Bariatric medical directors not only perform weight-loss surgery, but also have a wide range of professional responsibilities.
Bariatric medicine is a relatively young and evolving field within the surgical profession. Medical directors of bariatric programs, therefore, are called on to not only perform weight-loss surgery, but also oversee a cross-disciplinary team of professionals who aid patients in losing weight. Bariatric medical directors typically hire and supervise all staff within the program, direct all patient care and maintain quality control of the program.
Position Description
A bariatric medical director is responsible for the overall planning and operation of a facility's surgical weight-loss program, be it a self-contained division or a specialty practice within the overall surgery division. The director oversees the ongoing analysis, development and implementation of practices to improve efficiency and effectiveness of services and program functions. This individual is responsible for the daily management of the department and serves as the liaison to coordinating care throughout the hospital. In the end, the director is responsible for each and every patient's surgical, nutritional and psychological needs and other wellness care as well as ensuring that the department complies with regulations and operates with fiscal responsibility. Medical directors establish standards of practice for the department. They evaluate management and ensure adequate staffing and appropriate training. They support communication among hospital division staff and, at times, throughout the larger network of patient care.
Educational Requirements
Bariatric medical directors are most often board-certified surgeons who have obtained their medical degree and advanced medical education for surgery and, in particular, weight-loss surgery. In addition, directors must obtain varying amounts of continuing medical education. In addition to obtaining the required technical expertise, bariatric surgeons and medical directors must acquire an understanding of morbid obesity as a disease and have knowledge of the numerous diseases and conditions induced or aggravated by morbid obesity, such as diabetes and heart disease.
Training and Certification Requirements
As bariatric surgeons, hospitals typically seek board-certified (or board eligible) physicians who have had fellowship training in minimally invasive surgical procedures, including gastric bypass, gastric banding and gastric sleeve surgery. Boards that certify bariatric medical directors include the American College of Surgeons, the American Board of Surgery and the American Board of Bariatric Medicine.
Surgery
Most bariatric medical directors have performed thousands of weight-loss surgeries, the most common of which include gastric bypass, gastric banding and gastric sleeve resection. Gastric bypass is the most commonly performed. The surgeon creates a small pouch using stapling techniques to divide the stomach and connect it to the intestine. The procedure involves bypassing the lower stomach, reducing the size of the stomach and diverting gastric juices, thereby decreasing appetite.
With gastric banding, an inflatable silicone band is placed around the upper part of the stomach to restrict the passage of food. The procedure helps give the patient a sensation of fullness. This is called a "feedback mechanism," which helps the body control the size of the portions the patient eats. Once the band is in place and healing from the initial procedure takes place, it can be adjusted and removed.
In gastric sleeve resection, a surgeon removes about 85 percent of the stomach, leaving enough to contain about three to four ounces. In addition to controlling portion, the procedure signals appetite control. The surgery is generally performed laparoscopically, with a minimally invasive incision so that hospital stay is short and recovery is quick.
Oversight and Planning
Bariatric medicine is growing rapidly and some directors are operating as "one-stop" shops for patients seeking weight-loss solutions. Instead of being exclusively focused on surgery and on pre- and postoperative functions, bariatric medical directors oversee a wide range of professionals, including nurses, physician assistants, dietitians and nutritionists, sleep and physical fitness experts, psychologists, insurance coordinators and other allied health professionals who provide continuum of care for patients. As an evolving practice, the field is also coming under increased scrutiny by medical boards and associations and government agencies. Increasingly, states are passing laws and associations and government agencies are issuing regulations and guidance on run a bariatric medical practice. Therefore, medical directors of these programs must stay abreast of the changes occurring and ensure the program stays in compliance and uses best practices.
