Pay for the DS... Walk out with something else.

[Munchkin]

Another one on FB today. A prospective patient jumps through all the hoops and gets insurance approval for the DS. Goes in to see her doc and gets a surgery date in September. Then when she is on the way out of the office, just as an aside, the surgeon says, "Oh, by the way, I have decided to do the ERNY, not the DS."

Sure the patient is mad but what can she do? She has to find another doc and start over. This could cost her another year and thousands of dollars. How many days off work for appointments sometimes hundreds of miles away. Lost time, lost money. Plus if insurance is paying I think the doc's actions are some type of insurance fraud as well. He is charging the insurance company for tests that lead up to a surgery he has no intention of doing.

We know this is 9 kinds of wrong. Then there are the folks who went in for the DS and ended up with the SADI. Or all those bait and don't switch docs who say they do the DS just to get my fat ass in the office so they can sell me their RNY or Band.

All these deceptive practices are bad business and bad medicine. Why are they tolerated? Simple, we don't have the money, resources to fight them. At the very least the docs who practice the deceptions listed above should have to refund you or your insurance company all monies spent based on the fact you trusted them to perform as agreed and provide the product they said they could provide. As professionals we are supposed to be able to trust, they should be held liable for our losses.

Do the docs disrespect us this much or do they think we are stupid? What's the real story? Some of us are stupid and too well trained to do whatever the doctor says to do. Others are just overwhelmed and vulnerable. It's not an easy decision to pursue WLS. Once you make the decision, you just want it done and the process just goes on forever.

So I own a business, Munchkin's Quilts. You walk into my store and show me a picture of your purple bedroom and ask me to make a purple quilt to match. I agree. You come in to pick up your quilt and it's red. But I tell you I decided the room was too purple and you needed a different accent color so I did red. At this point you ask for your money back. Yes, I should give it to you probably along with mileage for your trip back to the store. I failed to provide the product as promised. Why are doctors held to a different standard?

So what's my solution? I think doctors need to be 'secret shopped'. Start with all those docs advertising the DS on OH. Record every conversation, video every consultation. And sue every one of them who does not do what they say they do. And I'm thinking there has to be a way to turn this into a money making business.

Everyone has to have an angle!

 

[southernlady]

I probably would have said..."And I have decided that you are fired. Thank you for being an ass".

TBH, I would have stayed fat and on an insulin pump before getting an ERNY.

 

[kirmy]

I'd sue for misrepresentation but I'm an arsehole.

 

[Larra]

Yes, he done her wrong. But SHE still has the power to walk out of that office. She can also call her insurer and let them know what happened.
OR, she can sit his ass down and tell him she will only have a DS, that she is going to write "no ERNY" on her consent form, and that if he isn't ready and willing to do her DS she is going elsewhere and going to let the insurer know what happened. Preferably with a witness with her.

Yes we are a vulnerable population, and there are people who take advantage of that. It had to be a very difficult moment for her. I can't even imagine the disappointment and feeling of betrayal she must be experiencing. But she can still maintain control of her life and not let anyone else make this decision for her. and if you are in contact with her, tell her I said so. Oh, and if you happen to know what surgeon this was, let us all know.

 

[JackieOnLine]

fantastic post, Munchkin...did you mean to start it on R&R? I kind of wish it was on the main board so everyone could see it.

course, it's a totally legitimate rant

 

[Munchkin]

fantastic post, Munchkin...did you mean to start it on R&R? I kind of wish it was on the main board so everyone could see it.

course, it's a totally legitimate rant

No worries! Feel free to move it is you want!

 

[Munchkin]

Yes, he done her wrong. But SHE still has the power to walk out of that office. She can also call her insurer and let them know what happened.
OR, she can sit his ass down and tell him she will only have a DS, that she is going to write "no ERNY" on her consent form, and that if he isn't ready and willing to do her DS she is going elsewhere and going to let the insurer know what happened. Preferably with a witness with her.

Yes we are a vulnerable population, and there are people who take advantage of that. It had to be a very difficult moment for her. I can't even imagine the disappointment and feeling of betrayal she must be experiencing. But she can still maintain control of her life and not let anyone else make this decision for her. and if you are in contact with her, tell her I said so. Oh, and if you happen to know what surgeon this was, let us all know.

She did walk out. But that doesn't solve the problem. Seriously, it's a racket. So this individual goes to another doc. Now this test or that test is too old. This doc requires you see ONLY his favorite head shrinker. Will she live another year without developing some new serious comorbidity?

In context my comparison about the quilt is a bit facetious. My red quilt may not help my customer...but my failure to perform as agreed surely won't hurt her. These docs are causing real patient harm.

I am trying to extract the name of the doc....

 

[Larra]

Munchkin, I agree with everything you're saying. This is delaying what I assume (without knowing this individual) is medically necessary care. If he couldn't, or wouldn't do a DS, he should have said so up front, and she could have found another surgeon without all this delay. No matter what she does she can't restore things to the original situation, though hopefully all or most of her tests will be accepted by her new surgeon.
Still, I'm glad she's chosen to move on. It's a far better decision than letting someone else dictate her choices in this fashion. She has a problem now, but she would probably be stuck with his choice for the rest of her life.

 

[Charris]

That happened to me when I got approved got a revision to a sleeve even though he said I wouldn't loose any weight with it. I was on OH AND Ms. Batt sent a pm quick u need a ds and disappeared. Lol I researched and went to Dr. J SINCE he advertised he does them I took my info class with 3 that were scheduled for it. I went to him told him I wanted it his exact words " NO WAY NEVER YOUR TOO SMALL U may get one but not from me". I said ok then. I called and cancel my surgery but Cigna called them they told them the request for surgery with Dr. K WAS Insurance fraud. So then the scheduler call she said well I thought dr J was going to do it in 2 parts. I said he said Never so no thanks! Hopefully they won't try to mess her up like the dr tried doing me.

 

[Charris]

Ps since I already had my approval they just switched dr and I had surgery 45 days later due to my mom passing and that was Dr. K first available surgery date

 

[DianaCox]

If it was this person, the surgeon was GREENBAUM - and I am deeply disturbed by this. If he feels unsafe doing the DS on her, he should tell her to go find another surgeon, not just that he is going to do a different surgery than originally promised.

lisa813Posts: 1
Surgery on Monday 8/18/24 2 hours ago via Tapatalk
Post by lisa813 on 2 hours ago
Hi everyone!
I have to thank "history tracker" for telling me about this group. She has been very helpful and kind to me on the Facebook group. I originally had the lap band in 2004. It was HORRIBLE. All I did was throw up. I had it removed in 2005 and then had RYN done. I went from 304 to 180 and stayed there till I got pregnant in 2008. I gained 27 lbs during pregnancy and lost 17 after birth and then maintained that weight for 2 years. I then lost my gma to stomach cancer. A year later I lost my father to liver cancer. I also have a teenage daughter with mental illness and around the same time she started on a downward spiral. Then I had an ovarian cyst removed and found out I had stage 4 endometriosis which I am still having problems with. Back in 2004 I also had failed back surgery and was left with 60% nerve damage down my left leg and constant pain in my back and leg every day. With all the pain and depression I started gaining weight again. I went to my original surgeon to get help to stop the weight gain and he put me on some medication to suppress appetite but all it did was make me extremely hungry and after that I always seemed hungry and just kept gaining. My mother recently had an endo and had polyps removed from her stomach that were not cancerous thank God. Between the cancer issue and weight regain I started researching my options which led me to be referred to Dr. Greenbaum. Back in January I started the process and explained to him I was concerned you could not get into part of my stomach and it bothered me a lot so I wanted to get the Biliopancreatic diversion so I no longer had this fear inside me. He said he could do the surgery and I went and did all I had to do. The 2 weeks before I was set in June I met with him and he totally switched surgeries on me and said he was doing a distal bypass instead. I was very confused and kept asking him questions and when I said but then I still can't get in my stomach which is why I want the surgery he said my chances of getting cancer are very slim and he felt this is my best option. After I read about it I called and canceled surgery and my husband and I went back and spoke with him. He said it's a complicated surgery and he will do whatever I want so I said I want the BPD/DS and that's what he has me down for now. He is removing my gallbladder and appendix as well and doing a liver biopsy and now after reading other stories I can't remember if he had me sign saying once he gets in there he can change the surgery if he thinks something else will be better so now I'm a little nervous about that and need to make sure I speak with him that morning. I am scheduled for 7am. I've lost 16 pounds on the 2 week diet and then today I cheated and ate real food because my mind panicked and told me I'm never going to be able to eat again and now I'm worried I'm going to cause myself a complication that could kill me. I can't even remember the clear liquid diet for the morning of what I'm supposed to have. I was so good up until the nurse called me Friday and told me they are putting in a picc line then it's like all this fear has come over me and I don't know what I'm
Doing anymore. I feel scared but I don't want to make my husband panic cause he's already nervous and I don't know what to tell my 5 yr old son about where I'll be and I still have to tell my mom I'm going for surgery but don't want to cause she is going to make me even more nervous cause she always panics and stresses me out. In the other room I kept reading about the horrible gas people have and that has me worried too. I'm just so nervous now. I know I need to get the weight off because it makes my back and leg pain so much worse. And I know for peace of mind I need to have one stomach they can see into easily and check. I am just so afraid now about leaks and gas and pain since I'm allergic to pain medication the only one I can take is [? drug name was banned by this website?? U-LTRAM?] and I've been taking it for 10 years now. I can't find my paper of what I'm supposed to eat/drink all day tomorrow if anyone remembers can you tell me. I know I'm panicking and I think I'll be ok I just don't want to come out with something else done or opened up and closed cause I ate solid food today. I'm just a bag of nervousness!

 

[Larra]

I just hope someone has told her to write "no ERNY" on her consent form! Of course she should speak with him before going into the OR, as she has planned, but putting it in writing and telling him not to do anything if he can't do a DS for her is far more powerful.
Of, as another alternative, if he has to do a DS in two stages that's not ideal but not the end of the world for someone with an RNY and lots of prior abdominal surgery. And that would at least get rid of the blind stomach issue that is troubling her, let her eat more normally, let her take NSAIDs for her pain (unless she's allergic) and probably help at least somewhat with her weight. And it wouldn't burn any bridges for completing the DS in the future.
So even at this point she does have options and she can take control, at least to the extent of refusing ERNY.
If someone who has access to her on Facebook would pass those thoughts along...or get her over here...

 

[Munchkin]

No, not the same person!

So here's another one....

 

[Larra]

Just a thought regarding the patient above, even if she wasn't the original Facebook person with this problem:

At best, we get one side of the story. What we read may or may not be totally accurate and may or may not be the complete story. Not that I'm trying to minimize the tough situation the patient finds herself in, but we weren't privy to all the conversations between her and her surgeon, whoever that surgeon may be. For example, it is possible that from the first, the surgeon MAY have said that he might be able to offer a DS or might not, depending on what he learns from her prior operative report. But sometimes people hear what they want to hear, and don't hear what they don't want to hear, and even the possibility of getting that RNY to DS revision that someone wants so badly might have caused her to not hear the "if" in what the surgeon was saying. Then, when she later finds out that he won't offer a DS, she is shocked and upset...because it's all news to her, but from the surgeon's point of view, the possible ERNY was always there and HE thinks he communicated this to the patient from the start.
There are other possible scenarios here, but you get the idea.

I'm not saying this out of lack of sympathy for the patient, and I still think she should take control, either by refusing ERNY and putting that in writing, or by moving on to another surgeon. And if she tells her current surgeon that she refuses ERNY, he then can refuse to do a DS. Each party has a certain amount of control. The patient can't force the surgeon to do an operation that he feels is too dangerous for her individual circumstances. The surgeon can't force the patient into the OR for an operation she doesn't want. So if what he's offering (not forcing!) is not to her liking, she needs to move on. It's just that in my own experience, I've had those experiences where I know exactly what I said to someone (and documented it) and what I said is not what the other person heard.

 

[bearmom]

I wish I had a dollar for every time I've heard of these instances. I was subjected to the "changing to RNY" at the last minute, after traveling a great distance to get my DS, and while I think the surgeon is a skilled cutter and would like to recommend him as an option for those on the other side of the globe, this is why I don't.

We are worn down from the obesity and all the shit it brings, and even the process of getting WLS. They know this. They know we are tired, and desperate. They have plenty of motivation to mislead for the extra money they can make by doing a faster, easier procedure with easier followup. Less worry about non-compliant nincompoops not taking supplements.

I mostly get why this is happening, but what baffles me is how many people get a warning (or MANY) yet seem determined to defend a surgeon they haven't yet had surgery with. They have clearly decided to go to whoever, and disregard warnings of bait and switch, a high complication rate or whatever. With literally one meeting, and the surgeon is so "nice" they have blind faith.

One of the important things about Bariatric Facts is that if there is a surgeon with a bad track record, it can be put out there uncensored. It's sad that most of the places I went to learn about surgery (not here, like back since 2007 and onward) are complicit in this deceit, in that they remove bad reviews for terrible surgeons, and allow what are certainly bogus glowing reviews for surgeons that are paying advertisers.

Secret shopping may help, but having a place with uncensored information (like, not OH or most nannyed FB groups) about surgeons, and having it be a TOP hit for online researchers would be good.