As a practice matures and evolves, decisions are made and changes are instituted to assure that the delivery of quality care is not compromised. Most of our decisions are driven by factors (medical, regulatory, and legal) that are out of our control. There are two significant changes that we have had to make to our laboratory ordering process.
First, we now have preferred laboratories that have partnered with us. The laboratory results are expected to be sent to us electronically, which should cut down on the time between the blood draw and when the results are available to us. The information on the preferred labs is located at: http://www.dssurgery.com/lab. Needless to say, there are no financial incentives for us. You should also check with one of the labs, as well as with your insurance company, to make sure that they are a contracted facility and that the order is covered under your policy. It is your responsibility to make sure that your insurance company will pay for the labs ordered. We are in no way responsible for the verification of benefits for the laboratory services that we order.
Second, we have had to change the way we order our yearly lab work. As most of you are aware, it is critical that weight loss surgical patients have continuous yearly follow-up care and monitoring. It is critical that the patients continue to receive yearly follow-up care, not only by doing their scheduled laboratory studies, but also by a yearly follow up in office exam. We provide a comprehensive two year follow-up to the patients who have had the the Duodenal Switch or Revision from other failed weight loss surgical procedures. This includes ordering the laboratory studies, review and interpretation of the results, as well as office visits as frequently as required or deemed necessary.
Due to medical, legal, and insurance issues, we can not order yearly laboratory studies without having seen the patient in our office prior to writing the order. Some patients may choose to have their labs ordered by their primary care physicians, in which case we suggest they review the information on our website. This is to assure that we are not ordering tests on patients who will not follow up with us, and the PCP's that have ordered the labs will be able to review the results and make recommendations. We apologize for this change, however, our hands are figuratively tied.
Over the years, patients have also requested that medication be prescribed solely based on lab results, even if the patient has not been seen by our office in years. We will not prescribe medication to any patient who has not been recently seen by our practice. An exception would be for patients or conditions whose treatment we have a firsthand knowledge of, that are not new findings based on a patient’s long-term condition. There are cases when a patient calls our office 8 years after surgery asking for Flagyl to treat gas, which we will not prescribe.