Harrassment: Bariatric Style – The Emails

5/12/14

The items from several weeks to almost a month ago, in written communication, have not been addressed, in regards to putting items in my records. By HIPAA law, there is no time restriction.

I’ll pass on that your security guard photographs & logs me for asserting my constitutional rights to free speech, including the office watching me. The multiple times the police have gone out, they have never seen me do anything other than behave with dignity and respect. That includes how I treated a nurse politely with inappropriate questions & the bariatric surgeon following me on public property.

I have made it clear that I have no interest in money, being photographed, or lawyers, but in getting appropriate health care. Care that the bariatric surgeon appears to have been incorrect in saying I didn’t need, or that my other doctors have indicated I couldn’t use. All because I don’t want to see someone else also hounded and suffer for saying they are a human being who is worthy of respect and to assert their rights under the law and published policies.

((I also mentioned that more than a year ago, I had suggested to the office in an email, that they needed to educate other healthcare personnel in bariatric after care)).

5/8/14

I politely answered the nurse when they went at distance length from the bariatric group staff door to initiate questions about what I was doing/intent/etc. on public property (not considering that I stated I was not a patient any longer, so why I was being asked such questions on public property raises motive questions) & was followed onto public property multiple times by the bariatric surgeon in another instance. I received a letter that contains incorrect facts, from my records, among other things. Most sad, considering I was extremely impressed by another one of your physicians I met.

I do not have the information requested below regarding another source for the HIPAA privacy people, as they have not responded to my photography related request. Prior history shows a difference between published practices & practices per se. What practices can we expect from the Privacy people is what I am looking for from another source. The same can be said for you, especially as to why you need lawyers when I bring legitimate concerns, with no lawyer in tow, that have never been completely addressed, & you have been given multiple opportunities to do so.

Please see second paragraph below, they stated nothing could be done for me. If regular doctors can’t deal with/recognize it, an ER doctor would not either. None of the Nutrition Journals use bloodwork as main indicators since 2011 for malnutrition, nor did you when you {a person who isn’t a doctor and never examined me} made your medical assessment that I did not have malnutrition in 2013, compared to a physician I had a history with and medical research to support the assessment. Do you have further information on who has experience dealing with a complication of bariatric surgery since the bariatric surgeon appears to not have, & non compete and “buddy” agreements don’t allow for care in the area from bariatric healthcare personnel? Or who doesn’t drop care when payments can’t be made, which is why a patient couldn’t make an office appointment, contrary to stated your policy?

Because our bodies are very good at compensating during tough times, doctors have observed that blood tests and external measures of illness are inadequate: there are very few indications a body is about to go into crisis until the damage has already been done. Too many families find out only after a life-threatening or fatal episode how close a loved one was to death. In PCM, however, the lymphatic system can’t keep up with the leakage, and the stomach area begins to bloat with its own waste fluids.

Starvation can cause (amongst other things) low blood pressure and poor circulation; osteoporosis leading to possible fractures, deformities, and pain; anaemia; stomach shrinkage, leading to uncomfortable stretching and feelings of fullness when more than a small amount is eaten; increased blood cholesterol levels due to lack of oestrogen; nerve and muscle damage; low glucose levels, which may lead to coma; kidney failure; and death through heart failure.

Thank you,

5/X/2014

> I’ve started getting a higher temperature, burning up at times, legs cramping & chest pains, a lot of problems eating and tonight, couldn’t eat without pain. My skin is breaking apart, my MPV and platelets are high for me, indicating thrombosis. I’ve not been able to take medications since November because when the albumin is low, drugs have nothing to bind to and are free in the plasma, amplifying the effects.
> Some of my bloodwork is high/low for me, meaning the effects of malnutrition are starting to show in the bloodwork because I can no longer compensate for illnesses that weren’t diagnosed & my care disrupted.
>
> Find me someone else who can answer the questions since I’ve been told there is nothing they can do for me. I’ll won’t make it through this because of the bariatric surgeon without any care in the area. They said that ‘if you don’t do as I say, I’ll put it in your record, and other doctors will see it, and wonder why’. They wanted to damage my relationships with other doctors. They succeeded. As an office worker said ‘YOU’VE lost a huge chunk of your care.” There were right. I will pay the price for that, although I even asked that the administration do nothing negative to the surgeon, and I’ve seen that the suggestions I made regarding the practice were implemented.

Privacy officers – acting in who’s interests?

Notes from the one phone conversation with the privacy group where my bariatric surgeon is located:

He called my work number. He said he was working w/a fellow employee on HIPAA violation, 5/31/13. I called back, w/leaving msg for him approx 1230 pm. He called back, phone messed up, I called him back about 115 pm.

He said he doesn’t want to go into it. No results of investigation could be given. Requested time line of what I submitted, as he said they didn’t give the results out. He said he was hesitant to do it, they didn’t do it, because of all the back and forth that has gone on between the doctors, etc. They had closed the case. The apparent indication was that they weren’t going to do anything because of the “back and forth”, even if it was verifying & stating when I called. “Too much energy had already been put into it”.

Its nice to know that you can get verification that a group TRUELY looked into your assertions when you can get NO information on what they did, what they asked, how they did it?

NO TRANSPARENCY. Always remember that.

Hidden records you can’t access – is that legal?

There was a lawsuit I found where the hospital admitted that they kept FACT information about a patient not included in the patient chart and that those things aren’t released. BE CAREFUL!

http://waterman.pro/virginia-patient-falls-lawyers-videotapes/

On November 27, 2012, the medical malpractice victim called VP/Dr. Stolle as an early case-in-chief fact witness at jury trial in Burrell. Notably, VP/Dr. Stolle testified about certain Riverside record-keeping re factual information of patient care not included expressly in its patient chart; and through him, the Burrell victim introduced into evidence Plaintiff’s Exhibit No. 30, the internal computer database printout of Riverside Hospital, Inc. that stated inter alia its high unto extreme fall risk patient’s mental status was “very confused”.

Record discrepancies pt 1

Here are just some of the confusing and odd medical discrepancies I had with my bariatric surgeon. I have had to make less corrections to most other doctors’ records, but remember once you get these things messed up, trying to get them corrected is near impossible. It also makes confusing records that much harder to try and get and coordinate care with others. When other doctors see records, they’re going to think the doctor is right, but if they can’t figure them out, you pays for that?

YOU DO!

——– Original Message ——–
Date: Wed, 29 May 2013 22:57:05 -0400

2/7/13 note: Email sent to bariatric coordinator stated reason for visit was to discuss whether or not I had messed up the sleeve gastrectomy. Celiac disease questions were directed at GI, however, he wouldn’t test at that time.

2/15/13 note: Note doesn’t include statements regarding the months of pain I endured due to misdiagnosis of gallbladder disease. I alluded to treatments prescribed without being given information about all options available, costs & benefits weren’t discussed. Due to those considerations, such decisions made without my input were stumbling blocks to compliance. No specific statements listed so that we can know whether the lab results were good/bad, or what actions I was to take in response to them.

3/27/13 note: GI indicated eating softer foods, less fiber, etc that conflicted with the foods/drinks recommended by the bariatric group. Allergist stated cutting out several food groups recommended by bariatric office. Compliance is next to impossible under these circumstances, and when the subject was brought up, was “blown off”.

4/8/13 note: Have medical documentation supporting that BMI is not a good indicator of health in athletes, nor is it accurate for us. Excess skin from weight loss, edema, bloating/gas from intestinal issues would skew weight results.

4/10/13 note: 5 months ago figure incorrect. Hospitalized for malnutrition in June 2012, 10 months ago. Didn’t eat a lot due to not being hungry and pain on eating from gallbladder. Food intolerances developed after this point in time. Confusing sentance: “She then went on to tolerate it she has very little upper body strength and is being and I waited by her primary physician for this muscle weakness. Have never reported being able to tolerate ground beef as stated in note. bariatric surgeon asked about chili previously, due to a chili contest I had mentioned. Stated coworkers had to help me back to my desk from being ill from attempting to eat chili. At this appt. he asked if I had tried anything else other than ground beef. I said no, he suggested steak. Discussion not in office notes. Confusing sentance: “She does eat significant amount of headaches”. Was not interested in “long” discussion about plastic surgery, just needed a list of items as to what the specific medical problem I had that needed to be fixed to get it done. I could never ascertain from any discussion, medical office notes, what the pinpointed problem was and how to solve it. This included 2 specific requests that were never answered, one for bariatric surgeon and one for nurse, for an appt. to discuss what their opposition specifically was. Confusing sentance, last sentance is one paragraph. In addition, states “she had not even been one year from her bariatric surgery”, when the second sentance of this office note stated I was 16 months postop. Confusing sentance: “severe plastic surgery sometime in the next few months”. Follow up in notes is for four months, but after visit, bariatric surgeon told his nurse to make an appt. in 2-3 months.

4/18/13 note: List was given. Note that the first plastic surgeon recommended had a 1.9 million dollar verdict against him due to death of a patient.

Note that in all these, the only physical exam was done by the nurse on my abdomen. Another nurse also took my blood pressure at the first visit.

Office Managers: can be just like risk managers

Here’s are a few excerpts from my emails to the practice/office manager of my bariatric surgeon:

——– Original Message ——–

Date: Thu, 14 Feb 2013 20:00:07 -0500
Good morning (I apologize for not saying that):

Thank you.

He doesn’t have to respond. He didn’t on my last email regarding the situation. I had considered only plastic surgeon previously, but because of the communication between him and bariatric surgeon, I’m required to look for someone else. That makes a vast difference in care & my outlook, as plastic surgeon supposedly is the best. Now I have to settle for less and scramble to find someone.

This is the second time where a relationship I had with a doctor changed due to discussion with bariatric surgeon. In discussing this with others, as with my gallbladder, I am treated differently without medical basis for this fact.

Sent: Wednesday, February 13, 2013 4:52 PM
Subject: call from bariatric surgeon

I got a call at 435 my answering machine time, about 5-7 min. before I got home. bariatric surgeon had called. I called, answering service said you all were closed and didn’t care it would be another week before I could find out what was going on.

I work in cubicles and everyone knows your business if you call at work. I have to wait either another week until I work from home on Wed. to find out what he wanted or I have to schedule time to work from home.

I’m sorry I missed him. I had no idea he would call, otherwise I would have cancelled going to my board meeting. Please let him know. I don’t have caller id so I answer the phone if I’m home (or the ringer doesn’t work & that’s happened before).

> Sent: Wednesday, August 22, 2012 4:37 PM
> Subject: Followup
>
> Thanks. I will let the practice manager know that the main concern I have is that my GI doc told me he wouldn’t do anything without bariatric surgeon’s “ok”. My relationship to my GI doctor should be based on what I have told him are my symptoms and (especially as the directions given to GI doctor were not complete) a more thorough history. I was able to ask for a HIDA scan test before bariatric surgeon talked with GI doc, and now the GI doc won’t repeat the scan. If they feel that a false positive was given, repeating the test would take care of that, and also that has been pinpointed as the area/region giving me problems. As no testing is considered that involves food or digestive action (when the pain, problems occur) is being considered, I fail to understand the medical reasoning behind not conducting testing to find a surgical problem to be fixed or why the direction of the gallbladder issues was changed.
>
> I feel that the issue is that bariatric surgeon feels it is mental, anorexia nervosa, and that’s why testing is being refused. It is obvious that from the GI’s followup (a one month appt.) that he does not consider daily RUQ pain to be an issue.
>
> Should gallbladder removal occur and the pain subsides, this will be another example of the group surgeon who was told of reoccuring pain, correctly told the doctor what the issue was, the doctor said it was “mental” or not physical, refused to address it, the patient went to another doctor, the surgical fix was made, and the pain corrected. This should be a cause for concern for the practice. I know it would be for a patient.
>
> Thank you,

Sent: Wednesday, July 25, 2012 8:23 AM
Subject: question for you

I’ve put in my medical record the below notes (please also refer to the emails from earlier this week in my medical record). I wanted to make sure that this does not “fall thru the cracks” and does get addressed. Patients have rights and responsibilities & we let our medical personnel know the reasons for not being able to follow through on a plan. Living my life in pain just to be kept alive, being forced to eat & the manner of doing so so that it causes me pain, that’s how I perceive the situation, I have a problem with. I’m not the only one either, so trying to “play off” I’m crazy, well no one who is around me and *KNOWS* me, we’re not buying into that. Whether smiling through it or complaining about it, doesn’t matter, nothing works to get a plan that I participate in (especially its formulation) and am fully informed about.

Is this something that you can do or do I need to take this further? I’ve been several avenues, several methods, and after months, there is still no resolution. I’ve made comments that I’d just rather drop than to continue like this: with no end in sight to an expensive plan that I haven’t seen address the underlying pain issue. All I see is that I get a reputation for not following doctor orders (that I’m not fully informed about other options, tests, given a chance to participate in the creation of a treatment plan, etc.) and for being a difficult patient, when the fact of the matter is that if I felt like I was treated with respect and compassion, included (or even asked) about a treatment plan, things would be different.

We come back to a complain I had months ago: listen to me. Corrollary: take me seriously; work with me; don’t blow me off – or expect the same treatment in return.

Let me know if you get this message and whether or not its workable.

Thanks,

I’m documenting the PICC line removal, etc. is directly due to pain (& other symptoms) that have either gotten worse, keeps coming back/not been resolved. The main reason I exercise is to take my mind off the suffering and to enjoy, with friends, the time left to me.

Need an appt. w/time to discuss the medical reasons why I haven’t been treated for pain, including tests performed to ascertain pain causes, why other doctors’ tests were/weren’t taken into account in making this decision, & timelines when it will be treated (or who I need to go for resolution). Also all diagnoses, course of treatment & timelines involved as to when this will lead me to full recovery, the alternatives, & where I am allowed to participate in my Plan of Care development & the way it is carried out. According to the group, “to have my pain appropriately & quickly assessed & effectively managed & to receive information regarding pain & suitable pain relief measures”. This needs to be addressed without delay.

Sent: Tuesday, February 19, 2013 11:06 PM
Subject: additions to medical record

Good morning,

Thank you for allowing me to review my records. I have some notes that I would like to have added to my record. If the enclosed document could be added to my medical record, I believe it would be helpful. It should provide greater understanding for any one reviewing the record.

Hope you have a great day,

Risk Managers: Deny, Defend, Investigate Pt 6

Just a few more of the items that I’ve gone thru. Think again, would you want to deal with this, when you simply were trying to get care and get some answers? This is why you want to investigate the surgeon thoroughly.

Sent: Thursday, July 18, 2013 10:28 PM
Subject: Re: Results

I don’t want to drag things out, but there are questions that have been around for months, unanswered by the group. How many questions/emails (number) do you have answered so far, is there anything that you have called/emailed that has not been addressed in 3 days by another party? What are the ETA’s on those?

Do you have a timeline from the the group HIPAA violation group? Do you have confirmation that I am not mentioned in any “secret” or nonpublicized database (EPIC or not) that “flags” me in any way, and that I am not mentioned in any computer, database, or communication other than that available to me?

What do you need from me to further your investigation? When do you expect to be completed with the first phase? I can email you on Tuesdays and Fridays to check progress.

Thank you,

Sent: Sunday, July 14, 2013 7:19 PM
Subject: Results

I had some questions for you, a couple of which (what you do and how to send record discrepancies to you) should have been answered already, that haven’t been. Please let me know this week have when you will have those answers or what has been done on the issue. It has been 3 weeks and I’ve seen no action on the group’s part.

I was placed on prednisone for skin problems. Had the malnutrition been taken care of earlier, I wouldn’t have had this problem, as skin issues are another sign of PEM. Now I’m taking a medication that we have no idea if it will mess up my stomach, due to lack of care. GI’s do not have experience in this area. My internist, who I had to produce medical documentation to get testing that was to be done in June, would not know either. This is in direct conflict with the assertion that my internist and GI could care for me.

——– Original Message ——–
Date: Wed, 19 Jun 2013 11:43:07 -0400

Good morning,

Thank you for speaking with me this morning.

One of my requests is that if there is any information regarding me and my patient care that I cannot access through electronic health record, or has not been given to me already in the doctors’ office notes, to be provided a copy of that. This does not include billing information. Please feel free to let me know the different types of information that I may not have covered in this email, as I may not need that information.

If you could also let me know the outcome of the questions I had in regards to procedures for requesting record modifications/additions, that would be helpful.

Thank you for you help.

——– Original Message ——–
Subject: Re: Information Request
Date: Wed, 19 Jun 2013 23:13:17 -0400

Good morning,

For a bit of clarification on surgery. I understand there is no bariatric care thru the group. If I was to need an appendix out, would that rule out any the group doctor? another surgeon was the original doctor I wanted for my bariatric surgery. I was refused going to him first for the bariatric surgery (just told I was to have bariatric surgeon, and that’s who I was assigned) and then that other surgeon’s office said he would not overrule bariatric surgeon’s refusal for the gallbladder removal surgery (my insurance called the office & bariatric surgeon did do the surgery). I was told something different by other admin. I have also been told that the reason I didn’t get another surgeon was that he is more of a general vs. bariatric surgeon. Several have said once one doctor operates on you, they don’t like to go in on someone elses’ work. A specific answer would be very helpful for me & to pass along to others, as I’ve been told one thing one time, a different one another time.

I’m without care now, and the contract I signed with the group was that I would return for follow up visits. If we don’t need care after surgery and can go elsewhere, then why did the group have me sign a paper stating that?

My Mother and I were told by bariatric surgeon that he would round on me the Tuesday afternoon I was in the hospital for my gallbladder surgery and never showed up. My Mom is 73 years old, and after several hours of waiting, had to drive home thru the a very congested major artery in rush hour traffic to get home. If you’re going to give me an answer, please keep it consistent.

I was told that plastic surgeon, a plastic surgeon, spoke with bariatric surgeon, then was told nothing was said, then it seemed there was conversation between them. That conversation was never in my notes, nor was there any documentation obtained on it. That is one of a number of questions I had about my care I couldn’t get answered while still a patient, or the answer would change. I’m looking at plastic surgery so if there is still an issue, I would expect to know about it.
Again, if there is any other problem or prohibition that I am missing, at least work with me professionally to find care before you throw me out. I’m having problems, my internists office told me that I had lost a “huge chunk of my care” and because of legal issues (not from me, non compete agreements?) no one else in the area will take me. After everything I’ve been through, if I can still find positive things to say about the office, please find that same spirit for me.

Thank you,

——– Original Message ——–
Subject: Re: ER – hospital
Date: Wed, 7 Aug 2013 10:15:41 -0400

Ma’am I’m talking about the blacklisting that appears to go on. I don’t want to come if we’re not going to treat me. I was recommended to go to the ER by the insurance nurse and the GI nurse. However, a PICC line is what is needed, and that would be a hospital stay. The only response I get is that my the group doctor tells me to go out of the area for care.

So I know what you say, but in practice, that’s not what is happening.

Risk Managers: Deny, Defend, Investigate Pt 5

There are the questions that were also never answered in terms of care:

I had a person who had their surgery also done with Bariatric Surgeon. They were given a gallbladder operation but I was refused it. I went to 2 different opinions who immediately diagnosed gallbladder disease, suggested surgery. I had my insurance call and inquire about it not being done in my case. The insurance told me that they were supportive of me. When I saw bariatric surgeon at that next appt. They said They wasn’t trying to dump me but if I didn’t like the care then go elsewhere, and other items along that line.

What I did not tell Them was that I had already tried to because of the differences in care I found between what others got and what I had, where I could read medical literature and not see reasons for those discrepancies. Also that I had contacted the doctors’ office and they said they wouldn’t overrule bariatric surgeon because They was in the same group, I was his established patient. The other groups in the area wouldn’t it, due to litigation/non compete agreements & because the other group had buddies.

6/24/13 to the risk manager

I received some documentation that I have a disagreement with, and was told I could send it to you. How may I do this?

I am finding that I’m missing some documentation requested of the administration. One of these items was documenting a call to the group on 4/17/19 that gave praise to the surgeon for his operating skills and his office staff. I said I had a hard time understanding the bariatric surgeon because of conflicting directions, with 2 examples.

It appears only part of the calls made to the group were documented and not all the conversation documented in there. Its not just that procedures were not followed in my case. There are a lot of specifics that are missing, like the factual rationale for diagnoses or why I still was not on a regular schedule for visits.

Contrary to the bariatric surgeons’ comments about my gastroenterologist in his letter, I got on my *4th* gastroenterologist before full testing was done. Results of an EGD/colonoscopy revealed esophagitis, gastritis, among other issues. The GI made a comment about reflux/GERD. Its in the bariatric surgeons’ records from last year when given PPI’s. Someone can please explain how and why my previous GI was endorsed when 99% of his business is pancreas related.

I visited a neurologist for upper body weakness. Her comment was neuropathy secondary to malnutrition. She asked me where my bariatric surgeon was, why it hadn’t been addressed, it doesn’t happen overnight. Malnutrition was also an issue in the past with the bariatric surgeon almost 1 year ago exactly. Who or what specialty is capable of diagnosing and dealing with that? I specifically asked for it to be discussed with the internist. It apparently was not, as I do have medical references that indicate malnutrition occurring. We are all trying to figure out the specifics regarding me not having malnutrition, considering I was never physically examined by the bariatric surgeon, or how wearing 4 jackets he could ascertain there is no problem with me.

Does the group remove patients that have issues following surgery so that any stats reported to any agency look more positive? Do you have data/statistics to support that assumption?

The money that the bariatric surgeon was given by a medical company, does the group use anything of that medical company in the bariatric program besides X?

I am sure we will have a few more for you.

One of the solutions of GERD (that does not resolve) in LSG is a revision to RNY bypass. The following items/timeline:

1) I say positive things about the office, ask for clarification w/examples of items, call you about a potential HIPAA violation
2) my surgeon dumps me,
3) am having problems getting answers to questions that should have been resolved when I was a patient & roadblocks now,
4) due to contracts/legal issues (non compete contracts?), I now have no care
5) obviously after 2 laparoscopies for endometriosis, a gastrectomy and lap choly for gallbladder within the past 18 months, no GI is not going to operate on me. GI’s do procedures not surgeries.

I think you can understand our changed outlook on the whole situation, given the GI problems & relation to the surgery(ies) without any care, & what honestly looks like retaliation due to the potential HIPAA violation. In that call, I said I didn’t want anything bad to happen to the bariatric surgeon, maybe he was overworked and needed another pair of hands. All anyone can see now is that someone who asked for mercy to be given to another, certainly hasn’t been given that by the same person they asked for clemency on.

Why don’t you make this known to people before surgery? One of your patients finally got relief after 2 years of pain, but without care, if it comes to having a recommendation of surgery, I will have none for the rest of my life. My church would say that is quite a “testimony” about the doctor, program. We thought one of the doctors was something else, but my doctors’ “witness” certainly makes a greater impact.

6/19/13

Thank you for speaking with me this morning.

One of my requests is that if there is any information regarding me and my patient care that I cannot access through my medical record, or has not been given to me already in the doctors’ office notes, to be provided a copy of that. This does not include billing information. Please feel free to let me know the different types of information that I may not have covered in this email, as I may not need that information.

If you could also let me know the outcome of the questions I had in regards to procedures for requesting record modifications/additions, that would be helpful.

I’m without care now, and the contract I signed was that I would return for follow up visits. If we don’t need care after surgery and can go elsewhere, then why did you have me sign a paper stating that?

My Mother and I were told by the bariatric surgeon that he would round on me the Tuesday afternoon I was in the hospital for my gallbladder surgery and never showed up. My Mom is 73 years old, and after several hours of waiting, had to drive home thru the a major artery in rush hour traffic to get home. If you’re going to give me an answer, please keep it consistent.

2/20/13 to the office/practice manager:

Good morning,

I have a couple of questions for you. These are general.

1) When it is noted that I’m responding or looking better, what facts are there to support that? Sometimes I am missing where those are in the notes.
2) When GI doc and bariatric surgeon spoke with each other, I didn’t always see a list of opinions or recommendations. I looked back over one area and found it but didn’t know if I missed others. I also didn’t see the ones where the plastic surgeon and bariatric surgeon spoke together.
3) Was there any disagreement on the treatment plan between the bariatric surgeon and the GI doctor? I got the impression that there was a difference from them, but was surprised in the notes to not see that.

Thank you for helping me understand what is going on,

2/19/2013 to the office/practice manager:

Good morning,

Thank you for allowing me to review my records. I have some notes that I would like to have added to my record. If the enclosed document could be added to my medical record, I believe it would be helpful. It should provide greater understanding for any one reviewing the record.

Hope you have a great day,

*** Note by law, you have the right to put items into your medical records. There is a procedure for this, which was NOT followed in my case.

2/14/2013 to the office/practice manager:

Good morning (I apologize for not saying that):

Thank you.

He doesn’t have to respond. They didn’t on my last email regarding the situation. I had considered only the recommended plastic surgeon previously, but because of the communication between him and the bariatric surgeon, I’m required to look for someone else. That makes a vast difference in care & my outlook, as this plastic surgeon supposedly is the best. Now I have to settle for less and scramble to find someone.

This is the second time where a relationship I had with a doctor changed due to discussion with the bariatric surgeon. In discussing this with others, as with my gallbladder, I am treated differently without medical basis for this fact.

*** I want you to note that there was question with this bariatric surgeon saying that They would do actions to make a difference in my relationships with other doctors.