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Bariatric Surgery Referral

Completed
  • Family Medicine, General Surgery

Resource Lead

Dr. Chris de Gara, Professor of Surgery, University of Alberta, Physician Learning Program Lead

Objective

To improve the knowledge and understanding of family physicians of the role of bariatric surgery in treatment of obesity.

Target Audience

Family physicians

Background and rationale

Alberta is in the grip of a morbid obesity epidemic: currently 90,000 Albertans are morbidly obese. Best behavioral modification techniques such as diet and exercise achieve, a rarely sustained, 10% body weight reduction. This is insufficient to reduce that long-term morbidity and mortality associated with obesity. Bariatric surgery is necessary to obtain the 30-40% weight reduction to restore the obese person to health. However, despite provincial obesity epidemic, referrals for bariatric surgery remain below bariatric surgery targets set by Alberta Health Services (AHS).

In concert with the AHS plan to deliver a provincial obesity strategy, bariatric surgical services will need to be significantly increased. Within the health provider sector a considerable amount of misinformation exists as to the effectiveness and access to bariatric surgery. Patients and referrers perceive lengthy wait times and barriers to access. Nutritionists, psychologists, nurses and even referrers view surgery as something that needs to “earned” and evidence of “failure” of non-surgical therapies.

In October 2011, the Physician Learning Program (PLP) and Bariatric Program team at Weight Wise Adult Weight Management Clinic undertook a quality improvement project to examine bariatric referral practices, protocols and related communication practices that promote surgical and medical referrals for bariatric surgery.  This project is part of the wider provincial five-year obesity management initiative of Alberta Health Services.

Project Update

The project uses a variety of communication methods for education related to bariatric surgery. Through a multiplatform (YouTube, ITunes, podcasts, vodcasts, TED talks) communication strategy the project will inform healthcare providers of the goals and roles of bariatric surgery in the management of obesity as a chronic disease. By this PLP also acts as an innovative learning tool helping physicians to cover their unperceived learning needs.

Considering that there are serious misconceptions surrounding the role of bariatric surgery, diversified communication approaches will help to increase awareness and understanding of bariatric surgery as an effective strategy of not only obesity management, but also for curing or reducing risk of associated diseases (type II diabetes, high cholesterol, hypertension, joint disease, cancer and sleep apnea).

As a first step of the project, a five minute video was created with detailed communication/distribution plan to enhance referrals of appropriate patients for surgical intervention. The video addresses certain misconceptions surrounding bariatric surgery by conveying the following messages:

  • Bariatric surgery is not an easy way out of obesity;
  • Bariatric surgery is not dangerous;
  • Bariatric surgery is a necessary and effective procedure because it achieves and sustains substantial weight loss compared to exercising and dieting;
  • Bariatric surgery is an effective procedure for treating and/or preventing a number of co-morbidities (type II diabetes, high cholesterol, hypertension, sleep apnea, joint disease, cancer)
  • Bariatric surgery is an important part of an overall approach to obesity management.

What Physicians are Saying About this Project

The video addresses many of the myths and concerns regarding obesity and bariatric surgery, and should encourage referring physicians to search further into this important topic to treat patients more effectively.

Dr Daniel W Birch MD, Professor of Surgery, Medical Director CAMIS, University of Alberta

Note for Patients

Persons wishing to find weight loss resources in their home community should consult their family physician

Resources

http://www.youtube.com/watch?v=T9erkVQ69zg&feature=plcp

Current Projects

An overview of our projects