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My 1st post and I need your advise



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Hi

My name is Mari and I live in Miami.

I went to my surgeon in Nov 2008 and we agreed that we would start the testing and letter gathering for my lapband insurance approval in January.

Between January and February, I scheduled my sleep apnea test ( I have sleep apnea it turns out), I got my mental health evalution, I went to my GP and did the required blood work and obtained a letter of necessity. I went to my old diet doctor and got copies of past doctor supervised diets. All this I submitted to the surgeon's office on Feb 27. At that time I was told that insurance approval would be 4 to 6 weeks.

At six weeks I called for status and my doctor's staff told me that any day now. I stayed in touch with the staff and in anticipation of having my approval readily, I was scheduled for a surgeon's visit on May 7.

That day the doctor asked his staff about why they had scheduled me for an appt and it was explained to the doctor that they had done so under the impression that I would get my approval by the appt date.

On May 14 I called the office and was told that the insurers medical director had my file and that the approval was to happen quickly. On May 21 I called again and was told a different story. I got suspicious and called the insurers only to be called that no doctor had sent any type of request for surgery approval for me. I called the dr's office and they swore up and down that the insurers were wrong.

When I called the Dr's office again on May 28, I was told that the office was moving and world not open until Tuesday, June 2. Before called June 2nd, I called the care coordinator of the insurance company and still nothing had been received or requested for me.

June 2, the staff would not take my calls, June 3, I managed to speak to them and I told them what the insurance had said. Of course the insurance was wrong, so they said. I asked the date the request had been submitted and I was told that since they moved, all patient files were in boxes and I had to wait until they opened the box in which my file was located.

June 5, I called the insurance and I was told that earlier that day a request for surgery had been received and I was given a case number. Today when I called the insurance company to follow up, (the dr's staff was just too rude after my last call) and I was told that on June 17, a letter was sent to my dr. with the approval and that copy of sent to me. I don't have that letter yet, but I'm certain I'll get it soon enough.

My insurance took 8 working days to get a letter of approval out to my surgeon! 8 days. I've been waiting and postponing things for months!

I choose this dr because he did my gallbladder surgery 15 years ago, he is well known in the area, pioneered laprascopic surgery, has written two books on the subject and is well known to my GP.

Question - I'm questioning how I will be treated by his staff before and after surgery. Should I change surgeon's at this late date? Should I tell the surgeon about his staff?

Depressed in Miami.

Mari

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wow. I'm so sorry to hear of the endless waiting on your end. I had a similar experience - and I found that when I kept calling my stuff finally got done and faxed. ugh! frustrating isn't it?

however, once I got my approval -- I too called my insurance and the date they sent me a letter. It took 10 days to actually receive the letter though! - anyway, when I called the surgeon's office with an approval, I was called back immediately. I had rarely been called back, let alone that fast. Had my surgery last Monday and when I called for my first post-op appt she got to me right away when she got in.

so ----- maybe they have so many of us wanting to go thru the hoops and they can't handle it all? maybe those of us approved already are priority? not sure.

Is your surgeon very experienced with lap band? I know you wrote that he did your gall bladder and is pioneer in laparoscopic surgeries and all, but how much with lap band? This is completely different in the after care aspect of the surgery ---- it isn't just surgery and done like most surgeries are. I'd want to know how many he has done before I trusted him with it.

just some thoughts

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Personally...I want a surgeon who does MY TYPE of surgery. All surgeries (and surgeons) are NOT created equal. The guy who took out my gallbladder (an excellent surgeon) does GALL BLADDERS. My banding surgeon does BARIATRIC SURGERY. He knows what to expect...he knows what emergencies can arise he knows about my AFTER CARE...my fills, my potential problems and how to rectify them. Because he has done over 2000 bariatric surgeries. He hasn't done a single gall bladder. My gall bladder surgeon was doing gall bladders while my WLS surgeon was doing bands and RNY bypasses and duodenal switches. See my point?

You want a surgeon who does BARIATRICS. RUN RUN RUN to a different surgeon. S/He should be able to obtain your records (they legally are YOURS) so you won't start at square one. Get one who only does bariatrics, get one with experience in that area.

You wouldn't want your gall bladder surgeon to operate on your knee or your heart, would you? Then why pick him for your band? Get a pro, like you did for your gall bladder! Good luck!

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Yes, he is well known for bariatric surgery in the area. I found his name in lapband blogs everywhere when I was thinking of getting a lapband. He also performed the by-pass surgery on my GP's wife. All the bloggers praised him for his skill and his personality. He is really is a sweet man. But his staff...........

Mari

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Yes, he is well known for bariatric surgery in the area. I found his name in lapband blogs everywhere when I was thinking of getting a lapband. He also performed the bariatric by-pass surgery on my GP's wife. All the bloggers praised him for his skill and his personality. He is really is a sweet man. But his staff...........

Mari

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Yes, he is well known for bariatric surgery in the area. I found his name in lapband blogs everywhere when I was thinking of getting a lapband. He also performed the bariatric by-pass surgery on my GP's wife. All the bloggers praised him for his skill and his personality. He is really is a sweet man. But his staff...........

Mari

The incompetency of his staff needs to be brought to his attention. He might lose your business because of this. His staff is who is going to schedule your appointments and answer your calls. You may want to think about that before continuing. If you are really secure in his ability, and are willing to overlook the incompetent staff, then proceed quickly and don't look back.

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Ok...but the staff is a huge portion of the "team". If they are not helpful, then you aren't getting good service. Because the band is just the start, and you DO want a good surgeon. But fills, questions, problems, all are generally handled, at least initially, by the staff. THEY must be as responsive as the surgeon.

Sometimes "kind" docs have the staff you've described on purpose, as a kind of "fire wall". I often find it odd that people would think that docs don't have a clue what goes on in their little worlds. I know it CAN happen but it does not happen as often as you'd think. So I'm not so sure that informing your surgeon will do any good but I am sure you should at least try. If they don't improve, you really shouldn't proceed. The aftercare (and access to that aftercare) is what makes the band work. It's like buying a car but being unable to get gas or oil changes. If you can't get the aftercare, the band won't do you any good.

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I know that everyone is different and desires different levels of pre-op/post-op care, but I would have walked out of the office the first time I was treated that way. Many physicians and staff feel that they are above their patients and can treat everyone disrespectfully (in their minds they think, "why not? I am still getting business"). Between myself and my fiancee, we have 25 or so doctor's in the family (and he pretty much grew up in the hospital with his parents), and as a result, neither of us tolerate any kind of disrespect or incompetency. Doctor's are just people, not superhuman gods.

As far as this surgery specifically, I plan to have a working relationship with my surgeon and his staff. I am not the easiest patient and pre-op, he and his staff probably fielded one call and one email a day from me with all kinds of questions. I expect my follow-up care to be equally comprehensive. No one ever treated me rudely, or ignored my calls. My surgeon even gave me his cell phone number. If I were you I'd find another doctor ASAP.

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Mari, I hate that that happened to you. It sets a bad initial tone. One thing a patient must feel is that the "team" (the doctor AND his staff) are all partners in your health care.

I know in my mother's time, the patient just pretty much sat back and took whatever the doctor and staff dished out.

But that's becoming less and less the case with us Boomers and younger.

But, if you think you can feel comfortable after such a disheartening beginning, that's what's ultimately important.

Have you researched any other surgeons in your area? There may be some that are super great and you just don't know it.

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