Variation in Outcomes at Bariatric Surgery Centers of Excellence
A new study published in the Journal of the American Medical Association reports a shockingly 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) across these 165 accredited bariatric centers.
This study (finally!) provides very strong evidence in support of two of Dr. Oliak’s long-held views, that center of excellence accreditation is ineffective at ensuring good outcomes, and that outcomes after weight loss surgery vary over a wide range between different surgeons.
The reason center of excellence accreditation does not ensure good outcomes is simple in my opinion. 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 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.
Despite all this, the rate of serious complications was found to vary 17-fold across the 165 centers of excellence. What is different at all of these accredited centers of excellence that could account for this variation? The surgeons!
The authors of the study conclude the same thing as I do – the most likely reason for the disturbing variation in outcomes is the fact that there are different surgeons at the different centers, and some are more skilled and do a better job than others.
To read more about Dr. Oliak and his Orange County weight loss surgery program, visit www.oliakcenter.com.