Information for Referring Physicians

To refer a patient to Dr. John Feng at the Palo Alto Medical Foundation for consideration for bariatric surgery, please simply have the patient call our office at (650) 853-6671 to contact the Deparment of Surgery Bariatric Surgery Scheduler, Vira Lopez. Please give them the website address to review all the information, especially before calling. The Bariatric Surgery Staff will help navigate any insurance issues and ask some simple screening questions.  The Staff will help schedule a reservation at an upcoming free information seminar and a new patient office consultation visit with the surgeon.  It is important for patients to attend the Free Seminar first to become familiar with the breadth of the latest information regarding bariatric surgery and how it works before going to the office visit.

In order for a patient to qualify for surgery, they must meet the following criteria that were established by the National Institutes of Health Consensus Conference in 1991:

• BMI must be 40 kg/m² or more if they do not have any obesity-related illnesses
• BMI 35-39.9 kg/m² with illnesses such as hypertension, diabetes, coronary artery disease, sleep apnea, and degenerative joint disease to name a few.

Not all patients who meet the weight requirements are necessarily candidates for surgery, especially since the benefits of undergoing the surgery require strict compliance with an aftercare program. To name a few, patients must meet the following criteria:

• Ages 18-64 years old
• Not medically disabled
• Not wheelchair dependent nor suffer similarly debilitating conditions
• Not diagnosed with Prader Willie Syndrome
• Not diagnosed with such conditions as Cushing's Disease or other exogenous causes of obesity (patients with polycystic ovarian syndrome can be considered candidates as long as the other conditions are met)

Of course, patients with extensive prior surgical histories of mainly the upper gastrointestinal tract are carefully evaluated to establish appropriate candidacy for bariatric surgery.

Please remind your patients that although many insurance plans cover bariatric surgery, each plan is different in specific reimbursement amounts, type of available procedures (not all companies cover the duodenal switch and rarely the sleeve gastrectomy for instance, but may cover the Roux-en-Y gastric bypass), etc. despite what they may say over the phone to the patient. Each employer may even have exclusions for bariatric surgery in their policies. The patient can pay as little as just their copay fee or deductible amounts to 90% of a $35,000 dollar or more total bill.

Thank you and I hope you find this information helpful.

John J. Feng, MD, FACS