For Referring Physicians

How to Refer a Patient

If you have a patient you feel could benefit from weight loss surgery, we’d like to help.

As you know, obesity is a chronic disease. Weight loss surgery can provide an effective and enduring therapy for morbid obesity. But surgery alone is not a cure – merely a tool to achieve weight loss and encourage healthy diet and exercise habits.

Long-term medical care is essential for morbidly obese patients, even after they achieve weight loss. Therefore, a close working relationship between you and our Team is essential.

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Fast Track

The Stanford Center for Bariatric Surgery offers a “fast track” for referrals and follow-ups. Once we establish a relationship, you can expect speedy appointments and streamlined screening. In addition, you’ll have both email and mobile access to our Director of Bariatric Surgery, Dr. John Morton.

Physicians and other health care professionals whose patients meet the criteria listed below can also contact the Patient Care Coordinator at (650) 736-7102. Let her know that you’re a physician interested in “fast track” for one of your patients.

Before your patient is evaluated in the Stanford Center for Weight Loss Surgery, as a primary care physician, you’ll be asked to provide the following information about your patient:

  • Name
  • Date of Birth
  • Address and phone number
  • Recent height and weight
  • Reason for referral
  • Insurance information
  • Relevant labs 

Referral Criteria

Patients being considered for bariatric surgery should:

  • Have participated in at least six months of medically-supervised attempts at weight management with documented weights over that time period
  • Have a BMI ≥ 35 with serious obesity-related co-morbidities, or have a BMI ≥ 40
  • Demonstrate commitment to comprehensive medical and psychological evaluation before and after the surgery
  • Agree to avoid pregnancy for at least one year after bariatric surgery
  • Be capable of and willing to adhere to post-operative nutritional guidelines
  • Provide informed consent to surgery

Obesity-related co-morbidities include:

  • Type II Diabetes Mellitus
  • Sleep Apnea
  • Pseudotumor cerebri
  • Hypertension
  • Dyslipidemias
  • Non-alcoholic steatohepatitis
  • Venous stasis disease
  • Polycystic Ovary Syndrome
  • Intertriginous soft tissue infections
  • Stress Urinary Incontinence
  • Gastroesophageal Reflux Disease
  • Weight-related arthropathies which impair physical activity 

Relevant Labs

Morbidly obese patients tend to have numerous co-morbidities that are occasionally occult. To fully optimize patients pre-operatively, we require the following diagnostic tests. These should be completed within six months prior to surgery:

  • CXR
  • EKG
  • Blood Work:
    • CBC
    • Complete metabolic panel including calcium and liver function tests
    • Thyroid function tests
    • Lipid panel
    • Fe Panel
    • B12
    • Folate, Thiamine
    • Homocysteine, C-Reactive Protein, Lipoprotein a - to assess cardiac risk factors
    • HgbA1C (if known diabetic)
  • EGD - note H.Pylori Status or UGI
  • Cardiac Echo – hx of phen-fen or long-standing sleep apnea or cardiac risk screen
  • Stress Test/Cardiac Catheterization – abnormal cardiac echo, family hx, IDDM, HTN, >20-pack year history, age >50, other cardiac risk factors: elevated lipids, crp, lipoprotein a, homocysteine
  • Greenfield Filter – usually indicated if hx of PE/DVT, severe sleep apnea, weight >400 lbs. Stanford physicians are able to place temporary filters that are removed 2 - 4 weeks after surgery.

These diagnostic tests will allow us to fully care for our patients and are always meant to assist care, not deny care. Please do not hesitate to contact the Center if you have any further questions.

 

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