Another Kaiser question -- waiting lists for real?

My good friend and her husband have been asking their respective Kaiser doctors about weight loss surgery for probably two years. And they keep getting told there is an 18-month waiting list at the Lancaster Kaiser facility. I'm not sure they're even on the list. (I know I was told I was on some list before I switched from Kaiser to Pacificare three years ago.)

Is this 18-month waiting list a reality or are they dealing with PCPs that are trying to discourage WLS?

They both have BMI's over 40 and comorbitities.

My friend is out on disability from work and her worker's comp doctor (non-Kaiser) is trying to get her surgery because he doesn't think her back will heal without significant weight loss. But that still leaves her SMO diabetic husband out in the cold.

Thanks for your wisdom.

To the best of my knowledge (and I admit I could be wrong) wls is not done at the Lancaster facility. Kaiser in Southern CA does do wls at one of two other faciilities, and also contracts out a lot of patients to non-Kaiser bariatric surgery practices.
    The waiting lists I've heard of are to get into the Options classes. The classes themselves take 5-6 months, and the waits I've heard of are maybe 3-5 months. I've never heard of an 18 month wait.
    It sounds like your friend and her husband are getting the runaround. I don't know why, but if they can't get their pcp to refer them into the bariatric surgery program they can file grievances. This worked well for someone I know who also had a bmi over 40 and her pcp refused to refer her. He even told her a grievance wouldn't work. He was wrong, of course.
    Once in the program, they can also file grievances to get out of the Options classes. The DMHC (dept of managed health care) will probably back your friends up, as such classes have never been shown to improve wls results (note - there are some people on this forum who liked the classes and found them helpful, which is great, others said they were repetitive and a waste of time and just delayed care).
    

Larra
 

Yes and No...there is a waiting list BUT it's not something their PCP can tell th em about.

I would have them tell their PCP to refer them to the bariatric program NOW.  If they tell them no it's time to get another PCP and they can also go to the Kaiser appeal program to get to the Kaiser Options program.

I know when I did the program there was a wait, but while I was waiting I was sent an orientation package and told to mail it back.  If your friends haven't gotten that, then I'll bet it's safe to say that their PCP hasn't referred them yet.  NOW once you get the package there can be a wait because Kaiser is more bogged down then 2 years ago when I got mine, but between my PCP appt in November 2006, I received the package within a month and the orientation was in another month so I went to the orientation in January 2007.  I was then told they would contact me when the Options classes started.  My evening classes starting in April, I got the call in March.

Hope this helps =)

Ms Shell

I am not sure about Lancaster but I am going through Kaiser Fontana.

My timeline so far is:
PCP visit Jan 28th referral to bariatrics program
1 week later got packet for history filled it out and called for orientation next day
February 26th Options orientation. Told 3 month wait to find out when you start classes.
June 1st called and got told my classes start July 24th.

Options classes are now only 20 weeks. I did not grieve the process since I need the time to make sure I have the sick time I need for the surgery. I have heard that there is a 6 month wait to find out when your classes start but I can not personally verify this. I have a very supportive PCP and he actually referred me on our absolute first meeting. I hope everything goes well for your friends.

Nathalie :)

PLEASE READ!!

Most likely they are dealing with PCP's that are trying to discourage them.

If their Dr's have been jerking them around for this long, it's time to get new Dr's! My Kaiser Dr. tried to tell me that he couldn't refer me to Bariatrics because I didn't meet Kaiser's criteria for WLS (my BMI was 46). I asked him to to refer me so I could get a denial and then file a grievance & he told me no, that when they denied me it would just go back to him.

I only ever saw that Dr. once. I filed a grievance to be let into the Bariatric's program based on the NIH (National Institute of Health) standards. Kaiser's standards are not the same as the NIH, Kaiser is much more strict. A lot of people don't know this. All it takes is one simple grievance and they will be let into Bariatrics as Kaiser HAS to follow the NIH.

As for the waiting period, it's a huge wait to start the classes and then classes are months long. You have to finish these before Kaiser will let you have surgery. That is what the wait is.

THESE CLASSES CAN BE AVOIDED! They can file a grievance against Kaiser's Option class requirements & most likely not be required to attend them. This will stop the waiting game Kaiser has going. Then all they have to do is pass the pre-surgery requirements (psych evaluation, etc.) and they can have their surgery.

Please PM me if you have any questions or need any help with this.

Wow, I spend a lot of time trying to answer your question & help your friends and you block me?? That's awfully rude of you.

I found your post while searching for people who have experience with Kaiser. I am attending an orientation meeting this week for Lap Band. I don't want to go to six month's worth of classes. I saw that you filed a grievance. What was the outcome of that?
Thanks

Those "classes" you say can be avoided--they offer valuable information to people considering surgery. I went through the classes, and they were not a "waste of time" . I would also encourage anyone interested in getting a RNY to attend a few support group meetings. It's at these meetings you learn more about POST OP issues, that you may not even realize prior to surgery. You'll meet others who will help educated you on how to deal with issues, or even avoid them. I had RNY over 3 years ago with Kaiser, who had a surgeon outisde the Kaiser doctor pool do the surgery. I attend 3 meetings a month.  At a support meeting lat night, the importance of support groups were discussed by 4 people who had RNY 4-6 months ago. All of these new post ops agreed that they learned MORE about post op issues in the support groups than they learned in classes prior to surgery. Any education about the RNY process is valuable. There are far too many questions on OH forums about simple post op issues, and the answers to 90% or more of these questions are routinely answered in classes or support groups.

YES, there is a wait for any of the required classes from Kaiser. The classes are required prior to surgery. Also required is a 6 months documented attempt at losing weight. If you haven't don't that, you'll be enrolled in a Kaiser weight reduction program.  DAVE

From the time I told my Dr i was interested in Bariatrics, til the first class was less than two months. They did say it's near a year wait for surgery, that includes the class times, pre-visits( psych, physical, labs,dietician etc)
I am impressed so far.

No. Cal  SF

Sosew, the reason your wait is so short is that you are in Northern CA. The OP was asking questions about the program in Southern CA, which is completely separate from the Northern CA program.
    In Southern CA, the classes take 5-6 months, AND the wait just to start the classes is 3-4 months. This is separate from all the usual pre-op requirements for psych eval, labs, etc etc. Some people have commented favorably about these 5-6 months of classes. Others have found them to be repetitive and largely a waste of time. And very, very few people understand that they can, if they choose, get out of taking the classes by filing grievances and appeals. There has never been a study that showed that people attending such classes did any better post-op than people who didn't. I tend to agree with Dave (hope I got your name right!) that you can learn far more about what life is really like with a given operation at a support group meeting than you will in any class (though he does say he liked the classes as well).
    Sosew, another thing no one at Kaiser is going to tell you is that you don't have to have just RNY or lap band. If that's what you want - great! But if you are interested in the duodenal switch (DS), you won't learn about it from Kaiser, and again you won't learn that if you should want the DS you can successfully appeal and get Kaiser to pay for it. It's best to learn about all your options pre-op and not have regrets post-op. Come on over to the DS forum and learn more about this option. And if you want some articles documenting the excellent results of this operation, send me a pm.

Larra