Tennessee Chapter of the American Society for Metabolic and Bariatric Surgery

| November 1, 2016

by Virginia M. Weaver, MD

State Chapter President: Virginia M. Weaver, MD Saint Francis Center for Surgical Weight Loss, Memphis, Tennessee

Bariatric Times. 2016;13(11):22–24.


The Tennessee Chapter of the ASMBS was initiated in 2007 with a mission to address the obesity crisis specifically within the state of Tennessee, which is perennially named in the Top 10 most obese states in the country.[1] The chapter serves to educate physicians, surgeons, integrated health professionals, and patients about the options available to treat and prevent obesity, and the critical role of metabolic surgery in the treatment of the disease. Access to care for patients, and fostering relationships with payers and employers, are also paramount objectives for the chapter. Collegiality and community among the state surgeons for purposes of improving quality care are current immediate goals for the chapter, with the development of a state collaborative group of surgeons well underway.

The state chapter began with a board of surgeons and integrated health professionals under the presidential leadership of Dr. Bill Richards, who at the time was Director of the Vanderbilt University Medical Center for Surgical Weight Loss. Dr. Jaime Ponce, Medical Director for Chattanooga Bariatrics, was Vice President and quickly progressed to be the President of the ASMBS/IFSO-North America. Subsequent presidents have been Dr. Douglas Olsen of Centennial Center for the Treatment of Obesity in Nashville, and Dr. Brandon Williams of Vanderbilt University. The current board includes Dr. Virginia (Jenny) Weaver of Memphis, President; Dr. David Dyer of Centennial in Nashville, Vice President; and Dr. Chris Sanborn of Erlanger Metabolic Surgery in Chattanooga, Secretary/Treasurer. Current Integrated Health representatives include Sarah Grimes, RN, CBN, of New Life Center in Knoxville and Pam Davis, RN, BSN, MBA, of Centennial in Nashville. The Integrated Health board members have been consistently led over the past decade by Pam Davis, who was recently named Integrated Health President-Elect for the ASMBS. This will make two Tennesseans who will have served as President for both the Physician and Integrated Health branches of the ASMBS, an honor for which the state chapter is very proud.

Most of the business and education efforts for our chapter center around the annual state meeting. Our meeting is held every spring in Nashville, the geographic center of the state, and is a one-day meeting that everyone in the state can easily attend. We routinely have attendance of approximately 125 physicians, surgeons, and integrated health professionals. Possibly the biggest draw for attending this meeting is an outstanding speaker lineup that addresses a variety of topics, including nutrition/dietary science, psychological issues, obesity medicine, access to care, as well as the technical aspects of bariatric surgery. Some of the out-of-state national speakers that have presented at our meeting include Drs. Alan Wittgrove, Bradley Needleman, Helmuth Billy, Robin Blackstone, Raul Rosenthal, Stacy Brethauer, Dean Mikami, John Morton, Dana Portenier, and Wayne English (who is now a TN member himself). Other national speakers have included Joe Nadglowski of the OAC, Chris Gallagher of Potomac Currents, Drs. Kelli Friedman Lisa West-Smith (both psychologists with bariatric expertise), and several doctorate dietitians and nutritional scientists. The depth and scope of our meetings makes for an incredible learning experience. Because of Nashville’s location, invitations are extended to healthcare personnel from all the surrounding states, and most years we have representation from 8 to 10 different states. The meeting provides at least eight hours of bariatric specific CME credit available for claim. The chapter is fortunate to be funded by our industry friends, which allows for us to host such a robust meeting.

Accomplishments

The board meets monthly by conference call. In addition to our annual meeting, the chapter convenes at ObesityWeek and includes both surgeons and integrated health professionals. There have been many issues relating to coverage, access to care, reimbursement, and care of the bariatric patient that have been successfully addressed over the past decade. One of the most notable cases was an issue that actually brought the chapter together and highlighted the critical role of a state chapter in managing bariatric access issues. In 2007, one of the large insurance companies began to require IQ testing in order to qualify for bariatric surgery. The IQ “cutoff” was not disclosed, and patients began to be denied coverage based solely on that testing result. The state chapter came together with the OAC and Walter Lindstrom among others in order to successfully overturn this requirement. A few years later, a payer decided to label a band adjustment that needed to be done in the hospital using fluoroscopy as a “surgical complication.” This was addressed and changed due in large part to the efforts of our chapter members. Last year, several of our surgeon and integrated health members met with the state insurance commissioner in order to build relationships and advocate for bariatric surgery. Another initiative that has garnered national attention was initiated by several of our chapter surgeons in conjunction with Vanderbilt University law professor Jennifer Shinall. She has done extensive research in discrimination law, particularly in the area of obesity, and has proposed that a lack of bariatric surgery coverage constitutes a form of gender discrimination. This idea was then taken to the national level of ASMBS by our Vanderbilt surgeons, and has parlayed into a letter of complaint to the U.S. Department of Health & Human Services. Lastly, several of our members are serving on a Technical Advisory Group (TAG) for TennCare in order to make recommendations concerning metric data and expected outcomes in bariatric surgery patients. TennCare is the state healthcare program that essentially replaced Medicaid for Tennesseans.

Future

As the chapter heads into its 10-year anniversary, new collaborative efforts to improve education and quality of care are being instituted. The final stages of the Tennessee State Collaborative for data collection and data sharing are being completed. Dr. Wayne English at Vanderbilt has spearheaded this project based on his experience with the Michigan Collaborative. Nearly every MBSAQIP COE in Tennessee has agreed to be a part of the effort, which will start out simply, evaluating and discussing the data points already collected by the MBSAQIP. We will soon be adding data points agreed on by the collaborative in order to address certain issues that may be unique to patients and surgeons in the state of Tennessee. The ultimate goal is to improve delivery of excellent care to our Tennessee patients. We are also instituting a quarterly chapter call for any surgeon to voluntarily present challenging cases as an expert panel discussion. This will hopefully create an atmosphere of collegiality, connectivity, and community among the surgeons providing care for individuals in our state affected by obesity. Hopefully the collaborative will be able to answer research questions in the future as well.

The Chapter would like to invite anyone interested to attend our 10-year anniversary meeting, scheduled for Friday, April 28, 2017. It’s a perfect time to visit the Music City. Please see our webpage at http://www.ASMBS.org and look for updated information on the program and registration information as it becomes available.

Acknowledgments

Dr. Weaver would like to thank Pam Davis and Dr. Brandon Williams for their assistance in producing this article.

References

1. Trust for America’s Health and the Robert Wood Johnson Foundation. F as in Fat: How Obesity Threatens America’s Future. 2013. http://healthyamericans.org/assets/files/TFAH2013FasInFatReportFinal%209.9.pdf Accessed September 1, 2016.

FUNDING: No funding was provided.

DISCLOSURES: The author reports no conflicts of interest relevant to the content of this article.

Address for correspondence: Please direct all correspondence to Angela Saba at asaba@matrixmedcom.com

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Category: ASMBS State Chapter Spotlight, Past Articles

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