| 2008 Important Exam Dates Application Deadline Early: July 1, 2008 Final: August 15, 2008 Certification Exams September 28-29, 2008 Tampa, FL |
| Certification Information |
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• Policies & Procedures for |
PCR Content Areas
The Patient Care Review is designed to verify adherence to the ASBP/ABBM Bariatric Practice Guidelines. Consistent documentation of the following demonstrate compliance with the current ASBP/ABBM Bariatric Practice Guidelines as presently required by ABBM:
Patient History
- Patient histories are taken before commencement of treatment.
- Patient charts consistently reflect that the patient history includes (with separate notations for each):
- dietary content inquiry
- weight history
- dietary history
- history of eating disorderscurrent medical problems, diagnoses, treatment
- past physical medical history
- past psychiatric medical history
- types of medications taken currently
- medication allergies
- review of systems (including mental status inquiry)
- family medical history (weight, physical, psychiatric)
- dietary supplements, herbs, "natural remedies"
- gyn history (menopause, etc.)
- patient's primary care provider if other than bariatrician
- consultations requested if necessary
- The physician has personally reviewed the information obtained and made appropriate notations regarding any positive findings in the patient history.
Physical Exam
- Physical exams are performed or reviewed by the physician before commencement of treatment.
- Documentation of the physical exam includes:
- height
- weight
- blood pressure
- pulse
- general appearance
- BMI (or some objective measure of obesity)
- head and neck
- thyroid
- heart
- lungs
- abdomen
- extremities
- neurologic
- abdominal circumference/waist-to-hip ratio
- skin
Lab Work
- Laboratory work-up is performed before commencing therapy.
- Chemistry profiles includes
- metabolic panel (glucoses, electrolytes, ca, renal, hepatic, blood sugar)
- lipid panel (total cholesterol, HDL, LDL, triglycerides, ratio)
- CBC (hemoglobin/hematocrit, platelets)
- Urine analysis
- thyroid function testing (TSH or free T4 or FTI [free thyroxin index: T3, T4, T7] recommended)
- Lab follow-up is performed if indicated.
EKGs
- EKGs are obtained if:
- there is reasonable evidence of present or past significant cardiac disease
- the patient has coronary heart risk factors such as hypertension, hyperglycemia or dyslipidemia
- there is a strong family history of cardiac disease.
Patient Counseling
- Counseling is performed in the following areas (both initially and in follow-up visits):
- appropriate eating habits
- exercise
- behavior modification
- appetite suppressants (if used)
- Patients are offered an appropriate, individualized plan.
Return Visits • Patient is advised to return at reasonable intervals for periodic follow-up and counseling. • On return visits, pulse and blood pressure are recorded, as are weight or BMI.
Medications
- Anti-obesity medications are prescribed in accordance with pharmaceutical labeling or in accordance with the ASBP Guidelines for Anorectic Drug Use or in accordance with published peer-reviewed medical literature (made available to reviewer at the time of the review along with copies for ABBM Board).
- The following is consistently reflected in patient charts:
- the patient has been provided information on the benefits and risks of the proposed treatment modalities to be used.
- inquiry has been made as to the patient’s understanding of the benefits and risks.
- the patient’s medication dosing, effectiveness and possible side effects.
- If medications are dispensed from the office, they are stored securely, packaged and labeled in accordance with applicable laws, and recorded and dispensed in accordance with applicable laws.
Maintenance
- Physician offers a maintenance program for patients who reach “goal weight.”
- The maintenance program includes individualized dietary plans, behavior modification, exercise and scheduled follow-up visits.
Copies of the ASBP / ABBM Bariatric Practice Guidelines are available to patients upon request.
Candidates must be able to demonstrate an ability to select different treatment modalities, organize and sustain appropriate intervention for obesity treatment and demonstrate principles of medical management.