The Bariatric Society of the Carolinas ASMBS State Chapter—Integrated Approach Adds Value

by Rana Pullatt, MD, MS, MRCS, FACS, FASMBS, and Nina Crowley, PhD, RDN, LD

Dr. Pullatt is the Director of Bariatric Surgery for the Charleston VA Medical Center VISN-7 and Director of Robotics, and bariatric surgeon for the Metabolic & Bariatric Surgery Program at the Medical University of South Carolina in Charleston, South Carolina.  Dr. Crowley is the Program Coordinator for the Metabolic & Bariatric Surgery Program is the Medical University of South Carolina in Charleston, South Carolina.

Funding: No funding was provided for this article.

Disclosures: The authors reports no conflicts of interest relevant to the content of this article.

Bariatric Times. 2019;16(10):22.

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Bariatric surgery has a storied history in the Carolinas with a long list of surgeon and integrated health leaders and innovators who have trained, practiced, and advocated for patients in North and South Carolina. The chapter’s founding can be credited to Roc Bauman, MD, whose work organizing the Bariatric Society of the Carolinas (BSC) in the early- to mid-2000s led to the official charter of Carolinas Chapter with the American Society for Metabolic and Bariatric Surgery (ASMBS) in 2008.

The BSC has worked to represent practices across both states to overcome insurance coverage barriers and provide a forum for members to network, share clinical experiences, and provide continuing education. Access to care continues to challenge patients in our states. Members, including John Scott, MD (ASMBS Super STAR and Chapter Past President) and Ranjan Sudan, MD (ASMBS STAR and Chapter Past President), have worked to improve coverage for state employees and those covered by the dominant third party payers. We have seen some successes—one of our South Carolina Medicaid plans, Select Health, has lowered the body mass index (BMI) threshold for people with diabetes to BMI 30 to 35kg/m². We hope to see coverage for bariatric surgery for the State Health Plan Employees of South Carolina, which has been limited since the benefit was dropped in 2005.

The chapter’s current leadership comprises President Dr. Rana Pullatt, President-elect Dr. Dana Portenier, Secretary Dr. Charles Kenneth Mitchell, Treasurer Dr. Keri Seymour, and State Access to Care Representative Ranjan Sudan.

Annual Bariatric Society of the Carolinas Meeting

Our annual meetings held in conjunction with the North Carolina/South Carolina American College of Surgeons (ACS) State Chapter provide opportunities to share best practices, learn new ways to serve our patients, and opportunities to connect with other local professionals. Our robust educational program has led to increasing yearly attendance, and we just finished our third annual meeting with a strong Integrated Health (IH) Workshop for our nurses, coordinators, advanced practice providers, dietitians, behavioral health professionals, exercise professionals, and others on the interdisciplinary team.

This year’s BSC Meeting Planner, Keri Seymour, MD, from Duke University, planned an all-star surgical program with national leaders to discuss important issues, such as “Getting Patients to the Finish Line” with Dana Telem, MD, MPH; “Aspiration Therapy” with Michel Gagner, MD; and “Choosing the Correct Procedure in an Era of Shared Decision Making: Who Decides?” with Shanu Kothari, MD. Local experts discussed preoperative issues, such as enhanced recovery after surgery (ERAS) protocols, insurance-mandated weight loss, hernia repairs, and outcomes in older patients. We unpacked the complex issue of sleeve leaks with several perspectives and explored complicated surgeries, such as failed fundoplication, sleeve revisions to bypass or switch, one anastomosis procedures, duodenal switch patient selection, and robotic surgery.

Integrated Health Workshop

What started as an idea to increase IH involvement in the BSC chapter has blossomed to a thriving IH Workshop exceeding even our surgeon membership with 45 to 100 attendees, depending on location. The IH session is responding to a trend in our membership toward fully integrated interdisciplinary care of the patient undergoing metabolic and bariatric surgery.

The IH Planning Committee, Nina Crowley, PhD, RDN, LD; Amber Kelly, RDN; and Jaime Bull, PA-S coordinated a robust and diverse lineup of discussions from our North and South Carolina experts include the following:

• Nutrition-focused physical assessment
• Integration of behavioral medicine into postsurgical care
• Exploring postsurgical addiction issues
• Self-care: making a plan to prevent burnout
• Beyond 43775: Deep dive into insurance billing/coding, self pay, appeals, denials, and revisions.

The IH team secured sponsorship from our industry partners and continuing education from the ASMBS for the workshop, proving that the ASMBS IH members are an interested and valuable part of the state chapter membership. In addition to educational sessions, our members had opportunities to network and share best practices within and across states. The IH section has been active through social media using a Facebook group for networking questions and as a platform to livestream educational sessions to those who could not attend the meeting.

The BSC chapter continues to work on improving access to care for people living in North and South Carolina who struggle with obesity, and we hope to continue to have an active, engaged membership throughout the year and between meetings. We are already looking forward to what John Scott has planned for our July 2020 meeting in Myrtle Beach, South Carolina.

Tags: ASMBS, bariatric surgery, integrated health

Category: ASMBS State Chapter Spotlight, Past Articles