Remote Unaffiliated Pre-surgical Psychosocial Evaluations: A Qualitative Assessment of the Attitudes of ASMBS Membership

Abstract Background Psychosocial evaluation is an important component of the pre-operative assessment process for people seeking metabolic and bariatric surgery (MBS) and is required for accreditation of MBS programs. Recently, independent companies without affiliations with MBS programs have been marketing a service conducting remotely-administered unaffiliated psychosocial evaluations for MBS (RUS), and American Society for Metabolic and Bariatric Surgery (ASMBS) members have raised concerns about these evaluations. Objectives To explore ASMBS members’ beliefs about RUS. Setting Online survey. Methods We developed a survey to evaluate ASMBS members’ opinions, experiences, and/or concerns about in-person and RUS psychosocial evaluations for MBS. Results 635 ASMBS members responded to the online survey and 156 responded to an open-ended question on RUS. Responses were coded based on a manual developed for this study, yielding themes of concerns about the quality of RUS, lack of ongoing relationships in RUS, and conditions under which/reasons why RUS evaluations could be acceptable. Conclusions Respondents expressed both interest in and concerns about RUS in pre-MBS psychosocial evaluations. Use of RUS has the potential to improve access to MBS by providing a convenient and efficient means of completing the psychosocial evaluation. Conversely, respondents expressed concerns about the background and training of RUS providers, the quality of the reports, and the limited relationships between both the RUS provider and the MBS patient and the RUS provider and the MBS team. We discuss the clinical and research implications of response themes, particularly for patients in rural areas or who have other barriers to care.