Research survey on bariatric surgery medical tourism in Alberta

Could you be more clear please? Comparable to what standards?

This latest post can be read as "We're seeing that people having surgery out of country are having roughly the same amount of complications as those having it here. This survey will help us know if this is true and help dispel prejudice against it."

Is this what you're saying?

I also wanted to share some thoughts of Dr. de Gara, who is one of the few bariatric surgeons in Edmonton:

The primary bariatric surgery performed at the Royal Alexandra Hospital in Edmonton through Weight Wise Clinic Alberta Health Services is safe. There were no deaths in years, anastomotic leak rates are almost non-existent, hospital lengths of stay are 2-3 days and our performance fall within the American College of Surgeons Centre of Excellence criteria.

There is no doubt that bariatric surgery can be performed safely abroad. But the problem for Alberta is who should look after those in whom the operation didn't go so well, who is doing the rigorous screening preoperatively (to achieve the highest chance of success), who is doing the rigorous post operative care to ensure that goals are achieved and diet and lifestyle monitored? Are those who choose to go abroad for surgery queue jumping?

Dr Kim

  I have now had my surgery and filled out your survey.  My experience in Mexico was far more pleasant than most of the people I've spoken to who have had surgery here. The scope of your survey is very narrow and doesn't address how people select their out of province surgeons or how they prepare for surgery. If support was available to screen and help people willing to pay for their own surgeries prepare for surgery , it might improve the situation as a whole. I have requested and been denied access to post bariatric education classes through Weight Wise even though I was in the program for the second time when I had my surgery. It seems that we should be punished for taking financial responsibility for our health instead of rewarded. As for your question about queue jumping.... Really!  Our system is already two tiered, and I just saved the province a lot of money paying for my own surgery and made room in the system for someone who can't afford to pay for surgery. Is it too much to ask that at some point egos get set aside and the greater good be considered?

I am beyond insulted by that last line. Queue jumping involves putting someone ahead of the rest of the queue, generally for money or other benefit, resulting in the other people in line being hurt by slowing down their own procedure, resulting in a possible decline in health.

I was initially turned down for WLS by the Weight Wise program because I was too healthy and was managing to maintain a 45# loss on 1500 calories without whining. My dietitian had told me I'd be an excellent surgical candidate because I was able to be so compliant, but the Dr Sharma disagreed - I was devastated.

The "rigorous screening" Dr de Gera refers to - what are they screening for? According to Dr Sharma's formula, what is required to qualify is poor health caused by excessive weight. If the goal is the highest chance of success you'd think the patient you'd want is one who is in good health other than being obese.

I was allowed back into the program after a 12# regain (after an injury that made exercise impossible for 2 months) with a 4 month wait and the understanding that I'd be starting back at the beginning - with no promise of surgery this second time around. Knowing how crushed I'd been when turned down the first time, I took stock of our finances and decided (with the support of my family and family doctor) to pay my own way.

I did the research - read reviews, talked to people who'd had surgery with the 3 surgeons with the best reviews (number of procedures, frequency of complications, quality of nursing care and type of facility). After contacting each of the 3, I chose Dr Aceves, and was able to book my surgery for 3 weeks later.

I didn't push ahead of anyone. If anything, there was benefit to the queue in my choosing to pay my own way, since someone else was able to take my place in the Weight Wise program.

If the point of this survey is the common good, what would be helpful is for Alberta Health to do some research of their own, and when someone goes through the Weight Wise (or other) program and doesn't "qualify" for surgery here, offer them a list of safe self-pay options. Then, once again if the common good is the goal, have the same aftercare available to those patients as to anyone that has the surgery locally. I don't have need or desire to go to endless dietitian and nurse visits, but having a clear protocol for my annual blood tests would be helpful, and other people might find some of the other aftercare resources useful.

Yes, some might call this tiered health care, but the reality is that we already have a multi tier health care system. For instance, when my husband needed to have a sleep study done, our doctor told him he had 2 options. He could be added to a list of people having a study done through Alberta Health, which could take as much as a year, or, if we had supplemental insurance or could afford a $150 fee, he could have the sleep study done the following week.

Another form of tiered health care that is already happening is people travelling from other parts of Canada to have WLS here. Do you consider it to be queue jumping for them to come to Alberta in order to have surgery sooner than if they waited at home? Are they pushing in front of someone else? Taking the place of an Albertan who has to wait longer - or not be approved at all?

Since we have "universal health care" in Canada, should WLS not be available in all provinces - and with reasonable wait times? (A matter of 3-6 months from referral by the person's GP) Since the health benefits (and financial benefits, both personal and to the health care system) are significant, should there not be more surgeons training to do WLS all across Canada? Perhaps WLS should be classified with hip and knee replacement surgery and money allocated to improving both access and shorter wait times. "Contracting out" is considered a reasonable option in some industries - "medical tourism" could easily be brought into that sort of umbrella, with some research done into surgeons and facilities to ensure that outcomes are comparable to having the surgery done locally.

Kelly-Anne

Well said!

Jill