Finding a new General Practitioner after bariatric surgery can be challenging. I am currently in the process of looking for a new GP. Mine is wonderful, but she has too many patients and it can take four months to get in to see her even for something minor. I have been rescheduled several times, some because of Covid -19 and some there was no reason given.

After bariatric surgery, it is imperative to get bloodwork done every year. It has now been over two years since I have had bloodwork done. When I asked the physician’s assistant if I could get the bloodwork script so I could get it done, I was told to go to the ER if I needed it immediately. With insurance deductibles being what they are, getting that response when it’s something that should be able to be taken care of by your GP, I decided it was time to start looking.

Finding a new GP is not an easy task. Your new primary care doctor will need to be aware of the increased bloodwork and yearly tests that you will need for the rest of your life. Many doctors are not skilled at working with bariatric patients. This post will focus on:

• Recommendations
• Screening Questions
• Red Flags

Recommendations

Getting a recommendation from a friend who has never had bariatric surgery will probably not do you much good in this situation. The best place to look for a recommendation is from your bariatric surgeon. Most bariatric surgeons know who is experienced and comfortable dealing with the after-effects of bariatric surgery. Many surgeons will have an in-office list of general practitioners and specialists who are skilled in dealing with bariatric patients for aftercare. This is the first place you will want to check.

If you have moved to a new area, I would recommend calling a local bariatric surgeon and asking for a recommendation. Even if you are not one of their patients, they will most likely give you a referral.

You can also look to your support group for recommendations. One of the first things that I do, after I move, is to find a local support group. Since the beginning of the pandemic, most support groups have moved to an online format. Even if you cannot meet in person, having support is so important. You will want to focus on patients who have similar medical issues as you. I have PCOS, so a doctor who has experience with bariatric surgery and POCS is important. Ask around with your group to see who they go to and if they are happy with their doctor.

Screening Questions

It’s important to ask screening questions before you choose a new doctor. This is even important if you haven’t had bariatric surgery but even more so with some of the medical issues that can arise even years after bariatric surgery. There are some things you will be able to check online even before you schedule your first appointment:

• Are they taking new patients?
• Do they take your insurance?
• Is the office a group practice or is it an individual doctor?
• Are they approved at the hospital that I prefer to use?
• Do the office hours work with my schedule?

If you have found good information on your perspective doctor during an online search, the next step is to call the office and ask a few pre-appointment questions:

• How far in advance do I need to make appointments?
• Who takes care of patients after hours or when the doctor is away?
• If necessary, am I able to schedule a same-day appointment for urgent situations?
• Does the doctor or doctors work with post-bariatric surgery patients?

And finally, if you are happy with the answers you have received so far there are a few questions that you should ask the doctor at your 1st appointment:

• Do you have other bariatric surgery patients?
• Do you provide post-visit reports that summarize what occurred, what was discussed, and what actions need to be taken after the visit?

You will want to ask some specific questions if you are looking at finding a new OB. Pregnancy after bariatric surgery requires a few additional tests and a workaround for other normal tests.

• Have you had other OB patients that have had bariatric surgery?
• If they have had an open procedure do you recommend a C-section?
• Are there any additional tests that you require of your bariatric surgery patients?
• What do you do in place of the glucose tolerance test? Most bariatric patients cannot do this test without getting very sick.

Red Flags

Some doctors would never recommend bariatric surgery to any of their patients. They will not be a good advocate for you if they are not supportive of the surgery in any situation.

• They ask you if you’re still on a liquid diet. I had an OB/GYN ask me this when I was pregnant with my second child. I had the surgery 4 years prior and this was after he told me that my child would most likely be brain damaged because of the lack of nutrition that they would receive.
• They blame everything that is going on with you medically on your gastric bypass This is also called GBGB for gastric bypass gone bad. It happens in emergency rooms a lot as well.
• They don’t understand your medication needs. After bariatric surgery, there are medications that you cannot have. NSAIDs are a huge group to avoid after surgery. I had one GP who wanted to prescribe NSAIDs to me even after it had been written in my chart several times. I had also told him during several visits that I could not have them because of the gastric bypass. He said that was old information and I should be able to take them. Any doctor that does not respect your wishes not to burn a hole in your new pouch is one you should run from immediately.
• They refuse to listen to you. You know your body and you know when something is wrong.

What to do if you have made a mistake when picking a doctor:

Following the recommendation above and getting a referral, using screening questions, and watching for red flags will give you a great chance of choosing a good doctor, but it is not a guarantee.

If you have chosen a doctor that does not give you the support that you need, first, realize that this is not your doctor. You need a doctor who’s going to be supportive of you since you have already had gastric bypass surgery. You have done the research and you know the risks. Some doctors believe that you should never have had gastric bypass. That is not your doctor.

If you have chosen to have surgery, you need someone who’s not going to blame every little setback on your surgery. You need support and encouragement and a doctor who is going to want you to be the best and healthiest version of yourself possible. Sometimes that means you need to find a new doctor.