Primary care providers' attitudes and knowledge of bariatric surgery. Surg Endosc 2020 May;34(5):2273-2278
Date
08/02/2019Pubmed ID
31367984DOI
10.1007/s00464-019-07018-zScopus ID
2-s2.0-85082729271 (requires institutional sign-in at Scopus site) 15 CitationsAbstract
BACKGROUND: Despite the increasing obesity prevalence among American adults, relatively few qualified patients proceed to bariatric surgery. Suggested explanations include referral barriers for weight loss management at primary care provider (PCP) visits. This study aims to assess the referral and practice patterns of PCPs treating patients with obesity. Our goal is to understand treatment barriers in order to implement targeted interventions that enhance quality of care.
METHODS: A 39-question electronic survey was emailed to PCPs at a single academic institution with community physicians. Questions explored providers' demographics, referral patterns, and knowledge of pathophysiologic obesity mechanisms and bariatric surgery qualifications. Frequency and univariate analyses were performed and compared providers' demographics, positions, and BMIs between referring providers and non-referring providers.
RESULTS: Of 121 surveys distributed, we achieved a 33.9% response rate (n = 41). 78.0% stated that > 15% of their patients in the preceding year were classified as obese. PCPs indicated initiating weight loss management conversations < 50% of the time with 48.8% of patients. Provider-identified barriers to discussing weight loss surgery included being unsure if patient's insurance would cover the procedure or if patients would qualify (24.4% vs. 19.5%). In addition, 43.9% of providers felt that the risks of bariatric surgery outweigh the benefits.
CONCLUSION: Despite a large percentage of patients cared for by PCPs being classified as obese, few providers initiate discussions on weight loss options with potentially eligible surgical candidates. The barriers identified indicate an opportunity for improved education on patient qualifications, strategies for streamlining conversations and referrals, and reinforcement of the safety of surgical weight loss. Providers' desire for this education demonstrates an opportunity to work toward minimizing the referral gap by increasing patient conversations about these topics.
Author List
Lopez EKH, Helm MC, Gould JC, Lak KLAuthors
Jon Gould MD Chief, Professor in the Surgery department at Medical College of WisconsinKathleen L. Lak MD Associate Professor in the Surgery department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultAttitude of Health Personnel
Bariatric Surgery
Body Mass Index
Communication
Female
Health Knowledge, Attitudes, Practice
Humans
Male
Middle Aged
Obesity
Physicians, Primary Care
Referral and Consultation
Surveys and Questionnaires
United States
