I had sleeve surgery in the US at the Franciscan Weight Management System here in Federal Way, Washington, by Dr. Houseworth. I have not seen him since the day of surgery, as my follow up appts have been with his Nurse Practitioner. I am 4 months out and have see her twice. My daughter did all the prep testing with Dr. Houseworth also, but even though the insurance company paid for all the testing, they ultimately refused her WLS. So after spending several thousand in pretesting, she is now left with only one option.... To go to Mexico. We selected dr. Ariel Ortiz with FACS credentials,through OCC, which is a Center of Excelleance. Both distinctions that are also assigned to Dr. Houseworth. I asked the NP today if she would be willing to do the followup work for my daughter when she returned from surgery. She discussed with dr. Houseworth and he declined to keep her as a patient if she had her surgery in Mexico, even though she has done all the pretesting with him. REALLY???? I don't get it. Is she just supposed to forgo having the surgery because the insurance declined coverage? She cannot even get approved for a loan for $28,000 that it would cost her to have the surgery here in the US. What option does she have if she does not go to Mexico? I am at a loss as to why the drs refuse to see patients after having surgery in Mexico. She has been refused service by Dr. Holzclaw, my PCP, also. Is this just a Washington state issue? Does anyone know of a dr in the Seattle/Tacoma are that will accept my daughters as patients after they return from Mexico? I am so frustrated and ticked off!

I am very very very concerned for the drs. doing followup care for patients having surgery by another dr. in another location. Placing orders for follow up blood work and maybe even doing something as drastic as ordering a barium swallow could cost them their career. OMG! I am sure the fact that they didn't get the money for the initial surgery has nothing to do with it. Yeah, right. ????

My goodness. CowgirlJane just emphasized my earlier points. Let go of the Mexico mentality and stigma. Let go of the liability argument. Again, people relocate for a million reasons. Someone please explain the liability logic and how that applies when it is NOT Mexico........

Exactly.

Doctors have and will continue to take care of other doctors and surgeons' work, and it's quite terrible that an issue is made of it at all.

My goodness. CowgirlJane just emphasized my earlier points. Let go of the Mexico mentality and stigma. Let go of the liability argument. Again, people relocate for a million reasons. Someone please explain the liability logic and how that applies when it is NOT Mexico........

Exactly.

Doctors have and will continue to take care of other doctors and surgeons' work, and it's quite terrible that an issue is made of it at all.

Exactly!

I had two vertebrae fused in my neck by surgeon A in Utah. He also did my 3 month followup and X-rays. Then surgeon A retired and I moved to another state so I had surgeon B do my 6 month followup and X-rays. Well surgeon B charged me 3X as much as surgeon A for X-rays (which I filed a complaint against and won because it was discovered that hospital was double billing clients) so I went to surgeon C for my 12 month followup with X-rays and an MRI. I never had any issues finding a doctor to take me as a patient even though they didn't do my surgery.

So no, there doesn't seem to be an issue if you take "Mexico" out of the equation, thus my belief the problem is arrogance and prejudice, not necessarily liability and $$$.

I do agree that physicians do have a right to protect themselves, but where does that right end to where patients can't get any local care because not everyone is sue happy? Why is it blanket no no no rather than look at the situation and see? Just because someone didn't do the surgery, if it is to cover some aftercare, its basically saying I didn't get $$$ out of you for the surgery, the main thing, so you are not worth it to me to take on as a patient.

I have the problem not just because of the legal non compete agreement, but because with additional issues, no one wants to do anything because they believe the original surgeon should have taken care of it. He just didn't want to be bothered to listen or anything else. I can see why docs have a problem: why should they get dumped on because someone didn't do their job.

hypothetical question. If you lived in say Ohio and needed heart surgery. Your spouse changes jobs and you now find yourself living in New Mexico. Too bad, so sad that no one will see you on follow up and you must instead return to Ohio for follow up? What happens if your surgeon retires or goes out of business or moves? i don't think anybody would think that is reasonable.

I do agree that physicians have a right to "protect" themselves. I also think patients should have the ability to access follow up. forget about Mexico for a minute - if a person went to Vegas for surgery - I suspect they may still have problems finding follow up because it is WLS.

I had the band in Germany BECAUSE I LIVED THERE. It wasn't to save money, it was covered by my company provided insurance by a certified, experienced surgeon. I still had a hard time getting support once I moved back to the Seattle area. That just doesn't seem right.

I dont think you are talking about elective surgery? You had a surgeon who retired, this is where someone chooses to go to Mexico and pay for their services but they wouldn't pay for the surgeon they are asking to take over care. I don't think its close to the same analogy but again it does give a point to the arrogance and predjudice point quite well.

Exactly!

I had two vertebrae fused in my neck by surgeon A in Utah. He also did my 3 month followup and X-rays. Then surgeon A retired and I moved to another state so I had surgeon B do my 6 month followup and X-rays. Well surgeon B charged me 3X as much as surgeon A for X-rays (which I filed a complaint against and won because it was discovered that hospital was double billing clients) so I went to surgeon C for my 12 month followup with X-rays and an MRI. I never had any issues finding a doctor to take me as a patient even though they didn't do my surgery.

So no, there doesn't seem to be an issue if you take "Mexico" out of the equation, thus my belief the problem is arrogance and prejudice, not necessarily liability and $$$.

Actually, my neck fusion was elective surgery. I could have gone with PT and steroid injections, but I insisted on surgery instead. And I did pay surgeon B and surgeon C for their services...their followup exams and X-Rays and MRI. Just as I've paid my PCP and gastroenterologist for their followup care after going to Mexico for my VSG. I'm one of the fortunate ones that has compassionate doctors that aren't prejudice and have no problem with the fact I had surgery in Mexico. My PCP is actually quite impressed as he's seen other bariatric patients from local surgeons not do as well as I have.

I also have a friend that had gastric bypass in California several years ago and then moved to Idaho. She's had numerous problems with dehydration, Vitamin deficiency, diarrhea, vomiting, etc. She has never had any problems getting care from other bariatric surgeons or doctors, despite the fact they didn't perform her surgery. How is that different from treating a patient that had surgery in Mexico? Same complications, same "liability" since the followup docs didn't perform the surgery.

Edited October 29, 201411 yr by Kindle

Not in this area at all. I dont know how much of it is the legal agreements between Sentara and Bon Secours or not though.

I think the issue on necks may be different than WLS. Different surgeon mentality. It also depends on the $$$ that those surgeons are getting.

Actually, my neck fusion was elective surgery. I could have gone with PT and steroid injections, but I insisted on surgery instead. And I did pay surgeon B and surgeon C for their services...their followup exams and X-Rays and MRI. Just as I've paid my PCP and gastroenterologist for their followup care after going to Mexico for my VSG. I'm one of the fortunate ones that has compassionate doctors that aren't prejudice and have no problem with the fact I had surgery in Mexico. My PCP is actually quite impressed as he's seen other bariatric patients from local surgeons not do as well as I have.

I also have a friend that had gastric bypass in California several years ago and then moved to Idaho. She's had numerous problems with dehydration, Vitamin deficiency, diarrhea, vomiting, etc. She has never had any problems getting care from other bariatric surgeons or doctors, despite the fact they didn't perform her surgery. How is that different from treating a patient that had surgery in Mexico? Same complications, same "liability" since the followup docs didn't perform the surgery.

Okay I have to be that guy I guess. First off. DO doctors in Mexico have to go through the same rigorous training as they do here in the US? Answer NO they take some pre med courses in HIGH SCHOOL AT AGE 15, then go right from high school to med school for four years. Then they do 1 year residency in a rural area hospital or clinic then they get to take their boards. Difference in training time? 4 YEARS. Here's the real reason why I would not go to mexico for surgery. If your surgeon screws up, face it, it happens, this is major surgery not clipping your toe nails. If it happens, you have no recourse. You cannot sue, you're on a self pay excursion, so if you suddenly need emergency care you have to pay for it out of pocket. All I can think of is flying down to mexico, then having surgery and two days after surgery trying to fit into an airline seat with fresh incisions, and in a lot of cases still oozing and draining. Somehow getting fluids in me, and keeping infections out, from the worlds most cramped common space ( an airplane) , yea that's what I want to do right after surgery. Be in a foreign country where my wife or family can see me, especially if something goes wrong.

I also would like to bring up one MAJOR point, too many of you are acting very very childish. My doctor is better than yours, seriously, c'mon get a grip, if you cannot act like an adult how are you going to succeed with this surgery. Stop the denial, stop the oh care is better there anyway , it is al just you justifying your actions, we have all done it with food, please don't do it with surgery. If you went to or are going to mexico, it is because you cant afford it here. Great good luck. that's your choice. Do not expect others to agree with it or to somehow forego their own experience and knowledge of the surgery here in the US.

I am very very very concerned for the drs. doing followup care for patients having surgery by another dr. in another location. Placing orders for follow up blood work and maybe even doing something as drastic as ordering a barium swallow could cost them their career. OMG! I am sure the fact that they didn't get the money for the initial surgery has nothing to do with it. Yeah, right.

DO you even listen to yourself? You really think a surgeon , sits around waiting for people to com in with other surgeons issues and says WAH I dint get your surgical money so im not gonna like you. What do you think they are 5 year olds? They risk a lot of lawsuits from people who get substandard care or even good care but a screwup is a screwup and if you cannot sue doctor Mexico, who will you sue? Seriously. I have insurance under my wifes company, but her company specifically made her insurance deny all bariatric surgeries Specifically. SO what did I do,. I pay extra out of my own pay to have an insurance, for just me , a company that will pay 90% of my surgical costs. I now have 2 Insurances. you do what you have to, you have to go to mexico, good go for it. But do not belittle those who do not have to as if you are the enlightened , and everyone else is wrong.

Actually how many lawsuits are there? I don't see or hear of it. I'm looking for the articles that came out recently saying it was getting harder and harder to sue and more people are getting medical bankruptcy.

Just because another surgeon comes in behind another one doesn't mean someone is going to sue or have big problems. I don't see a huge increase in people complaining on here about complications. Its more aftercare or the lack/access thereof.

I think the issue is a combo of all 4 issues named already but I would bet that lawsuits are what they use to excuse it.

There are good and bad surgeons in every country all over the world. Just because they were trained and practice in the US doesn't make them good. And just because they were trained and practice in Mexico doesn't make them subpar. As for my surgeon's training, it certainly doesn't fit into stevehud's explanation.....After high school, my surgeon went to undergrad and medical school for 6 years. He then completed a 4 year residency in general surgery, followed by another year in advanced bariatric surgery. That's 11 years of formal medical training. He's proctored over 60+ surgeons in the US and Canada in laparoscopic surgical techniques. He's performed over 12,000 bariatric surgeries (including repairing other surgeon's botched jobs) and has been doing VSGs longer than any US surgeon. He's been employed by Allergan and by Johnson and Johnson as a professor at their bariatric surgery training facilities. His surgical facility in Tijuana is an International Center of Excellence. He is a Fellow of the American College of Surgeons. Pretty sure they don't give those credentials away in gum ball machines.

And as for why I went to Mexico for surgery, money was not an issue. Neither was the issue of who can I sue or not sue. I researched all of the surgeons within 200 miles of my home as well as top surgeons in Tijuana (logistics to any other destination got too complicated). I went with the surgeon with the most experience, lowest complication rate, and most highly qualified support staff. And guess what.....I had a fun 4 day vacation in Mexico with my sister, went shopping and sightseeing, met some nice people, enjoyed a great movie on the flight home, had an easy recovery, was back to work within a week, lost over 100% of my excess weight and am easily maintaining well below goal. I truly hope everyone has as good of a surgical experience as I had, no matter where you go or who your surgeon is.

Edited October 29, 201411 yr by Kindle

I can certainly vouch for a problem with surgeons in the US. When:

you ask them to fix their problem,

you are not suing them or anything,

and other doctors have (AGAIN!) told them that the surgeon was wrong and I did need care

educate themselves on complications after surgery

ask for a collaborative relationship

ask that treatments be made with respect to my values and wallet

things like that, and they don't give it, what are you to think? Especially after they spend time trying to "hush up" and tell you they'll respond in writing and never do. That's all the way up to the board and asking do you think this is ethical and they won't answer.

Yep. What Kindle said.

I'll also throw in some info that is not so well known. Fact: U.S. doctors obtain an undergraduate degree (4 yrs) before going to medical school (another 4 yrs). They can pass with a 70 (a C)....One point less is a D.....Hmmm. So, they can graduate from medical school and be YOUR doctor, barely having passed anything; it happens all the time. The title of MD is still the same whether they earned As in school or barely passed. You would never know that when you walk into their practice or trust them with your life for a surgical procedure.

Yes, there are surgeons in MX who have less training than U.S. doctors, but there are also surgeons operating on patients who barely passed anatomy and physiology classes. So there's that.....

The point is, you can receive poor care right down the street from your house. You can receive poor care in MX, Belize, the UK, New York, etc..... It can happen anywhere. MX surgeons do not operate in alleyways with dirty spoons and forks that are left over from Cinco De Mayo.

If you choose to go there, you have every right too, and it's your job to do the research and find a surgeon who has the credentials you are looking for. Upon your return, there is no reason a PCP can not order the routine labs needed for follow ups. They do your regular / annual labs don't they? I guess it would be asking too much to have a couple of other labs drawn at the same time, right?

If you get dehydrated, you get dehydrated. Administering fluids will happen the same way it did prior to surgery. Vomiting and pain? CT scans, MRIs, CXRs, and ultrasounds all done the same way. The medical treatment is universal (for the most part) which means you can travel to Timbucktoo and should receive comparable care, which any doctor / specialist can do.

Again, if surgery in MX is NOT in the equation and it's simply a case of someone relocating for their job, how does the liability logic work when another doctor needs to assume your care?

Public Announcement: If you sign a consent form, you are having elective surgery. Period. It matters not what type of surgery it is.