Post by NovaNav

The Bariatric Patient Who Can't Cross the River Access gaps in surgical care rarely show up in outcomes data until it's too late to do much about them. The patient who never starts the program, who drove 90 minutes to an appointment they couldn't keep, who tried to complete a four-month pre-op process at a system two states over and ran out of logistics before they ran out of motivation. That patient doesn't appear in your complication rates. They just never become a case. Dr. Robert M. Cunningham, MB BCh BAO, MRCS, MPH, FACS, DABOM built the only bariatric surgery program within roughly 90 minutes of a large swath of Western Iowa. Not because the demand wasn't there before. Because the infrastructure wasn't. When he negotiated his contract, he came with a proforma, got the program's path to accreditation in writing before signing, and spent the better part of a year assembling dietitians, physical therapy, psychiatric evaluation, and a program coordinator before the first case ever went to the OR. The common misconception he pushes back on directly: that bariatric surgery is the easy way out. The reality is a four-to-six month pre-op commitment involving multiple clinical disciplines, insurance-mandated visit requirements, and lifelong follow-up. The barrier to completion is not motivation. It is geography, logistics, and health literacy. His solution to the geography problem was a hybrid model, in-person where it mattered, telehealth where it removed a barrier. Psychiatric evaluations done remotely. Nutritional education done in person, with dietitians who knew their patients by name. The operational insight for health system leaders: underserved catchment areas are not a charity case. They are an access problem with a volume answer on the other side. #PatientExperience #HealthcareInnovation #HealthcareProviders #AIHealthcare #AccessToCare #HealthcareAccess #CareCoordination #PopulationHealth

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