Knowledge and Perception of Bariatric Surgery Among Primary Care Physicians: a Survey of Family Doctors in Ontario

Mark Auspitz, Michelle C. Cleghorn, Arash Azin, Sanjeev Sockalingam, Fayez A. Quereshy, Allan Okrainec, Timothy D. Jackson

The primary objective of this study was to identify Ontario family physicians' knowledge and perceptions of bariatric surgery. The study population included all physicians practicing family medicine in Ontario who were listed in the Canadian Medical Directory. A self-administered questionnaire consisting of 28 questions was developed and validated using a focus group of seven primary care physicians. The questionnaire was distributed to 1328 physicians. One hundred sixty-five surveys were completed. 8.8 % of physicians did not have any bariatric surgical patients, and 71.3 % had no more than five in their practice. 70.2 % referred no more than 5 % of their morbidly obese patients for surgery. Only 32.1 % had the appropriate equipment and resources to manage obese patients. 92.5 % of physicians would like to receive more education about bariatric surgery. Physicians with no history of referral (n = 21) were earlier into their practices and had less morbidly obese patients than physicians with previous referrals (n = 141). They were also less likely to discuss bariatric surgery with their patients (30 vs. 79.3 %; p < 0.001) and less likely to feel comfortable explaining procedure options (5.6 vs. 33.9 %; p = 0.013) and providing postoperative care (26.7 vs. 64.2 %; p = 0.005). 55.6 % would refer a family member for surgery, compared to 85.4 % of physicians with previous referrals; p = 0.002. There appears to be a knowledge gap in understanding the role of bariatric surgery in the treatment of obesity. There is an opportunity to improve education and available resources for primary care physicians surrounding patient selection and follow-up care. This may improve access to treatment.