Nov. 4, 2022 - Weight Loss Surgery in Delaware: Care Coordination of the Bariatric Surgery Process

For today’s Bariatric Friday, Kemal Erkan, Chairman of American Surgery Center, is accompanied by Dr. Isaias Irgau to discuss care coordination. Dr. Irgau’s specialization is weight loss surgery, which is also known as bariatric surgery. Bariatric surgery is the most effective treatment for morbid obesity. When a person’s weight is approximately one100 pounds higher than their ideal body weight, they are considered morbidly obese and meet the criteria for bariatric surgery.

Dr. Irgau mentions Erkan’s passion for ensuring that the care coordination aspect at American Surgery Center is of the highest quality. Erkan explains that their patients have differing levels of needs from the surgery center, “we are very unique in terms of the approach to the care coordination because we have about five nurses, four administrators, the surgeon, three dietitians, as well as the facility.” He states that some patients need their hand to be held throughout the process, and the surgery center needs the care coordination resources available for patients to make sure they do not get lost in their journey. Erkan always tries to ensure he understands the patients and how certain situations are managed by each patient. The process is extremely personal for the patient, so by understanding them it creates a very meaningful experience. Dr. Irgau elaborates, “only one percent of those who are eligible for bariatric surgery come forward requesting bariatric surgery, so the one percent that is coming forward are the ones that are making a lot of effort, that are going against the grain of what they hear, or what they are told or how they are perceived because of morbid obesity, and they are taking the step. The last thing we want to do is give them hurdles and obstacles and make it hard for them.” They explain how there are so many steps in preparing for bariatric surgery; this is why it is so important that the care coordination is set up well. Patients should not feel discouraged by the process. The pair mention how their dropout rate is far less than the national average, and this is accredited to their stellar care coordination.

Erkan states that patients “are going to be assigned to a care coordinator” upon beginning the bariatric surgery process, and the patient will have one dedicated person at the surgery center who is in charge of assisting the patient with their followup appointments as well as specialist appointments. Erkan explains that “having that one point of contact is extremely important so that you know that it is always going to be one person that you have to deal with. The beauty is we talk every day for one hour, and your case is being discussed… we are not missing anything from one week to the next, and our nurses report back to us about what is needed and what is not.” Dr. Irgau recognizes patients have lives outside of their appointments, and sometimes it is difficult to make appointments. However, he explains that the all-encompassing system they use at the surgery center makes it very easy to keep patients on track for all required appointments that “the care coordinators are so critical in facilitating.”

The pair then touch on what happens on the back end of the bariatric process. They explain how care coordinators are also a bridge between the test results and the surgeon themself to ensure the surgeon sees the results in a timely fashion. Often test results in this process require further appointments that need to be made and addressed quickly. “The back end work of the care coordinators following up on a daily basis of what is happening with their patients and then communicating that to the surgeon, is enormously helpful,” Dr. Irgau states. He also mentions that they introduced Karen, Patrick and Denise about two months ago, and they have not yet had their surgery – “the reason is because of this preparation period.” Dr. Irgau continues on by saying, “patients may wonder why is this all necessary sometimes, well it is necessary because

bariatric surgery is a life-changing surgery, it is not like other surgeries where you have an ailment that a surgeon takes care of and you go back to your primary care doctor. With bariatric surgery, we’re actually changing the way a person lives in terms of how they eat, how they perceive food, how active they are going to be, what kind of health problems they are going to be confronted with and that all requires preparation, not only physically but also mentally and emotionally as well.” This preparation requires interaction with numerous specialists and navigating this would be extremely difficult without the help of the care coordinators at American Surgery Center. Every piece of the preparation process is integral in ensuring that the surgery date does not get pushed back. Erkan then states, “what we expect our patients to do is to make sure they understand the role of the care coordinator, so they need to work with them, and communicate with them and make sure they understand that they are part of the team and are trying to help. We want to make this experience more pleasant… for these three individuals and the many others who are part of the program… it's not easy, but we make it a lot easier… to any patients who are considering bariatric surgery, this is the number one most effective way to treat morbid obesity, and we want you to take advantage of the process.”