Windsor's Regional Bariatric Assessment and Treatment Centre  Windsor's Regional Bariatric Assessment and Treatment Centre will provide medical screening and assessment services. Bariatric assessment services are provided on a physician referral for patients meeting the following criteria: BMI >40 kg/m2 or BMI >35 kg/m2 with significant obesity-related co-morbiditiesAcceptable operative riskFailure of non-surgical weight loss programsPsychologically stable with realistic expectationsWell-informed and motivated patientSupportive family/social environmentAbsence of active alcohol or substance abuseAbsence of uncontrolled psychotic or depressive disorder Range of Services Screening and Assessment For obesity utilizing anthropometric measuresFor related conditions utilizing laboratory outcomesAssessment and identification of obesity releation conditions through clinical findingsAssessment and identification of psychosocial outcomes using psychosocial measures for depression, mood disorders and eating disordersAssessment of readiness to change behavioursPatients will participate in extensive nutritional evaluation and counseling preoperatively, including assessments with Dietary (up to 5 vistis)

, Registered Nurse (up to 3 visits), social, work, and physiotherapyOnce surgery is booked, patients will attend a Pre-Surgical visit with nursing including attendance at a patient information session facilitated by a Dietitian and Social Worker Surgical Interventions Pre and post surgical managementEducation and booking of bariatric surgical optionsOn-going post-operation follow-upPost-operative visits will include an assessment with the multidisciplinary team at the 1, 3, 6, 9, 12-month marks as well as a yearly assessment for 5 years following surgeryPatients will incorporate benchmarks and best practices for bariatric surgery and pre and post-operative care where available and as recommended from time to time by the Ontario Bariatric Network ("OBN") Advisory Board and endorsed by the Ministry. Referrals Referrals will be accepted from physicians in the community and hospital-based physicians. Referrals will come to the clinic with laboratory results and x-ray results from outpatient centres. 

Scheduling Most outpatient visits that are booked from physicians' offices will be scheduled through the Hospital's automated booking system. Hours are flexible to accomodate schedules but are by appointment only. LocationEast Wing, Casgrain Building at Hôtel-Dieu Grace Healthcare1453 Prince Road, Windsor ON  N9C 3Z4Phone: (519) 257-5111 Ext 79103Fax: (519) 971-9566 Hours of Operation8:30 a.m. to 4:00 p.m. Monday through Friday and by appointment onlyShe had once dreamed of easy, medically enhanced weight loss, but Beth’s high hopes came to an excruciating end last year with a “huge pop” — from inside her body. Like thousands of other Canadians struggling with obesity, the Toronto woman, helped by her mother, had paid for weight-loss surgery at a private Ontario clinic, won over by marketing that promised rapid, effortless slimming. Within three years, though, she needed revision surgery after the restrictive band implanted around her stomach in 2008 slipped.

Then she felt that fateful pop, followed by violent, breathtaking pain, and the clinic’s pledge of post-op care began to crumble, forcing her to visit two public hospitals for urgent help.Sofa And Loveseat Sets For Sale Beth spent a week in one facility before the band, which had literally fallen apart inside her abdomen, was surgically removed, all costs picked up by the provincial medicare system.Toy Pomeranian Puppies For Sale Cheap ‘I was very angry and most of all disappointed, because my Mom had spent her retirement money on something that was a promise of health’Used Prom Dresses Orlando “I was very angry and most of all disappointed, because my Mom had spent her retirement money on something that was a promise of health,” said the 24-year-old, who spoke on condition her full name not be published.

“Eventually [medicare] had to go in and fix everything that they messed up.” Beth’s experience, though, was far from unique, highlighting what seems to be an increasingly common collision between private and public medicine in Canada. Surgeons working in taxpayer-funded hospitals across the country say they are routinely helping pick up the pieces of privately performed weight-loss operations. Patients show up complaining of serious complications, unpleasant side effects or just the inability to shed pounds after an investment that can top $16,000 — and limited help from the company that originally treated them. An Edmonton program has estimated the cost to taxpayers of treating patients who had gastric bands implanted by for-profit clinics in Canada and out of country at millions of dollars, and suspects it has seen only the “tip of the iceberg.” “I think it’s a crisis, to be honest. It may explode at some point when all these people have ongoing issues,” said Daniel Birch, an Edmonton surgeon.

“It’s a tremendous cost to the patient and to the system, with no sustainable quality-of-life change.” A specialist in Toronto says he has never implanted a gastric band — the preferred operation in private clinics — but has removed 20 of them in the last few years. Patients typically indicate they received little support from their clinics, which seem anxious to recruit patients but less eager to provide crucial care after the operation, said David Urbach, surgical director of the Toronto Western Hospital’s bariatric unit. “They privatize the profit and they socialize the losses,” he charged. “All the risk is borne by the public system.” Yet the mere fact that patients are paying to undergo surgery at private clinics with uncertain success rates highlights another problem: backlogs in the public system that can force obese patients to wait years for an operation, said Dr. Birch. And private does not necessarily equal sub-standard. One private-clinic director said his own facility provides extensive care after surgery, with excellent patient outcomes that have been reported in a peer-reviewed journal.

When private surgery works for patients with a medical need, it actually saves the public system money. The surgeon, who asked not to be named so his company was not linked to negative publicity, said he has even operated on patients whose public-hospital weight-loss surgery failed. He admitted, however, that some for-profit clinics are not so conscientious, and he has had to take on many of their patients. “It isn’t just the public system that’s dealing with the complications,” the specialist said. “They [other clinics] are my nemesis, too.” Bariatric surgery, usually done with minimally invasive keyhole techniques, is certainly accepted as an effective, and sometimes the only, intervention for the seriously obese. As many as 70% of patients with type-2 diabetes are virtually cured of the disease after surgery, noted Dr. Chris De Gara of the University of Alberta. There is less agreement about the best type of weight-loss operation. Private clinics usually install gastric bands, liquid-filled devices fastened around the top of the stomach to create a little pouch and make patients feel full quickly.

A tube threads out to a “port” on the abdomen, allowing liquid to be added or removed from the band to tighten or loosen it. Most common in teaching hospitals and sometimes called the “gold standard” is the more invasive Roux-en-Y gastric bypass, where a small pocket is surgically created but most of the stomach is bypassed. Some studies have suggested as many as 40-50% of bands will fail, though that still means many patients do well, and centres in Australia have produced much better success rates by providing extensive support to band patients. The problem, in fact, may not be the procedure itself. Surgeons in public hospitals say many private clinics seem to skimp on the crucial preparation and after-care needed to make any bariatric procedure work. The actual operation makes it harder to over-eat, but major diet, lifestyle and psychological adjustments are also needed. “It’s very naïve to think that a simple surgical procedure will fix a complex behavioural and genetic and societal problem,” said Teodor Grantcharov, a surgeon at Toronto’s St. Michael’s Hospital.

Beth underwent a medicare-funded bypass operation in Ontario last week, saw an array of health professionals — from pharmacist to psychiatrist — beforehand and has a similar list of appointments for the next year. ‘I had two ER visits, plus the surgery, all at public hospitals. It just takes all the financial weight off of [the clinic]. It’s definitely not fair that taxpayers have to worry about their mess-up’ In contrast, her only prep before the band was implanted was to meet with a clinic sales consultant. Afterward, she had brief visits so the device could be adjusted, a revision surgery and one appointment with a nutritionist whom she said was barely qualified. When things go really seriously wrong, it seems some clinics are reluctant, or just ill-equipped, to take corrective action. In a case made public by a disciplinary ruling this February, a patient of the same company and doctor as Beth’s had to visit hospitals repeatedly and be operated on by a different surgeon when her band began to erode dangerously inside her.

At a special “revision clinic” launched four years ago in Edmonton, doctors have since 2010 seen 124 patients who had gastric bands implanted outside of Alberta, the majority at a private clinic in Ontario, the rest in other countries. The doctors removed about half the bands, and the demand is growing: the number of removals has doubled each year, with 13 devices taken out just in the past four months, said Dr. De Gara. A paper published in May by his team estimated the cost to the system of treating 62 patients who had problems after private weight-loss operations in other provinces or countries was $1.8 million. In Toronto, Dr. Grantcharov said about 10% of the 80-100 bariatric surgeries he does every year are to take out failed bands, the majority implanted at private clinics in Canada. Illustrating the complex interplay between private and public health-care, revisions of gastric-band operations on Vancouver Island are sometimes done at taxpayer expense by the same specialist who performed the original, private procedure, said Dr. Samaad Malik, a University of British Columbia surgery professor.

Still, if governments dedicated more resources to bariatric surgery, fewer patients would need to seek out the less-comprehensive treatment offered by some private clinics, suggested Dr. Birch. Ontario did boost its spending on the field in 2009, and Toronto’s Dr. Urbach maintains wait lists are now a thing of the past. Dr. Birch in Alberta is unconvinced, arguing Ontario has “not even touched” the true backlog of patients who need the operation. In B.C., the College of Physicians and Surgeons has tried instead to bolster the standards of the for-profit clinics. It took the rare step of imposing rules for private weight-loss surgery, requiring that they be offered only as part of a comprehensive weight-loss plan, and that clinics report long-term outcomes. “It gives patients an option,” said Dr. Heidi Oetter, the regulator’s CEO. “For many people to be told there’s a six-year wait (in the public system) to get a procedure, it’s hardly helpful to them.”