Monday September 28, 2009
Obesity Surgery: do you get what you pay for?
It’s impossible to cover the entire field of obesity in a little less than 28 minutes of radio. There are many back stories we wish we had time to explore.
As Dr. Arya Sharma said on latest episode of WCBA, there are a million Canadians who would qualify immediately for bariatric surgery. Yet only a couple of thousand actually get it.
There are many reasons for this. On the show, Dr. Daniel Birch, one of very few bariatric surgeons in Canada, talked about the reluctance of his colleagues to take up the specialty. Some see bariatric surgery as a more dubious calling than taking out gall bladders or colon cancers.
Maybe so. But there are other considerations as well. Some bariatric operations are covered by provincial health plans. For instance, gastric sleeve and gastric bypass are covered, but lap band surgery isn’t.
That doesn’t mean that lap band surgery isn’t available in Canada. But it does mean that if your province doesn’t pay for it, then the price comes out of your own pocket.
And here’s a bit of “bariatric black art”. Some surgeons like the fact that lap banding is not covered, because that fact means they can set the price at whatever the market will bear. That’s a refrain I’ve heard again and again from physicians and surgeons who do procedures not covered by the provinces.
So, you probably don’t pay for a gastric sleeve or a gastric bypass. But you do pay for a lap band. How much? Listen to an interview we did with Dr. Chris Cobourn, a bariatric surgeon who practices in Ontario. He's done more than 2000 lap band procedures. He believes that paying for surgery increases the chance that the patient will fully buy into the operation.
See if you agree.
And while we’re at it, listen to more thoughts from obesity guru Dr. Arya Sharma
Previous Comments (4)
I had my stomach stapled a little over 18 years ago,I have lost over 150lbs. The worst thing about having the stapling done is that I feel I have lost me the person. Before I have the operation, when ever I complained about pains in the stomach or that my back on my right side hurt I was told to lose weight. Just before the operation my surgeon, had a altrasound done on me the found I have a gall bladder ready to burst. The Dr. who I had been seeing, when informed of the gall bladder said, "well guess you will be losing weight now", no "I am sorry" or anything. Being obese is not for the faint of heart. You take alot of BS and abuse. Thank you for doing a show on this very over looked problem.
I never miss your show, I listen twice weekly to make sure I have heard everything correctly.
Again Thank you
Thanks for addressing this issue and for including Dr. Sharma, a leading expert in this field.
I have worked in the field of eating disorders for over a couple of decades and I continue to be horrified by the ignorance about obesity in the general population and particularly among doctors and medical students.
Many people who would never consider discrimating another group of people seem to feel very comfortable to do so with the obese, as has been told to me by many clients who suffer from such comments.
Thanks for your show's tremendous efforts towards addressing this and a myriad of other important issues.
Eating Disorder Psychotherapist,
Oh my! Where to begin!
When this episode of White Coat, Black Art came on the radio yesterday, I pulled over to the side of the road so that I wouldn't miss ONE WORD!!! I have always had a weight problem all my life and have been on enough diets that I could write a book.
I've spent thousands of dollars over the years, I have lost and gained hundreds of pounds each time. I follow the Canada Food Guide most of the time - I'm not an 'angel' and do have treats from time to time - but I eat whole grains, veggies, fruit, chicken, fish, no fried foods, skim milk dairy products, etc.
In 1994, when menopause came into my life, I also found out that I was hypo-thyroid and have been taking Synthroid since then. In February 2008, I was diagnosed as diabetic and was prescribed various medicines to deal with that little problem. At the time, I was already close to 250 pounds. Since then, I have gained 28 pounds and after reading the side effects of my medication, one of them was weight gain. I am so mad and frustrated about the whole thing - I feel so helpless. As your various guests on the show yesterday stated, I got the same sympathetic instructions from doctors and dieticians - "Go on a diet and you'll lose the weight"!
I am in New Brunswick and last year a coworker told me about her referral to a Bariatric surgeon in Moncton. Up until a few months ago, he was the ONLY doctor in the Atlantic Provinces who was performing Lap Band surgery and Bariatric surgery. I immediately made an appointent with my Nurse Practioner at the time and had my name put on the 'referral list' for surgery. When I called shortly afterward, I was told that I would have a 5 to 7 year wait! I am now 68 so I don't have to tell you how depressing that bit of news was!
Since last autumn, another doctor in Bathurst has started performing these surgeries. My file was transferred up there and I was told that my wait would be about 1 to 2 years. Over a year has gone by and no word yet but I feel confident that my name will come up soon - God willing! I had even called Quebec and other provinces about getting the surgery done 'outside the province'. No problem there as long as I had around $15,000.00 to pay for it as it would NOT be covered by my provincial Medicare!
I'm sorry to dump on you like this but your program yesterday was aimed at me and thousands of others like me. I would LOVE to be in touch with other people going through the same anger and frustration as I am - maybe we can encourage and support each other.
Thank you for allowing me to vent!
Judy McNab (firstname.lastname@example.org)Judy McNab, September 29, 2009 12:59 PM
How timely your program was this week. I am scheduled for a consult next week with Dr. Cristou in Montreal. His website says he is the ONLY surgeon doing bariatric surgery full time.
I seriously began considering surgery last summer but postponed the application process due to an unplanned pregnancy. Now, I am hoping for freedom by the end of October. I contacted a surgeon in Calgary. He is currently funded for 25 surgeries per year. His waiting list has 850 people. You do the math! My guess is that a lot of those people will die waiting. Even if the Alberta government upped their funding as promised, he would still only do 125 surgeries per year. Gee. That brings the waitlist to only 7 years.
I am one of those who have been fat their entire life and suffered through much ridicule. I always tried to make my personality overshadow my size. Unfortunately, living that way leads to mental complications. But despite being fat, I tried to be active. In fact, at 275 pounds, I became a letter carrier. I then learned the difference between being fat and fit. I walk for 4 hours a day delivering mail, including up to 5000 steps a day. I look forward to doing that job much more comfortably.
The comment from your podcast that struck me the most was comparing an obese person to an heroin addict and expecting them to shoot up 5 or 6 times a day, but only the proper amount. That is exactly how it is except that an obese person is expected to plan, shop and prepare their "drug" every day, often for others, without getting caught in the trap of advertising and saving time with prepared foods.
Brian, I love your show. You and your team do an amazing job. I am so glad you are back for another season. Something to listen to while I am waiting for my surgery!Kristen Dawson, September 29, 2009 10:57 PM