Conversion Rates From Initial Consultation to Bariatric Surgery: A Single-Center Community Practice Experience

As part of the accreditation process for bariatric surgery, patients must go through a preoperative pathway. There will inevitably be patients who are seen in the clinic but never undergo surgery. This rate of attrition is different for every practice. Our objective was to evaluate the percentage of patients who eventually undergo bariatric surgery at a community practice.

A single private practice was evaluated. Patients initially seen in the clinic were followed to surgery completion or until they dropped out. A period of 21 months was evaluated. Patients with at least a 6-month follow-up were included.

There were 479 patients who underwent evaluation during that time. Forty-three percent of these patients went on to have surgery. There were 216 patients who did not have surgery, with most of those patients never progressing past the first visit. One patient became pregnant and dropped out, 2 did not achieve medical clearance, one moved out of town, and one obtained surgery at a different program. There was a significant increase in the rate of attrition if the wait period was 6 months or longer ( P <0.05).

There are no national benchmarks as to what percentage of patients complete the preoperative process at accredited bariatric centers and undergo surgery. This solo private practice has a conversion rate of 43%. Longer waiting times appear to increase the rate of attrition. Mandated wait times function as barriers to patients undergoing surgery and should be abandoned.