Obesity Surgery | 2021
How do Patients Access Bariatric Surgery? An Analysis of Referrals to a Large Academic Medical Center
Abstract
Despite the evidence supporting bariatric surgery as the most effective treatment for obesity, fewer than 1% of eligible patients ever undergo this treatment [1]. Prior work has demonstrated multiple barriers to bariatric surgery at the level of referring providers. These include reluctance to refer to surgery due to a lack of knowledge about the available procedures, uncertainty about patient eligibility, and concerns about long-term safety [2–5]. Other barriers to accessing bariatric surgery include individual patient factors (e.g., ineligibility due to current smoking status), insurance factors (e.g., inadequate insurance coverage and requirement for prolonged trial of medically supervised weight loss), and bariatric program-specific factors (e.g., number of specialist evaluations) [2, 3]. In the United States, patients can access bariatric surgery either through provider referrals or self-referral. While provider referrals are often required for patients to be evaluated for bariatric surgery, little is known about bariatric surgery referral patterns by provider specialty [2, 6]. Understanding sources of bariatric surgery referrals may reveal key opportunities for targeted efforts to augment referrals and ultimately increase bariatric surgical procedure uptake among eligible patients who desire this treatment. Moreover, such efforts may be further informed by understanding specialty variations of referrals that resulted in subsequent surgical operation. To address this gap, we performed a descriptive study to characterize sources of referrals to a major academic bariatric surgery program over a 1-year time frame. We investigated number of referrals from individual providers to discern