American Society for Metabolic and Bariatric Surgery State Chapter Spotlight: Florida, Puerto Rico, and the Caribbean State Chapter

| November 1, 2017


by Samuel Szomstein, MD, FACS, FASMBS, and Michel Murr, MD, FACS

Samuel Szomstein, MD, FACS, FASMBS, is an associate chairman of the Bariatric and Metabolic Institute and Section of Minimally Invasive Surgery in the Department of General and Vascular Surgery, as well as director of the fellowship program in advance MIS and Bariatrics, for the Cleveland Clinic in Weston, Florida. Michel Murr, MD, FACS, is a Professor and Director of Bariatric Surgery at University of South Florida in Tampa, Florida and the Founding President of the ASMBS Florida state chapter

Funding: No funding was provided.

Disclosures: The authors report no conflicts of interest relevant to hte content of this article.

Bariatric Times. 2017;14(11):20–21.

The Florida state chapter evolved from the “Florida Coalition” that was born out of a crisis in 2005 when Blue Cross/Blue Shield (BC/BS) terminated coverage for bariatric surgery. One of their senior administrators said, “Gastric bypass is extremely risky and of questionable benefit,” which galvanized a strong response from Florida surgeons.

Although doctors from the area believed that BC/BS based their decision on financial considerations, the physicians knew the explosive growth of bariatric surgery had attracted enterprising surgeons that lacked appropriate training. Their poor outcomes tantalized the media, which made the BC/BS decision seem justifiable to the public and state officials.

By serendipity, Michel Murr, MD, FACS, met Rep. Sandra Murman and pleaded his case. She offered to raise awareness and suggested hiring a lobbying firm. Selling the idea of political action to the conservative executive council of the American Society for Metabolic and Bariatric Surgery (ASMBS) was especially challenging. Florida was not the only state that wanted to organize, and advocacy required substantial funding.

In the interim, Murr called on his local congressman, Adam Putnam, and then visited John O. Agwunobi, MD, MBA, MPH, the Florida Secretary of Health, and Harvey Sugerman, MD, who is a Floridian and Past President of the ASMBS. The secretary directed Murr and Sugerman to the chief financial officer (CFO), who regulated insurance companies.

Disappointed by their meeting with the secretary of health, but not deterred, Murr appealed to the ASMBS for funding. Dealing with  the same crisis in Virginia, Neil Hutcher, MD, FACS, then President of ASMBS, worked with Murr to secure the necessary funding, which came from ASMBS members, including partners, and, most importantly, the Florida surgeons.

With a lobbying firm on board, Murr and his delegates got timely access to more than 15 elected and appointed officials in Tallahassee. The delegation to Tallahassee included Murr, Sugerman, and Murman, as well as Bob Marema, MD, FACS, and Vincent Zeringue. Other members of the steering committee were Jeffrey Lord, MD; Raul Rosenthal, MD, FACS, FASMBS; Patricia Beyers, MD; and Keith Kim, MD.

Together, the delegation submitted a ‘Position Paper’ to the CFO of Florida, Tom Gallagher, which he used to bring BC/BS to the table. The insurance executives were annoyed by their strong action but continued to be evasive about reinstating coverage without instating quality measures first, which came later with Surgical Review Committee (SRC)/Centers of Excellence Program (COE).

Dr. Daryl Peaden asked Murr and Lord to present the position paper to the Committee for Health, which he chaired. Committee members Peaden, Pruitt, Saunders, Fasano, and Dawson extended their support to the coalition to work on reinstating access to obesity management and bariatric surgery. Subsequently, they provided the scientific language to an Obesity Prevention Bill (Senate Bill 1324), and submitted a community-issue budget request to educate primary care providers about diagnosis and treatment of obesity, including bariatric surgery.

In addition to legislative action, the chapter was very active in communicating with the media, generating more than 13 interviews. The chapter later convened an “Obesity Summit” to raise awareness. The keynote speaker was then presidential candidate Mike Huckabee.

By 2006, the coalition had become a chapter under ASMBS, and the financial crisis made it impossible to fund the Senate Bill. Fortunately, Centers for Medicaid and Medicare Services (CMS) announced coverage of bariatric surgery, and COE standards were being implemented. Much of the legislative action of the chapter concluded, and focus was shifted to local advocacy to enhance employer-based coverage plans.

As of 2016, 27.4 percent of adults in Florida have obesity, according to data from The State of Obesity website. This The state ranks 36th in the country for the states with the highest obesity rates. However, Florida is fourth among 10-to-17-year-olds for combined overweight and obesity at 36.6 percent.

Annual Meeting

The Florida, Puerto Rico, and Caribbean chapter has had an annual meeting every year since its inception, with the exception of 2017. The date for the 2018 meeting is to be determined. The chapter has had two “Chapter Journal Club” sessions, which are broadcasted to all members via the internet and are coordinated by State Chapter Vice President Muhammad Jawad and Andre Texiera, MD. Additionally, the chapter has also had two educational dinners sponsored by companies in the industry.

Accomplishments

Under the leadership of Samuel Szomstein, MD, FACS, FASMBS, elected as the second Chapter President in November of 2013, the chapter grew from a handful of members to its current 76 active members. It also became financially stable, and currently has over $24,000 to be used for chapter activities, efforts, and projects, which include the following:

  • The Florida chapter created an Integrated Health Executive Board. Lynne Thompson, RN, CBN, is president and Lillian Craggs Dino is vice president
  • The chapter expanded to include Puerto Rico and the Caribbean.
  • Numerous advocacy efforts with state legislators were coordinated by the Chapter STAR (State Access to Care Representative), Joseph Chebli, MD.
  • The first ever statewide Pedometer Challenge was held on February 2, 2015. Over 560 people participated from 36 different bariatric centers and walked over 2,900 miles, or 6.1 million steps. This campaign was so successful that ASMBS created a nationwide pedometer challenge inspired by theirs.
  • Advocacy training meetings were sponsored by the chapter, which was organized in conjuction with Lynne Thompson and Obesity Coalition’s Joe Nadglowski.

Join the Chapter

The chapter has raised almost $24,000 in the Florida state chapter account. They want to encourage all surgeons and integrated health providers to join the Florida, Puerto Rico, and Caribbean chapter. Chapter dues can be paid now by logging in to the ASMBS website: http://asmbs.org/login, and clicking “Renew Today!” For those who have already paid their ASMBS dues and opted out of the Florida, Puerto Rico, and Caribbean state chapter dues but wish to pay them now, visit the links below:

Surgeons. www.asmbs.wufoo.com/forms/2016-asmbs-online-payment-form-mds-only/

Integrated Health. www.asmbs.wufoo.com/forms/asmbs-online-payment-form-integrated-health/

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Category: ASMBS State CHapter Spotlight, Current Issue

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