Clarity Bariatrics (Lap Band Centers of Texas) Develops Strategy to insure Primary Care Involvement with Weight Loss Surgery and Combating Depression
By Ronald A. Duperroir, posted October 26, 2009
Recently the American College of Preventive Medicine announced a new position statement saying primary care physicians have a key role in combating the under treatment of depression. In their report they cite that all adults should be screened for depression, and primary care physicians should do the screening, according to a position statement issued in October by the American College of Preventive Medicine. With 6.7% of American adults — about 15 million people — experiencing depression in any given year, the prevalence of the disabling and potentially deadly condition makes it imperative that primary care doctors regularly screen their patients, the college’s statement said.
The physicians associated with Clarity Bariatrics (aka Lap Band Centers of Texas) support the concept of total well being of personal health when it comes to the management of care and surgical weight loss. While we do not see as many patients as a primary care physician, we support this position statement. Every patient who presents to one of our clinics is required to have a psychiatric evaluation conducted prior to surgery. Patients who are enrolled in the Clarity Bariatric program are also encouraged to continue undergoing psychiatric counseling as they lose weight. We believe this process helps patients adjust to their new bodies and how they perceive changes in how society reacts to “the new them.” Our Bariatric Coordinators arrange for individual therapy with clients along with facilitating psychotherapy support groups, and psycho educational groups. Programs like these not only help our patients to achieve their goals but assist those to overcome challenges that may require treatment of hidden mental trauma, anxiety, Bipolar Disorder, PTSD, and stress management.
It is an agreed upon fact, that primary care physicians are the principal health care contacts for most patients with mental illnesses, according to the paper, published in the October Journal of Family Practice. More than a third of primary care patients experience some form of depression, and 10% of patients have major depression. Concerning within the college’s position statement is that most depressed patients seeing primary care doctors go undiagnosed. Note worthy of mention, the authors acknowledged that primary care doctors already have a full plate. Pay is declining, the administrative burden is increasing and patient visit times are shrinking. It is our position that all providers should be screening for depression. It’s a simple intake test and question if results are positive: “has your primary care physician diagnosed you with depression?” If the patient replies no, why would we not share our concern and send the results back to the referring primary care physician in addition to the findings the patient was referred to us about? We are all providers of remedy – why not help the front line care providers combat this serious diagnosis?
Our surgeons talk patients about the importance their primary care physician plays in their overall wellness; that surgery, psychiatric and nutritional counseling are just some of the tools the primary care doctor has available to them to keep them well. We often see patients who self refer to us for the Lap band procedure without obtaining guidance from the primary care doctor.
While we accept the pursuit of the patient’s request, we keep the primary care doctors in the loop and encourage the patient and other specialties to do likewise.
Sources:
“Screening adults for depression in primary care: A position statement of the American College of Preventive Medicine,” Journal of Family Practice, October (www.jfponline.com/pages.asp?aid=8010)
