t tell me your going to call and then don’t. Honestly, I was turned off by the whole program (as was my DH) by the time we left, and yes I probably would have enjoyed Dr. Quinlan more, but the financial emphasis and not having an insurance expert there was a big negative. More than that, the presentation was “this is what you need to do and do what we tell you” (my DH said (it was a “Do this or else” presentation), and I was expecting “this is what we can do for you; please select us”.

Magee-

---Pre-Seminar: This is by far the largest group I’ve heard of in Pittsburgh (one just left so it’s 5 Drs.) which allows them to diversify (ie. Dr. Eid specializes in PCOS patients). They’ve therefore got a ton of patients and experience (but no real difference in numbers from the other hospitals if you look at it per Dr.). I’ve been to Magee for other female issues and so I was comfortable looking at them. The big negative for me is also how big the practice/program is. There are lots of negatives online about how impersonal the care is (you hardly see the surgeon except at the surgery, people love all the Drs. but not the rest of the process/staff), long waits for fills and they’re not with the Dr., staff treats you like a number, everything you would expect from a big office. They do have a great reputation for the surgery part so I signed up for the seminar at our CranberryTownship hall.

---Seminar: It was a small group since it was in Cranberry (I’m sure the ones at Magee are bigger groups), so I really liked the smaller group. Dr. Eid gave the entire presentation. I learned a lot more details from him then at the St. Margaret’s. It was more LB friendly and he even said “The final decision on which procedure is ultimately your choice.” He did a great job at presenting it as a collaborative process (Dr. with you). The presentation was much clearer and I learned more about the procedures. He was great at stopping to take lots of specific questions along the way. But a real negative was even as he said “This is your best chance to ask questions, we don’t get this kind of time to sit down with patients when they come in, so take advantage and ask questions now.” Again, if there was an insurance expert there, I didn’t know it. It was that after awhile not very many insurance questions were asked…maybe because it was just the Dr. in front and we all knew he wouldn’t know. A few came up and a lady “from his office” not sure of role, tried to field a few general ones. ie. I asked what insurance wants to see on the 6 mo. Diet and he fielded it to her. She pointed out that people have been denied for gaining even 1 pound on the 6 mo. Diet. I later read in their packet to take home that insurance doesn’t want to see you lose much either (they suggest a pound or two), which is the kind of details I was looking for (some here at LBT say their insurance wants a 5% loss). So how do I know if she was talking about my insurance? The packet they give you is by far the fanciest; glossy brochures from their supplier and their group, but after looking it over it has the least information I can use. My DH and I left with the same impression- Dr. Eid was great, wonderful even, but I’d probably just spent as much time with as I was ever going to get to. They did call me back (Gail, I think, was very pleasant) the next week to tell me I probably wouldn’t get approved. I asked why family history wasn’t something they asked about, and she said because it doesn’t make a difference to insurance. I knew then that I was probably going to get the hypertension diagnosis this PCP visit since they were saying that last visit (which did happen). So I asked Gail if I should call her back if that happened…she didn’t really answer, dodged it actually, but she didn’t give me the warm fuzzies that even hypertension would matter “you can start our program if you want but I want you to know now that you probably won’t be approved” (I’d already called their insurance gal and she told me the same thing…what I wanted to know is Why not?). I believe the pre-program at Magee also costs a lot out of pocket, not sure, just said you could do their pre program or with your PCP, but again they gave NO financial information at the presentation (I can’t give any financials at all). So in summary, again we wished there was an insurance piece to the presentation or at least an expert there, and I knew I was going to be “just a number” at Magee, at least for all the pre/post, which there’s a lot of.

Allegheny General-

---Pre-Seminar: Again, a small, well respected group with 2 Drs. like St. Margaret’s. I’d read lots of wonderful things about the Drs., but overall very negative things about their staff. I had actually contacted this group first, as they were who my PCP recommended most. I got through to Susan in Rec. (very nice), but no answer at the insurance desk (I’d started this in Sept. so I had basic questions), in fairness I don’t think I left a message. I did send an email which I never received a reply to, so I put off scheduling a seminar because that confirmed the slow/never reply comments I’d read. After the other 2 seminars in Oct. I decided to give them another go and scheduled a seminar.

---Seminar: I’ll be honest and say I went into this one with some lower expectations after the first 2. I attended this morning. They have seminars twice a month, which keeps the groups small, very small. The first ½ hr.+ was a presentation by their insurance expert (what’s this? alleluia!!!). Patty was great! She was knowledgeable, organized, patient, and kind, she even had different sheets for all the different insurance co’s. and better yet she was there to take all our questions…and everyone had a lot! She didn’t give vague answers to questions, she told you things the insurance co’s. don’t even tell you (ie. To a guy there on Medicare)…”Medicare won’t tell you to do this 6 mo. Diet the way I’m telling you to document, but they won’t approve you if you don’t.” My obsessive compulsive side was finally appeased…honesty at last! She spent as much time as we needed and even stayed for the Dr’s. presentation so she could field questions, be available at the break, and at the end…heaven. I went up to her at the end and asked the question I’ve tried to get the others to answer (I don’t get why it’s so hard to get a straight answer)…With the hypertension now, will my insurance approve me? And If not, specifically why not? I actually got my answer, from the expert! BTW it was yes, and specifically I need only 1 of the “big” comorbidities. She told us that they even do the very sick patients…mentioned that UPMC (Magee, St. Marg.) send the patients that have heart issues, etc. to them. Now on to the other part. Dr. Uchal was the presenter and he was great. The actual presentation was very well done and he gave a lot of good details. He stopped many times to answer questions (probably more questions asked by this tiny group than the other 2 seminars combined). So it was VERY interactive, which was great! I even asked a few specifics….2 types of bands they can use there, so I asked about the segmented one pinching. He even gave his specific opinions…more honesty!...ie. “Everyone with a BMI over 40 should have WLS, the benefit’s outweigh the risks”. He even brought both types of bands to show us. At one point he even asked after reviewing the bypass “Is anyone in here even interested in the bypass or did I just waste your time?” A few were, but how much more “band friendly” can you get? It was great! The packet they give you isn’t full of glossies, but it’s packed with info. I needed..get this- the ACTUAL powerpoint presentation he gave (how novel). Their progams of ongoing education seminars and support groups is free...to anyone- even if you had surgery somewhere else (they invited us to a 'dealing with the Holidays' speaker coming up). We can call now to get a consultation with our surgeon (the other programs made you wait until you were 3 or months into the diet). He ended and told us he hoped we would be back even came up to each person after to thank them for coming and gave us his card…he asked me where I got the info. on the band…I said “Lap Band Talk”…he smiled…me too.

SUMMARY- I could pick any of these 3 places to have this done now. I found at least one Dr. at each place I’d be comfortable with (haven’t met Dr. Quinlan, but I’m guessing he’s fine). They all are great programs and they have similar numbers; # procedures they do, complications, etc. I know I want to feel comfortable with more than just the Dr./stats. I need to feel comfortable with the basics of a program, they’re philosophy and how I’m treated. Heck, how many times am I going to be in their office over the rest of my life? I guess now is the time to admit my last job (I’m at home now since we’ve moved for DH job) was with a Fortune 500 leading Business Process Improvement both internally and as a value-added service with their customers (I worked a lot with major hospitals all over the East coast). Let’s face it at these seminars; after you hear the basics and understand you might die but your willing anyway..Even the perfect candidate for approval is going to have some insurance questions…Get an insurance expert there and give them time to speak/answer questions! I want a group that’s going to be my advocate and on my side; not someone I’m just giving my business to. Can you guess who I’ve picked?

Edited November 14, 2008 by Band_Groupie

[KathyfromPgh 0]

After reading your dissertation which btw was very interesting, I think you picked AGH. Was I right?

[Band_Groupie 3]

Kathy- "dissertation" LOL . Yep, I really thought the rest of the day about it and decided the only thing AGH didn't mention having was an exercise physiologist (but I'm guessing they might have one for a fee), and that wasn't something I would use anyway. It's too far away to go to work out and I used to teach exercise part time (pre-kids) so I'm good.

I think the lesson here is if you have a major city near you that offers good choices, why wouldn't you try out more that one to see which one fits you best? To me this was an even bigger decision than other surgeries I've had where you're done in a few visits...I was really interviewing the whole group for a lifetime of care.:tongue2:

[ShiraSimcha 0]

Now I am starting to have second thoughts about Magee's program. Especially the part about fills. Excela's program seems ideal for me but the whole hospital scares the crap out of me and I am hesitant to let them cut me after the bad experiences we have had. Still, their aftercare is by far the best. Now I am just confused. AGH is a little far for me to do on a regular basis so Magee worked the best for me.

ARGH! :tongue2:

[Band_Groupie 3]

Shira- What is Magees policy on fills (they didn't tell us)? At AGH you get a certain # of fills (I can't believe I didn't ask how many- but I will) included with your surgery. I think I remember you saying that Excela had a "lifetime" plan...wow? AGH also said that our insurance, Highmark, covers only 90 days of post-op care no matter where you go (that's probably only the first fill if you're waiting about 6 weeks, right? So you're right that what the hospital includes above that is an issue.). Does Magee cover a certain no. or a certain amount of time? I'm getting my new questions together for AGH insurance girl, thanks.

Just googled Excela...they hadn't come up on my radar when I researched this (probably because they aren't near me). It sounds like your PCP is there, so maybe this would be easier for you (If your healthy I think this surgery is pretty safe to have done anywhere- JMO)? Or if Magee doesn't work out, if you're East of town, would St. Margaret's work for you? Now that you know what you want & what your questions are...you could give them a call? They didn't offer any info. on their fill policy either so I can't help you there.

[KathyfromPgh 0]

Band Groupie

:Dancing_wub:

Haha, I was right. Just to let you know, I was banded this past Monday 11/10/2008 with Dr Uchal from the Allegheny Gen'l practice. I live in the North too and decided just to go to Allegheny without looking at the others. I went to the seminar and was impressed. I've had a long time allegiance and admiration for AGH so there wasn't any issue with the level of care.

I felt good about my decision then and now. I am at Day 5 of the Clear liquid Diet which is somewhat difficult but not horrible.

:tt1: Dr Uchal is like a TV doctor. When he walked into the Surgery Staging Room, I heard the song, " You're So Vain" in my mind and thought he actually looks like a doctor on the Guiding Light or something. Most doctors are not so handsome. haha. To add to his appeal, he smiles like a leprachaun yet he is very nice, direct and professional.

:bored: :Dancing_sorry: :w00t: He had an entourage of residents with him in the OR and when he followed up in my room. The care by the nurses was over the top. They made sure everything was taken care of and were very responsive to me. I had to stay two days instead of one because of high blood pressure, a questionable swallow test and low potassium.

Dr U and Dr Colella take the "high risk" :crying: patients from the other practices, so that should tell you that are highly regarded by their peers/competitors. I can deal with anything from the staff if I know the doctors are top notch. If you have any additional questions, let me know.

Kathy

On my weigh to success!!

[Band_Groupie 3]

Ohhh Kathy! I'm so glad to find you...you'll be 6 mo. ahead and I can watch how it goes (no pressure here). Yep I mentioned his "4 ducklings" (interns) in my blog yesterday...he had the girl give a few tiny pieces of the presentation. A few days earlier and I could have been there at the same time...bringing balloon bouquet!:Dancing_wub: Hope you don't mind obsessive questions about AGH (when you're feeling up to it)...tell me to get lost when you've had enough!

- Since they offer both types of bands, which one did you chose and why?

- Did you select the spot for your port (since it's our choice), if so, where & why?

- How many fills/unfills are included with your surgery for free?

- Did you use AGH for any of the pre-op testing and if so, who exactly and would you recommend them? And confirm for me that ins. covers all the preop testing?

- How have you found the staff so far?...after emailing Patty with no response I was moody when I saw she was presenting, but she was great...knew the answer to every tiny question about anyone's insurance; we had folks from OH & WV too.

I'm so happy your on the other side now! Take it easy :Dancing_sorry: and let us know how you're doing. -BG

[KathyfromPgh 0]

BG

I received the laproscopic Lap Band because it seemed to fit my needs. My friend had that one and she is happy, healthy, and thin. I ruled out the Gastric Bypass because it seemed to drastic and too much cutting. I have a genetic bleeding disorder called Von Willebrand Disease and wasn't crazy about all the internal surgery.

I talked with Dr Uchal 7 or 8 months ago, explained the situation and he recommended the Laproscopic LapBand, so I went with his advice. As far as the port, again I let him pick the spot since he knows more than I do and he is the one filling it. :Dancing_wub:

One of the residents was Dr Rebecca Solomon, I believe. She was very sincere, sweet and observant. I know she will make a great doctor if she stays this way. :Dancing_sorry:

I don't know about the fills yet. I hope my insurance covers some or all of it. I have Highmark Blue and a rep just called to follow up on my surgery. That was a surprise. I was approved in just a few days after I handed everything in.

I used AGH for everything included my 6 months of dieting. I went to see Dr Andrews for that. AGH Pulmonary Group, AGH Cardiac and AGH Blood. My insurance covered everything. The nice thing about using AGH is that the other groups are onboard, non judgemental, they know what is required and where to send it. I didnt want to have to explain that to miscellaneous offices all over Pittsburgh. I just Dr Colella referred me and then they knew. YEAH!

I waited until the 5th month to get all that done because I didn't want to hear something like this is more than 60 days old so you have to do it again.

Patty is hard to pin down but always nice. The office staff have no personalities at all, but are responsive. The Surgery Nurse, Melissa is great! The blonde gal (not Patty) who did the final Pre Op Class was a hoot! Loved It. :crying:

I didn't care about an excercise physiolgist either. I am joining my old gym in West View after the Holidays or Club Julians.

What part of Cranberry do you live in?? Are u from there??? I live off the Mcknight Rd exit of 279N.

[Band_Groupie 3]

Thanks for all the great info.! I'm with Highmark too (they cover 90 days post op so at least the first fill). Did you do the psych visit at AGH also? Hope you're doing well. We've been in Pgh for 8 years now; just off the 228 exit/7 Flds.