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Medical Tourism Kills

Bariatric Surgeon Denver

I saw a patient in the office for a weight loss consultation the other day. For the sake of discussion, let’s call her “Kate.” Kate meets all of the criteria for bariatric surgery, being just over five feet tall, with a weight in the low 200 lb range. She also has a fairly large hiatal hernia and severe acid reflux, in addition to some other medical problems that put her at high risk for sleeve gastrectomy. On the other hand, she is a great candidate for a gastric bypass with hiatal hernia repair, a larger, more extensive operation, but one which I perform quite frequently.

Unfortunately, Kate’s insurance does not cover bariatric surgery.

I explained the self-pay system that we have built into our program, which includes contingencies for unforeseen complications, but this very well-educated, financially stable patient stated, “That’s okay, I’m going to go have it done in Mexico.”

Please don’t get me wrong, Mexico has some outstanding Bariatric Programs, with excellent surgeons. The problem is the lack of follow-up for American patients, and the need to return to Mexico should anything go awry. When I raised the aforementioned issues to Kate, she replied, “You can take care of me if anything happens.” Unfortunately, Kate, that puts me in a very difficult situation. Fixing another surgeon’s complications is fraught with danger. Each surgeon has a different way of doing a procedure; and suture material, stapling devices, and hernia mesh used in other countries may not meet the guidelines of the FDA, which can end up creating a huge and complicated mess inside the abdomen.

I have now repaired, revised, or performed what we refer to as “damage control” on over 40 cases that were performed in Mexico and other countries, and I was featured in a newspaper article about some of the problems from other countries that I have had to correct. Medical tourism is a prolific and lucrative industry, but it should be discouraged in the setting of procedures that can be performed safely and effectively by surgeons that have a vested interest in following their respective patients.

The Hippocratic Oath of “Do no harm,” is not a universally applied principle. Developing and maintaining a long-term relationship with patients is one of the reasons I chose bariatrics as my specialty. Weight loss surgery is one of the few surgical disciplines that enables a surgeon to follow patients forever after surgery. In fact, the Center of Excellence designation requires us to follow our patients long-term after surgery, and we are held accountable for lack of follow up and/or complications. Our data demonstrate that the more points of contact a patient has with a bariatric program (surgeon, dietitians, mental health, support group, nurse practitioners, physician assistants), the better he or she will do long term.

Going to another country to save some money might make sense if having a minor procedure, but a laparoscopic roux-en-y gastric bypass, with a simultaneous hiatal hernia repair, does not qualify as a minor procedure. Please folks, and especially “Kate”, think about the reasons you or your loved one is considering bariatric surgery. You want to get healthy. You want to be around for your family. You want to enjoy life, and get rid of a bunch of medications. Don’t throw everything away to save a few bucks, and then hope that someone back home can fix an unnecessary surgical disaster. Find a local, board certified, Center of Excellence Bariatric Program to take care of you. Do it right the first time, and let’s get healthy together.

Let’s get healthy together!

Dr. Matt Metz, MD, FACS
Medical Director
Bariatric and Aesthetic Surgery Associates

Balloon Technology is Here!

Balloon TechnologyMany of you have asked about the stomach balloon technology that has been all a-buzz in the media lately. I have recently begun collecting names of patients that are interested in these advanced devices. I perform the procedures under conscious sedation (no general anesthetic), through the mouth (no incisions, no scars). Using an endoscope, I insert a shaped balloon into the stomach, and inflate it to a certain amount that reduces hunger, and increases fullness.

The balloons are temporary, and must be removed 6 months after insertion, also with an endoscope, and also under sedation, without general anesthetic. Patients go home the same day in both cases, and have been shown to achieve as much as 40% excess weight loss in some studies.

The procedure is not for everyone. Patients with large hiatal hernias, or previous bariatric surgeries, or active ulcer disease generally do not qualify, and the balloons are currently only approved for patients with a BMI between 30-40 kg/m2.

Insurance does not currently pay for gastric balloon therapy, but we have worked out a very reasonable self-pay price, and financing is available.

If you are interested, please call my office at 720-851-1610 so we can get you started. The balloon technology is a very exciting adjunct to our practice, and I am very pleased to be the first surgeon in the region to offer one of the dual balloons, as seen in the media.

Let’s get healthy together!

Bariatric Coverage for All Who Qualify!

I’m so fortunate to have been invited to participate in the Access to Care meeting for State Chapters of the American Society for Metabolic and Bariatric Surgery. Our group is hard at work to improve access to bariatric benefits for folks without insurance coverage for weight loss therapies . I will keep you all posted, and I really appreciate your support as I help represent this region of the United States!

Let’s get healthy together!

Dr. Metz Invited to Present Loop Duodenal Switch Data at International Meeting

Loop Duodenal SwitchI’m so honored to have had the opportunity to present our initial data on the Loop Duodenal Switch, or SIPS procedure, last week.  While it was truly inspirational to meet face to face with other pioneers in the Surgical Community, my favorite comment came from the national study coordinator, who said, “You’re Dr. Metz?  I thought you’d be older!”

Congratulations to our super-motivated and dedicated patients, colleagues, and support staff for this tremendous undertaking.  I will keep you all posted as we move into final phases of the study.

Let’s get healthy together!

Work Your Butt Off

“It’s a great tool for me, but you still have to work your butt off.”

“I eat like a normal person now. I’ve learned better habits, but I still can’t eat a ton of food.”

A patient several years out from his sleeve, with a now normal BMI said the aforementioned things to me today in clinic. I happened to be at the front desk annoying our amazing office team when the gentleman in question walked into our waiting room. Had I not known he was coming in for an appointment, I never would have recognized him. He’s down over 130 pounds, and all the ladies were staring at him with approving eyes.

This particular patient was told by another physician that, had he not had bariatric surgery, he would not have lived to make today’s office appointment with me, and he is only in his middle 40’s.

I am so impressed with his dedication and perseverance, and I’m truly in awe of his family support system. He, like so many of our patients, is an inspiration to me. Thank you, Sir, for making my day today!

Let’s get healthy together!

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