Gadbois Kyle, MD, FACS, Hwang Stephanie, MD, Takata Mark, MD, FACS, Fujioka Ken, MD, Fuller William, MD, FACS. Scripps Clinic Medical Group
Introduction: Obesity is a significant problem in the United States, 34.9% of adults are obese1. With more than 100,000 patients undergoing bariatric surgery in the United States every year2, many post-operative patients are being managed by their primary care physicians.
In a survey of primary care and subspecialty physicians, primary care physicians are only moderately familiar with the National Institutes of Health (NIH) guidelines for bariatric surgery, and only moderately familiar with the bariatric procedures that are currently performed3. Another study found 35% of surveyed primary care physicians “did not feel they had adequate resources to provide good quality long-term medical care to operated bariatric patients” and 45% of primary care physicians “felt competent to address the medical complications of obesity surgery.4
Methods: A 14 question survey was electronically sent to active PCP physicians treating bariatric patients in the Scripps Clinic Medical Group. Surveyed physicians had a record of treating bariatric patients with no type of bariatric surgery being excluded. An ordinal scale of five points was used ranging from “Not Helpful at All” to “Extremely Helpful.” There was one final qualitative question allowing for a free text answer.
Results: The electronic survey was completed by 60 survey respondents out of 183 providers sent to (32.8% response rate). There were eight free text, qualitative comments with respect to the survey’s final inquiry. Questions were split into three categories: post-operative medications, common post operative patient concerns, and post operative laboratory and nutritional guidelines. Sixty-four percent of respondents answered more guidelines on post-operative medications and laboratory and nutrional guidelines would be extremely helpful. 42% responded that more guidelines on common post-operative patient concerns would be helpful.
Conclusions: Primary care physicians in our medical group could benefit from more guidance in the management of bariatric patients and more comprehensive guidelines.
References:
1. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of Childhood and Adult Obesity in the United States, 2011-2012. JAMA. 2014 Feb 26; 311(8):806-14
2. Livingston EH. The Incidence of Bariatric Surgery has Plateaued in the U.S. Am J Surg. 2010 Sep; 200(3): 378-85
3. Avidor Y, Still CD, Brunner M, Buchwald JN, Buchwald H. Primary care and subspecialty management of morbid obesity: referral patterns for bariatric surgery. Surg Obes Relat Dis. 2007 May-Jun;3(3):392-407.
4. Balduf LM, Farrell TM. Attitudes, beliefs, and referral patterns of PCPs to bariatric surgeons. J Surg Res. 2008 Jan;144(1):49-58
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