A Note From the President

Published in April Issue             

Dear Friends and Colleagues,

I would like to share with you highlights from our Executive Council meeting that took place last weekend in Miami, Florida. As it is customary, we have this face-to-face meeting in order to discuss what are considered the most important issues facing our society.

I kicked off the retreat by presenting to our Executive Council members an overview of our committee’s 2016 goals and objectives. In upcoming issues of connect, our committee chairs will also be presenting their projects to you.

As a council, we reviewed and unanimously approved two important position statements that address a) the successful surgical treatment of type 2 diabetes with metabolic operations issued by the II-DDS in London last year and b) the highly controversial mandated preoperative weight loss by insurance carriers. As you well know, a significant number of our patients affected by the disease of obesity and its associated lethal medical conditions do not have access to care because of insurance-mandated preoperative weight loss. Based on a thorough literature review conducted by our clinical issues committee, we concluded that there is no scientific evidence to support such a policy by insurance companies.

Another important subject we discussed at length is the future of surgical training in the US and how it can affect bariatric surgeons. As is public knowledge, the American Board of Surgery has been contemplating changing the current model of 5 years residency plus an optional 1 year fellowship to a 4 years residency plus 2 years fellowship that would result in a certificate of focused expertise in several non ACGME accredited surgical specialties such as hepatobiliary surgery, bariatric surgery, foregut surgery, advanced gastrointestinal surgery and surgical endoscopy just to name a few of them.

While the members of the EC are unanimously in agreement that this would be a very important step forward for our specialty, concerns were raised as to what will happen to those bariatric surgeons that are already in practice for years and cannot be grandfathered to have such a certificate. In an attempt to explore further options to support those bariatric surgeons who have been already in practice I asked Dr. Eric DeMaria to create a “bariatric certification task force.” The aim of this task force was to evaluate the development of an ASMBS endorsed certificate that can demonstrate that bariatric surgeons that do not have an ABS certificate are qualified to perform bariatric surgery. At the retreat, we reviewed Pro’s and Con’s and also evaluated what would be the possible requirements to qualify for an ASMBS endorsed certificate. Our thoughts are that experience (years in practice) , reporting outcomes to a quality improvement program (such as MBSAQIP), volume and quality of cases performed (primary and re-operative procedures) and a high stake exam should be amongst the most important aspects to be considered. To that end, Dr. DeMaria did a monumental job looking into the actual number of bariatric fellows that are currently being trained on an annual basis and the need to increase or decrease such a number based on demand. I invited Dr. DeMaria to write this important work and submit it for publication in SOARD. The initial analysis suggests that we might be training too many fellows in relation to the number of jobs available on the market.

The financial outcome of our successful conferences in Las Vegas (Obesity Weekend) and Los Angeles (Obesity Week) in 2015 were presented by Georgeann Mallory and our secretary treasurer Dr. Samer Mattar. We reviewed the outstanding work done by Dana Telem, MD and the members of the Sleeve Gastrectomy Care Path Task Force. Dan Jones, MD called in to discuss and review the soon to be launched Essentials in Bariatric Surgery. Both are amazing projects that I am sure you will benefit from.

Finally, we had a thorough review and discussion about the current presidential election process. As you may have realized, for the last decade with rare exceptions the Secretary Treasurer gets voted to become the President Elect. In the last 5 years, however, we changed the election process and voted the position of President Elect, despite the fact that we had a Secretary Treasurer working on our behalf for a 2-year term. The latter could have resulted in having a board member spending 5 years working as a member at large and Secretary Treasurer at the Executive Council level and then losing the opportunity to become President to a member who spent significant less amount of time serving on Executive Council and who may be less familiar with the main issues affecting our society.

Just for the information of our membership, the Executive Committee of the Council formed by your Secretary Treasurer, President Elect, Current President, Past President and Our Executive Director, Georgeann Mallory, meets regularly every Thursday evening between 8 and 10 PM to discuss current society issues. In addition, this group meets on a weekly basis with other important committees and on a monthly basis with all members of the Executive Council, where minutes are reviewed and important decisions are being made.

In order to prevent this occurrence, I suggested that instead of having our membership vote for a President Elect, the society should vote instead for the position of Secretary Treasurer. The result would be that once an Executive Council member becomes Secretary Treasurer (and unless the ECEC and Executive Council members decide otherwise for extraordinary reasons), he or she will automatically become the President Elect. I strongly believe that by changing our voting process, we will maintain continuity and also recognize commitment. The Executive Council agreed in Miami to bring this change in bylaws to our membership for an electronic vote. I look forward to your participation and support.