Two Fountain Valley hospitals are the focal points of weight-loss surgery in Orange County, a new state report shows.
Figures from the Statewide Office of Hospital Planning and Development show that Orange Coast Memorial Medical Center and Fountain Valley Regional Hospital and Medical Center accounted for about 58% of the more than 1,200 weight-loss procedures done at local hospitals in 2009, the most recent data available.
Orange Coast and Fountain Valley are among seven area hospitals that performed surgeries that year, according to the report, which only tracked surgeries done in hospitals. Outpatient clinics also perform weight-loss surgeries.
The concentration of surgeries at the two Fountain Valley hospitals is tied to one medical group.
“That’s a story that goes back to 1997 … I proposed to (Orange Coast) at that time to start a bariatric program,” said Peter LePort, a bariatric surgeon who has specialized in weight-loss surgery since 1985 through his medical group, Lite and Smart Dimensions.
LePort is in charge of the bariatric programs offered by Orange Coast and Fountain Valley.
Orange Coast Chief Executive Marcia Manker supported the program’s inception, according to LePort.
At Orange Coast, LePort said that weight-loss surgeries have grown from eight patients a month at its start to some 80 patients a month today.
Total Surgeries
Orange Coast performed 426 weight-loss surgeries in 2009, or 35% of the total performed in the county. Fountain Valley, which is owned by Dallas-based Tenet Healthcare Corp., was responsible for 313 surgeries, or nearly a quarter of the total.
“There’s definitely competition between the two hospitals, although I’m involved with both of them,” LePort said. “But I’ve shown them how the competition helps get them more patients, not less.”
Other Orange County hospitals that reported gastric bypass surgeries in 2009 include Chapman Medical Center in Orange, with 297 surgeries; UCI Medical Center in Orange (119 surgeries); St. Joseph Hospital-Orange (39); Mission Hospital Laguna Beach (19); and Placentia-Linda Hospital (1).
Bariatric surgery isn’t cheap—prices range from about $17,000 to 26,000, according to the American Society for Metabolic and Bariatric Surgery, a professional organization in Gainesville, Fla.
Price likely played into some up-and-down numbers during the study period. The state’s figures show that there were a high of 1,662 such surgeries performed in Orange County in 2008 before a sharp drop in the wake of the recession to 918 in 2010.
LePort said that nearly all of the patients his group works on have some sort of insurance coverage. He also said that some plans want potential patients to undergo medically supervised dieting and meet other conditions prior to a decision on whether the surgery will be covered.
“Some plans will exclude bariatric surgery,” he said. “It depends on the employer.”
Private insurance paid for 80% of the weight-loss procedures performed during the study period, the report said, while “self-pay,” or cash patients, only accounted for 4%. Medicare and MediCal also paid for some surgeries.
Orange Coast markets its bariatric programs through a website that includes video, advertisements, lectures and coverage in broadcast and print media.
Word of mouth and referrals from other doctors also bring patients.
LePort said his group is “open about it” if patients bring up recent news reports about deaths stemming from weight-loss surgeries performed at some other clinics.
“We tell all our patients what the risks are, chances of dying and having complications,” he said.
The state’s report also focused on the types of weight-loss surgeries and their prevalence.
Most Common
One type, called “open Roux-en-Y,” involves a surgeon opening a patient’s abdomen, creating a small pouch at the top of the patient’s stomach, sealing the rest of it off, and then cutting the small intestine and reconnecting it.
“Lap Roux-en-Y,” the most common surgery, is similar to the open surgery but uses a laparoscope to make small incisions in the patient. Long, narrow fiber-optic surgical instruments are then used to perform the stomach minimization and intestine cutting and reattachment.
The report also found that surgeries done with the Lap-Band, a reversible silicone stomach band from Irvine-based Allergan Inc., are gaining popularity.
Lap-Band surgeries statewide grew at a fourfold rate, to 3,260, in 2009.
Fountain Valley performed 103 Lap-Band surgeries in 2009, while Orange Coast had 62.
“The open gastric bypass probably started decreasing in number in 2001 or 2002,” LePort said. “Today, most gastric bypasses are done laparascopically, not open.”
The report shows that the total number of Californians who undergo weight-loss surgeries at hospitals increased by about 7% between 2005 and 2008.
