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Today, Metabolic Syndrome and its most important components, Obesity and Type 2 Diabetes have reached pandemic proportions which made people aware that present treatment options were not sufficient. That is why alternative options were sought and Metabolic and Bariatric Surgery came out as the answer.
Of course, it is hard to claim that Metabolic and Bariatric Surgery is the perfect solution, but it is the most effective treatment we have at the moment. It is an ever evolving field, new procedures, publications coming out every day and its demand, along with its popularity, increases as well. And where is demand, there is supply. This led to an increase in the number of people and clinics/centers/hospitals which offer services in this field. It might be easier for people who work in the field of metabolic and bariatric surgery to differentiate the procedures from each other, understand and interpret their outcomes, and but can the same be said for common people? It might be known to professionals that which centers/doctors offer high quality healthcare services, but what about the patients? Also, for clinics and doctors in this field, how can they improve their outcomes? What mortality rate is acceptable and what should be accepted as excellent? What can be done to improve the performance of clinical personnel, how should their training be organized, how to organize a clinical pathway? Do we have to repeat the mistakes of our predecessors until we can find the right answer?
The answer to this question is of course; ‘’NO’’. There are standards laid for us, standards that have been founded on facts, tested again and again in time and evolved with experience. And this is where accreditation programs come in.
Accreditation programs, which are administered by independent, international institutions around the world are shaped by these standards. Program participants which can fulfill these standards earn recognition as Center/Surgeon of Excellence both among the public and patients, payers (government and insurance companies) and scientific community. Which means everyone wins, so to speak. Of course there are many different aspects of this process, but what I can tell of is our own experience.
During the process, the most remarkable thing I observed was that the program brought the entire team together. In-service trainings, weekly pre-op patient discussions and multi-disciplinary meetings made everyone realize that each one of them is a crucial part of the team. Every one came to know what other people do, learn from their experience, understand their difficulties. This strengthened their respect toward each other and feel that they are an integral part of a bigger group. Not only that, but regular multidisciplinary meetings and weekly pre-op evaluation meetings greatly improved our patient selection, which overall improved our statistics regarding complication rates, post-operative hospitalization, etc. In-service trainings increased the awareness of our nurses towards complication symptoms. This also improved their confidence, knowing that they are our first line of defense as they are responsible for the monitorization of the patients. Regular patient meetings helped us understand what each patient expects of the operation, their difficulties, their opinions. We also received positive feedback from them, as they said that these meetings made them feel unique, which is exactly what we want because we know each patient is different. All in all, the program integrated each member, and truly made us a team.
Therefore, it would be fitting to say that Center and Surgeon of Excellence designations and the program process were truly a milestone both for me and my staff.
In conclusion, it is my firm belief that Center of Excellence and Surgeon of Excellence accreditation programs are indispensable for Metabolic and Bariatric Surgery and I would strongly recommend it to any institution, team and surgeon working in this field. It was really a remarkable experience.
Alper Celik, MD
Metabolic Surgery Clinic