Ethical docs? Take the quiz

and ask them what they score:

Ethical Doctor Quiz

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Bariatric surgeon says get help from an internet forum

Now how many times have we been told to seek help from our surgeons and not forums? This isn’t the only time I was told to check out other sources.

On top of that, do you think that treating some patients one way and others a different way, for the same issues is appropriate? Does it mean that you have to make your surgeon like you to get care? If so, what kind of care do you really think they provide?

——– Original Message ——–
Subject: Further questions
Date: Thu, 20 Jun 2013 08:52:51 -0400

One of the questions I had for admin that was not answered was what specifics can they point out in the allegations made against me in the reasons for dropping my care (with proven problems) when they’ve had someone get pregnant against the time recommendations, the person stated they were “afraid” to tell the surgeon, but the whole office was delighted for them. Also, since patients do regain weight after the surgery, and it is due to overeating, whether or not they’ve treated those patients. Without a medical reason, in medical research, the reason is due to “bypassing” the bypass or overeating. This is basically not following the directions of the center in eating, drinking, and exercising.

I would also note, I was never on a timeline that is published by the center for follow ups. If there weren’t problems, why was I scheduled with appointment followups for my bariatric surgeon? I would note that some of my problems have been written up in the medical literature as known issues after bariatric surgery. This is something a bariatric surgeon would know, not a PCP nor an gastroenterologist, as the literature is not gastroenterology based but bariatric surgery based.

I have also never received a timeline of that I had a followup appt. in June with bariatric surgeon, from the April appt. and then when I discussed a HIPAA privacy violation, after that I was dropped from care. I believe I have the reason why the group will not provide that timeline.

As a followup, I have been told that another surgeon is more of a general surgeon. This was why I was not able to have them do my bariatric surgery. I was then refused by his office to go to them for the gallbladder surgery, although his office was the one I contacted first. The bariatric surgeries appear to go to a couple of doctors, mine included. Is that correct? What are the percentages of surgeries, bariatric vs. general that the doctors listed in the practice do? How many codes was my insurance billed under that went for bariatric care vs. general surgical care? It seems the group says you have to go to this doctor for this issue, but when they want to restrict care in practice, they’ll restrict it from all the doctors. All my care was listed under bariatric care for bariatric surgeon.

While it is listed in my records that bariatric surgeon would help my PCP and gastroenterologist, I can find no record of them discussing any care with them. Is that correct? The only one I could find out was the yes I do/no I didn’t discrepancies with a former plastic surgeon.

——– Original Message ——–
Subject: Couple others
Date: Thu, 20 Jun 2013 10:39:06 -0400

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 another doctors office and they said they wouldn’t overrule bariatric surgeon because they was in the same group, I was their established patient. The other groups wouldn’t do it due to non compete agreements and the “buddy system”.

——– Original Message ——–
Subject: Suggestion
Date: Thu, 20 Jun 2013 15:22:53 -0400

On 5/8/13, I questioned bariatric surgeon about sources for help because the other centers can’t take me, and they suggested obesityhelp.com. So that is the group’s recommendation from the surgeon, that I seek help from an internet forum?

Please verify that with me. I know I made it clear to the office, in writing, that the former dietician you had on staff couldn’t help me and ended up asking on the support group. I had asked a supplimentation question back a few months ago to your bariatric nurse and was told to ask my PCP. If this is true, why are we required to follow up with the office, if all that is done is bloodwork once a year (or 18 months and 24 months mark)?

Thank you,

Aftercare: bariatric surgery’s failure

I was just over 13 months out from surgery. My surgeon never examined me … as I told the office. Do you still think they provide aftercare? Think again! ASK and know what your surgeon does and GET REFERENCES not just THEIR WORD.

Sent: Friday, January 11, 2013 12:38 PM
Subject: Re: Pls let the nurse know know

Well am I even going to get examined? I have a thing at 230 and I’ve not even seen bloodwork posted.
I would have thought that a surgeon with a patient who complained of a swollen belly would look at it but they didn’t.

Sent: Friday, January 11, 2013 6:25 AM
Subject: Pls let the nurse know

I wasn’t examined or anything last Friday. All that happened was he looked at the old labs and my weight, nothing else. He saw the papers not the patient.
I’m breathing more shallow now. Its not just when I eat.

Thanks,

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”.

A bariatric nurse can’t answer this?

On 3/5/2013 8:02 PM, wrote:
> You’re kidding right? My PCP hands off most of this to the office because its not really his forte. They are used to seeing other things. Not that he doesn’t try very hard, but just he has no idea where to start.
>
> I’m the one telling them what to run, blood work and all. Unless another doc tells me to or I’m reading and then watching signs for stuff (like my iron levels).
>
> Months ago I tried for an internist. The only one I could get after a bunch of “not taking new patients”, and have been on his ‘call’ list for months, just called today for an appt. I don’t mean in the next 2 weeks either. I tried for an FP and she’s booked until mid June.
>

*** Here is where I was told to ask my PCP by the bariatric nurse.

>
> —–Original Message—–
> Sent: Monday, March 04, 2013 2:21 PM
> Subject: advice on supplement
>
> Any idea on good potassium supplements that work for us (brand or type or certain mg/mcg)? I know the Flintstones may not be working for me.
> Potassium was low, it will take a few days for my regular doc to retest and get results back to me. In meantime, may as well just take supplements. Doggone bananas must be losing their mojo or something …
>
> Thanks!

More questions to ask your surgeon

Parts of these were picked up from reading other sites and other groups.

How long have you been doing Bariatric Surgery? You want SPECIFIC dates. Month and year.

What are your outcomes and how long have you been keeping your data and statistics?

The results at 2 years are longer are important to know and how many patients truly keep up. Is it only the “positive” ones or ones needing help due to weight regain? If the program can’t tell you that only 60% of their patients still follow up in 3 years, and if it is only the “no problem” patients, then what is a prospective patient going to expect from that program as far as their individual results?

‘There is a program is San Diego, for example, that quotes: “Long-term success rate of 99 percent since the program’s inception-patients maintain a 70 percent loss of excess body weight”. This type of reporting is harmful to patients in that NO program can achieve those results but people expect that the program will tell the truth!’

What are your (surgeon(s), group, hospital) specific complication rates for leak, DVT, stricture, bleeding and infection? What is your mortality rate?

A 1% complication rate is ridiculous to quote. ‘What you as a patient want to know is that the program keeps their statistics in an honest and realistic fashion. For example: we have looked at our first 1000 cases to fully evaluate OUR complications with the operation done the way we do it at our facility. Programs should quote their rates and not the “national rates”.’

What are the components of the program?

They should have multi disciplined approaches to obesity diseases, and the components to address all issues: specialized nursing care pre, post op, in the hospital, and present (my bariatric team didn’t have the nurse on staff as she told me, ‘I have a party to plan for’), exercise personnel, support groups that have major input from short, middle and long term, positive & negative patients, and psych help.

How far away is help if I need it in the hospital or soon after? What happens if the surgeon isn’t available? How does the local ER know how to deal with complications from surgery or recognize them? This would even be things like IV’s … banana bags are truly needed in our case, as the potential for a life threatening issue from B1 levels can happen.

Does the program offer all bariatric procedures?

‘Though a program does not need to do all operations and may feel more comfortable doing only one operation, they should still discuss all options in a relatively “non-biased” fashion. For someone to only push a Banding operation, for example, without offering any insight or opinion on the Gastric Bypass (or visa versa) would not be offering true informed consent to the prospective patient. If only one operation is done it might also be good to know why only one is done. Did the surgeon have too many complications with another operation? Is there some sort of industry support that may influence the choice? These are fair questions to ask.’

What is the data about the endoscopic pouch reduction?

‘We covered our thought about the pouch reduction issue in another section. There are several different “platforms” or techniques available and different technology is used for various approaches. It is very important that the surgeon have a lot of revision experience. There is a rather special mind-set that a surgeon needs to have to work through the complexities of failed or poor results. Since these are more or less unusual cases, the surgeon needs to have experience in treating patients with a number of different modalities. “If all you have is a hammer, all the world looks like a nail.” If the surgeon has never done a revision of a major operation then they may have a very biased look on what a patient might need. Add to this the factor of industry support and unfortunately, some surgeons allow their treatments to be guided by their pocketbook.’

Why investigate your doctor?

If you are wondering why I preach to investigate your doctor, here’s why. Make sure to educate yourself and get the best out of it you can for you!

There are a LOT of great doctors around. Don’t you want to patronize the ones who are here for you? I take the time to email, mail, or phone call the ADMINS of my good docs and let them know. Be specific in what they do to help you. Let the docs know too. I made baked goods and got cards for my doctors on Doctors Day and Nurses week also. Don’t forget the nurses!

10News – Team 10 finds some dentists hurt patients, yet keep licenses –
Anatomy of a Tragedy
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Ex-doctor William Valuck charged with nine counts of murder
How to be an Authentic Doctor#15 Professional Courtesy
How To Dump A Doctor e-Patients.net
How to Get Rid of a Disruptive Physician
How to Get the Right Diagnosis Why Doctors Goof – US News
http–ethicalnag.org-2010-07-15-reporting-impaired-incompetent-doctors-
http–hcrenewal.blogspot.com-2013-09-a-new-and-quite-perverse-hospital-ploy.html
http–medical-malpractice.lawyers.com-blogs-archives-19340-Seven-Reasons-Why-Falsification-of-Records-Does-Not-Pose-a-Major-Problem-in-Medical-Malpractice-Litigations.html
http–milawyersweekly.com-wp-files-mimlr-mimlr_sep05.pdf
Is your doctor addicted
Missing doctor found negligent in malpractice case
Murder in Your Hospital
Not Running a Hospital Hospital rankings I wasn’t cynical enough.
Off the Record Legislators try to put doctor discipline behind the curtain Reporting on Health
Off the Record When reeducation for physicians isn’t good enough Reporting on Health
Patient Safety’s First Scandal The Sad Case of Chuck Denham, CareFusion, and the NQF
Physician burnout Don’t blame the patient
Physician Communication with Hospitalized Patients Key Physicians Practice
reading  Death Rate Drops During Doctor Strike
Secrecy protects doctors with long histories of problems – KansasCity.com
The Devil’s Priests by Robert S. Mendelsohn, M.D.
The Doctor Weighs InShaking the hubris of the profession
The Texas Board of Medical Examiners – A Broken Promise for Texas Health & Safety Jeff’s Blog
Top 5 Reasons Why Internists Are Sued
Whistleblower Terminated from Northwestern for Revealing Human Experiments and Fraudulent Inducement – CNN iReport
Why ‘Cherry-Picking’ Patients Is Gaining Ground Tougher to Dismiss Existing Patients
Year later, meaning of Santillán case still debated The Chronicle
‘I’m your doctor and I’m here to kill you’