Finding a Surgeon

Several of my coworkers had great success with a surgeon in the Seattle area whose commercials are widely circulated on our local television networks. Since my insurance paid for this particular surgeon's services, I decided to attend one of his seminars. In February, accompanied by longtime friend, Kim, and I drove down to Gig Harbor (an hour and a half drive) from my home in Port Townsend.

The seminar was thorough but the surgeon was a bit, shall I say "pompous". He was more than a little condescending to the audience. He had a speaker who told of her weight loss success through gastric bypass. He described the different weight loss procedures in detail, never hesitating to tell us, "I devised this procedure" or "I am only one of a few surgeons in the country who does it this way and this is the only way it works". And, "I don't do fills for anyone who doesn't come to me for their surgery because I had people try to sue me". He was also very curt in responses to questions from the audience. This was my first red flag

Since I was so ready for this surgery I called his office the next day for an appointment. I was disappointed when I wasn't able to get in for six weeks. I asked to be put on a cancellation list only to be told "We're too busy to have a cancellation list. You just have to call back". Now I work in healthcare and it is my opinion that this isn't very good customer service. It wasn't just what was said but how she said it, rudely and abruptly. Another red flag.

The day finally came for my appointment (March 30th) I was taken aback at the sparseness of his tiny office and waiting room. He had only one receptionist and one gal working the back. He had about a dozen chairs (regular sized, not specially fit for the larger-sized patient) and his decor was very sparse. This was evidently "fill" day and the waiting room was full. It was really very unwelcoming. After about a 20-minute wait I was taken back to the exam room. The doctor arrived in about 10 minutes, looked at my file, checked my stomach, and told me I needed to have an EGD/colonoscopy before he could see if I would be appropriate for the procedure. I tried to ask some other questions about the procedure and he cut me off saying these questions would be answered after the procedure had been scheduled. Another red flag.

I then went out to the front desk, where a very harried receptionist (remember she was the only one available to check in al the patients coming in that day) scheduled my EGD/colonoscopy for six weeks in the future, with a followup appointment two weeks after that. That would make it May 23rd before I could even have start to have my LapBand procedure submitted for approval (and I was told it could take 3-4 weeks to have it approved and then another four weeks before it would be scheduled, so we were looking at end of July, possibly August). I asked if I could have the EGD/colonoscopy at my own hospital thus saving money and travel time and was informed that no, only Dr.______ can do this. Another red flag.

By the time I left his office, I was feeling totally uncomfortable. Within a couple days I started investigating other Lap-Band surgeons in my area that my insurance would cover. Just because I knew others who had success with this surgeon didn't mean that I had to follow the crowd.

I went on the internet and then made a few phone calls. One hospital that was a Center of Excellence was Mason General Hospital in Shelton, Washington, closer to my home. The surgeon performing the procedure there is Dr. William Neal in Olympia. I phoned his office, and they phoned me back the next day. Their office staff took time to talk to me, answer my questions including finances. I felt like I was being treated as a person who was cared about, not just another anonymous caller.

I was told, among other things whereas the first doctor charged $13,500 for his fee and it covered the first two fills and the others would be at least $150 each; Dr. Neal charges $5000 and the fills are included. Forever. I asked her to repeat this last part. The fills are included forver? Yes she says. Forever. The bad news was that he asks for his portion up front, so I would have to get the $5000 and then be reimbursed by my insurance. At first I thought that would be an insurmountable hurdle to cross. However a quick talk with my husband and I discovered we could borrow that from a relative. That hurdle jumped, I phoned the office and made an appointment for a consultation. They decided to get the insurance approval while I was waiting for my appointment. The medical records were faxed to their office on a Thursday afternoon. I was shocked, surprised, and pleased to receive a phone call the following Tuesday morning that I had been approved.

On April 23rd I had my visit with Dr. Neal. The office waiting area couldn't have been more inviting and comfortable. The leather sofas were so comfortable for the larger patient, the office staff friendly and inviting. They had several gals at the front desk, several in the back. Plenty of staff to take care of all their patients and an office large enough to accommodate everyone in comfort. They even have a large conference area adjacent to hold their seminars. I couldn't have made to feel more welcome. Dr. Neal himself called me in from the waiting room to his office. There he talked about my medical history, he explained the procedure -- even having a plastic model of the stomach and the band -- I finally understood all about the fills and why they were necessary! He then took me to an exam room where my vital signs were checked and he listened to my heart and lungs. Afterwards I went to a consult room where I the procedure and preop and postop diets were explained in even more detail and I was given a checklist for surgery (my surgery date had already been scheduled as May 13, 2008). He told me he wanted me to go on a MediFast diet for two weeks before surgery to lose around 10 pounds to help shrink the liver preop.

I left the office with a sigh of relief. What a difference between the two offices. I felt I had made the correct decision with the surgeon that fit best with me and my personality. I have even felt better as each time I have had to contact with Dr. Neal's office since then there has been someone available to either answer my question or get back to me in a reasonable length of time. When I called Dr._____ to cancel my other appointments it took me 15 minutes, they didn't even have an answering machine or voice mail and when I finally got a hold of them all I got was the excuse of "We have six lines and only two people to answer them" . I just shook by head. I felt even better about my decision. This was confirmed four days later when the hospital where I was going to have the EGD/Colonoscopy phoned to get some preprocedure info; Dr.____ office had never called to cancel the procedure even after I had called the office to have them do so.

My advice: When you look for a surgeon, if something doesn't feel right, it probably isn't. Find a surgeon that fits your needs but do your homework. Does the fee include fills? If not, how much do the fills cost? (you will need fills approximately monthly for the first six months, every other month for the next six months, and periodically over the second year -- this is per Dr. Neal's office, your surgeon's recommendation may differ and every patient is different). How much preop testing will you need? The first surgeon I saw wanted me to have an EGD/Colonoscopy, gallbladder ultrasound and psychiatric (MMPI) testing despite having no symptoms. Dr. Neal's theory is why go through these tests if you have no family history and no symptoms. Many times even if your insurance overs the LapBand, it may not cover these other tests, especially if you don't have symptoms. I did need to see a dietician preop, but her fees are billed to Dr. Neal and are part of his fee. And, since I live two hours away from her office, I was able to have a phone consultation instead of seeing her in person.

Next: Here we go