Published in May 2014 Issue             

Dr. Michael Nusbaum, Committee Chair

Michael Nusbaum, MD

Eight years ago, the ASMBS Executive Council voted to recognize local or state bariatric surgery professional societies and groups as formal local chapters of the society with the formation of the ASMBS State and Local Chapters Committee.

The Committee is charged with advocating for health care policy that ensures patient access to high quality prevention and treatment of obesity. Working to promote the ASMBS state chapter initiative, the Committee is continually evaluating the status of care in individual states and identifying opportunities for improvement.

connect recently explored the work of the state and local chapters with Committee Chair, Michael Nusbaum, MD, Director of Bariatric Surgery and Surgical Director of the Metabolic Medicine and Weight Control Center at Morristown Memorial Hospital in New Jersey.

connect: Please characterize the growth of ASMBS State and Local Chapters Committee since their inception in 2006?

There has been tremendous growth since the Committee was formed. We currently have 29 chapters and five pending, representing 39 states and one chapter for Canada.

connect: Why is it important for individual states to have chapters? What is
the value?

Communication and support. All politics is local and health care politics is exactly the same. Issues that arise within an individual state can rapidly be disseminated to the president of the state chapter and then be elevated to the ASMBS. The result is that responses to any issues that arise can rapidly be dealt with.

connect: What has been the impact of state chapters on issues in metabolic and bariatric surgery? What successes can you point to at the state level?

We have had many successes, including reducing the five years of documented weights previously required for bariatric surgery eligibility and reducing the two years of supervised weight loss requirements. The State Chapters Committee also works hand in hand with other committees like the Access to Care Committee to ensure that issues are dealt with as rapidly as possible.

connect: What are the biggest challenges and opportunities for the
state chapters?

Surgeons within the same state or region occasionally view each other as competitors rather than colleagues. It has been shown that there are more than enough patients to keep us all busy, as only 1 percent of those eligible for bariatric surgery actually seek help. We need to put those old feelings aside and learn to work with and support each other.

connect: Has policy related to obesity treatment become a state issue? How do you balance what is happening at the state level with whatís happening at the national level and how do they effect each other?

Absolutely. Each state faces individual challenges that need to be dealt with through contact with local representatives. Developing relationships with state senators and representatives allows the ASMBS to not only affect local change, but change on a national level as well.

connect: How do the state chapters interact with the national organization?

They interact through the State Chapters Committee, which creates a forum for the state chapter presidents to not only express concerns of their members, but also to seek help from the ASMBS and other state chapter presidents.

connect: What kind of support does ASMBS provide the chapters and what support do the chapters provide ASMBS?

The ASMBS provides the state chapters with support in setting up, maintaining and providing services for their state chapter. They also provide access support to their legislative representatives through the ASMBS relationship with the OAC.

connect: How do chapters keep informed as to what is happening in other states? Is there a mechanism by which the chapters exchange information and best practices?

The State Chapters Committee holds quarterly meetings of all the presidents. This is an opportunity for the presidents to express concerns about issues occurring within their state. What we have seen is that other presidents have often dealt with similar issues in their own states and are thus able to provide support and advice for those who find themselves in unfamiliar territory.

connect: What role does/can state chapters have with the State Exchanges under the Affordable Care Act?

Through legislative relationships built with the support of the OAC, state chapter presidents can develop relationships with their representatives and thus become involved in the state exchanges.

connect: More than half the exchanges exclude bariatric surgery. Can state chapters have a role in helping to change that?

Absolutely, through legislative relationships built with the support of the OAC, state chapter presidents can develop relationships with their representatives and thus influence change within the exchanges to include coverage and reverse the pattern of discrimination against the morbidly obese population within those states.

connect: What role does your committee have with the individual state chapters and ASMBS?

Our committee helps establish, maintain and provide support for all of the state chapters. It also provides a forum for the presidents to communicate with each other and communicate with the Executive Council of the ASMBS via the committee chairs.

connect: Is there a role for state chapters in establishing state collaborative within MBSAQIP?

Certainly. Whenever data is pooled the value increases exponentially.

connect: What were the highlights of the State Chapters Presidentsí Summit? Will there be more of these summits?

The Presidentsí Summit is held quarterly. Some of the highlights include providing assistance with dues collection, providing support for CME courses, and providing assistance with setting up and maintaining state chapters. In the future, we will also provide assistance with legal support and provide accounting services through national firms.

connect: What is your vision for how the state chapters will continue to evolve?

Some day I would like to see the State Chapters Committee become more like Congress in that the presidents would represent the members of the state in a national forum. I would also like to see the presidents have an influential role in the direction of the ASMBS, as they represent the membership at large.

State Chapters Presidents' Meeting & Workshop at ASMBS Spring Educational Event held on Thursday, June 19

In Miami, the ASMBS State and Local Chapters Committee will host a workshop and meeting for practicing surgeons and physicians who wish to increase their knowledge of best practices in running an effective local Chapter. The conference is designed for those seeking to modify their organizations to achieve more favorable outcomes in four main areas: (1) Chapter Building; (2) Advocacy; (3) Educational/Outreach; (4) Metabolic & Bariatric Surgery Accreditation and Quality Improvement Program state collaborative. Click here to learn more.