Bariatric surgery lifestyle

[Mat the coolcat]

MS-III here interested in gen surg. Just curious, what are the hours like for a bariatric surgeon? I know a lot of normal surgeons do gastric sleeves and roux-en-y's, just curious if any full time bariatric surgeons could comment on their lifestyle.

---

Members don't see this ad.

 

[Winged Scapula]

Its not the work hours that get you, its the phone calls from a largely psychologically damaged patient population.

Hopefully you have some buffer like residents or a mid level provider to handle them.

 

[SpecializedSurgeon]

Its not the work hours that get you, its the phone calls from a largely psychologically damaged patient population.

Hopefully you have some buffer like residents or a mid level provider to handle them.

True!!

But really, they have pretty awesome lifestyles, especially the ones who are quick in the OR.

Still, when those patients go south, they go down hard. Gotta be willing to come back and see these guys on the occasion that trouble strikes.

 

[TypeADissection]

That sounds suspiciously like breast surgery 😛

Oh snap. Oh no you di'int.

But in all seriousness, everyone has their cup of tea, and bariatric surgery is clearly not mine. Beyond the psycho-social issues with the patient population, it's that they're predisposed to internal hernias and SBOs (amongst other things). When you boil it down, you're essentially creating a pathology to fix another one. Thus, your index of suspicion for something catastrophic should be high when patients present. Their physiology may not behave like skinny people. Your physical exam may not elicit peritonitis. I'm glad there are surgeons out there who enjoy foregut work and I promise to send you every obese patient I have that is interested.

 

[VincentAdultman]

"Normal" surgeons do Roux en Y's?

For real?

 

[Smurfette]

Kudos to anyone who wants to do bariatrics. My view of the field is skewed by the fact that most patients with a history of RYGB make me think "really? how big were you before?!". Saw one today with a current BMI of 53. My former MA was convinced the surgery was a sham since everyone seems to lose weight and gain it back and more. I tried to point out the successes to her, but TBH they were the minority.

All the guys I know who do bariatrics take GS call to supplement their practice. These are community surgeons, not academics, FWIW, although they also took GS call at my residency program. So lifestyle is basically the same as that of GS from what I've seen.

 

[Winged Scapula]

That sounds suspiciously like breast surgery 😛

Touche!

 

[Apollyon]

Kudos to anyone who wants to do bariatrics. My view of the field is skewed by the fact that most patients with a history of RYGB make me think "really? how big were you before?!". Saw one today with a current BMI of 53. My former MA was convinced the surgery was a sham since everyone seems to lose weight and gain it back and more. I tried to point out the successes to her, but TBH they were the minority.

All the guys I know who do bariatrics take GS call to supplement their practice. These are community surgeons, not academics, FWIW, although they also took GS call at my residency program. So lifestyle is basically the same as that of GS from what I've seen.

There seems to be two groups of bariatric patients, and only one of which I see in the ED. The first group are the successes. Then, there's my patients - the bombs. When I was in South Carolina, I thought that every single pt that had GB was INSANE (not for having the sx, but just nutty). I didn't know of those that never came to the ED. They were the silent (I don't know if majority or minority).

 

[Winged Scapula]

There seems to be two groups of bariatric patients, and only one of which I see in the ED. The first group are the successes. Then, there's my patients - the bombs. When I was in South Carolina, I thought that every single pt that had GB was INSANE (not for having the sx, but just nutty). I didn't know of those that never came to the ED. They were the silent (I don't know if majority or minority).

That's a common perception.

As surgical residents, we only saw the disasters: the takebacks, the PEs, the wound dehiscence/leak, etc. The neurotic patients that would call at 200 am crying about feeling nauseated or asking, "my surgeon says that my pouch has stretched which is why I'm not losing weight, what do you think?" (to the intern on call).

When a medical school classmate asked me what I thought about her getting one, I was like, "NFW!!!" Of course, it was obvious I wasn't seeing the successes.

 

[SLUser11]

"Normal" surgeons do Roux en Y's?

For real?

Absolutely. Plenty of surgeons without specific fellowship training want to do bariatric surgery, especially since sleeves became popular, but there's still plenty of "normal" people doing bypasses. It is obviously more common when they had a strong experience as a resident, and/or they have an experienced partner to mentor them.

 

[VincentAdultman]

Absolutely. Plenty of surgeons without specific fellowship training want to do bariatric surgery, especially since sleeves became popular, but there's still plenty of "normal" people doing bypasses. It is obviously more common when they had a strong experience as a resident, and/or they have an experienced partner to mentor them.

Man that sounds crazy to me. But to be fair my exposure to gen surg is a little limited compared to you guys.

I could never do that, let alone deal with the complications. Glad some do though.

 

[SouthernSurgeon]

Man that sounds crazy to me. But to be fair my exposure to gen surg is a little limited compared to you guys.

I could never do that, let alone deal with the complications. Glad some do though.

I think the view of bariatrics is pretty skewed in here.

For the most part a private practice bariatrics job these days involves doing 70-80 percent sleeves and a select few bypasses usually on cherry picked patients

Major complication rate for bariatrics in modern times is well under 5%.

Most patients go home on POD2. A lot of centers starting to send their sleeves home on POD1.

There are some unique things to bariatrics though - late complications such as internal hernia and marginal ulcer. Recidivism and dissatisfied patients who haven’t lost the weight they want to.

But you make a lot of patients happy and have a real chance to change their lives

 

[VA Hopeful Dr]

I think the view of bariatrics is pretty skewed in here.

For the most part a private practice bariatrics job these days involves doing 70-80 percent sleeves and a select few bypasses usually on cherry picked patients

Major complication rate for bariatrics in modern times is well under 5%.

Most patients go home on POD2. A lot of centers starting to send their sleeves home on POD1.

There are some unique things to bariatrics though - late complications such as internal hernia and marginal ulcer. Recidivism and dissatisfied patients who haven’t lost the weight they want to.

But you make a lot of patients happy and have a real chance to change their lives

And the field changes pretty quickly. Sleeves were just becoming a popular thing when I finished residency (most of the patients I saw then had the gastric banding, so we all thought that bariatric surgery didn't work).

Plus us PCP types aren't huge fans of dealing with the long term effects of gastric bypass (B12 and iron deficiencies being the ones I see most often).