Red Flag Bariatric Surgeons

During the past decade, the number of bariatric operations increased more than ten-fold. The advent of laparoscopy has drawn many new surgeons to the field. The increased interest in bariatric surgery on the part of surgeons has lead to the development of a number of new bariatric surgical programs nationwide. Ten years ago, I was one of three busy bariatric surgeons in the state of New Jersey. Now there may be as many as 60 surgeons in our state performing bariatric operations.

All of this has lead to intense competition for patients among surgeons and medical centers. The Centers of Excellence initiative introduced several years ago by the American Society for Metabolic and Bariatric Surgery (ASMBS) was intended to provide prospective patients with reasonable criteria upon which to distinguish bariatric surgeons within their locale. There is ample information on the Internet regarding the Centers of Excellence initiative (see www.surgicalreview.org).

Glitz Over Substance

Unfortunately, competition for patients has contributed to a substantial amount of advertising in our field. Advertising has taken on a variety of shapes and venues including profusely illustrated websites, embellished patient testimonials, radio, television, and billboards. Although there a number of criteria that can be used to evaluate the competence and skill of physicians and surgeons, it is difficult in this day and age to not be overcome by the glitz, popup ads, and gaudy color photos that tend to dominate field.

Many of these ads obscure more objective and factual accounts of a surgeon’s or hospital’s experience. Although the Centers of Excellence initiative was designed in large part to assist prospective patients in making their choice, I have listed a few “red flags” that should prompt further investigation of a surgeon’s credentials. Note also that these “red flags” represent my personal opinion as a life-long bariatric surgeon and should be interpreted in that regard.

Beware of these Red Flags

1. Claims of successful outcomes far beyond the norm.
2. Claims of vast surgical experience that cannot be documented through other sources.
3. Excessive emphasis on the cosmetic aspects of weight loss surgery. Bariatric surgery is considered medically necessary because of the many health benefits that result from substantial weight loss. This is why bariatric surgery is covered by Medicare and private insurance carriers. Although cosmetic benefits can be a “bonus,” health benefits are the primary focus of bariatric operations.
4. Absence of Centers of Excellence status, despite claims of vast experience and success. Note that in order to qualify for this status, a surgeon needs to perform at least 125 bariatric operations in their career and be affiliated with a hospital/medical center that meets the Centers of Excellence criteria.
5. Billboard advertisements. This is the very type of advertising which serves to cheapen bariatric surgery. The emphasis should be on a patient's long-term health—not fly-by weight loss.
6. Frequent changes in hospital venue/location. Although these changes happen from time-to-time during the career of many physicians, a change in venue resulting from closure of a bariatric surgery program at a given institution indicates a MAJOR red flag. Moreover, a change in venue for a given surgeon after closure of bariatric surgical programs at two or more hospitals over a relatively brief period of time represents LOTS of red flags.

Perhaps one positive in the insurance industry’s requirement of a “medically supervised diet” is the opportunity for surgical candidates to evaluate several surgeons and practices before making their final decision. New Jersey Bariatrics welcomes you to assess our credentials and facility. Whether you choose us or another center, we encourage you to do your homework!