A study entitled “Variation in Outcomes at Bariatric Surgery Centers of Excellence,” published in the Journal of the American Medical Association in 2017, reports a surprisingly wide variation in patient outcomes across accredited bariatric surgery centers of excellence nationally.
Claims data were analyzed from 145,527 patients who underwent weight loss surgery at one of 165 accredited bariatric surgery centers of excellence in 12 states. The rate of serious complications was found to vary 17-fold (yes, 17-fold!), from 0.6-10.3%, across these 165 accredited bariatric centers.
This study provides strong evidence in support of two of Dr. Oliak’s long-held views, that outcomes after weight loss surgery vary over a wide range between different surgeons and programs, and that center of excellence accreditation is ineffective at ensuring good outcomes.
The reason center of excellence accreditation does not ensure good outcomes is simple. Center of excellence accreditation requires all kinds of hospital conditions to be met (e.g. having labels on hospital furniture that clearly state weight limits) that have a marginal impact on patient outcomes, but ignores the one factor that has the biggest impact on outcomes – the individual surgeon!
Center of excellence accreditation does, however, require hospitals to have the necessary equipment, personnel, and processes to adequately care for bariatric surgery patients. Center of excellence accreditation also requires programs to have surgeons with at least basic bariatric surgery training and experience.
This is all good, but the #1 determinant of patient outcomes is the individual surgeon! The bottom line is that some surgeons (even center of excellence surgeons) do a better job and achieve better outcomes than others.
Outcomes vary between surgeons
Gastric sleeve operations are not all the same
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