In order to improve the approval process, the Ontario Ministry of Health and Long Term Care established five Regional Assessment and Treatment Centres (RATC) in late 2009. Now all Ontario patients must contact one of these centres prior to applying to have your surgery done out of country.
We are committed to working with the Ministry of Health and Long Term Care to ensure timely access to care and will not accept applications for bariatric surgery to be covered under OHIP unless approved by one of the five RATCs.
Below we have outlined the process you need to follow.
Step 1:
To determine if you are an eligible Bariatric candidate, your general practitioner will need to provide a referral for you to one of five RATCs in Ontario.
The role of the RATC is to triage physician referrals, provide medical screening and assessment services to determine if you qualify for bariatric surgery in and/or outside of Canada and facilitate the application process.
To be considered a surgical candidate by an RATC, you must:
- Have a Body Mass Index (BMI) of 40 or great or 35 with at least 2 existing co-morbidities
- Have tried other weight loss programs
- Be motivated and willing to make eating and lifestyle changes
- Be willing to work with the multidisciplinary team
- Participate in long-term follow-up
- Have not had any previous weight loss surgical procedures
Step 2:
Once you have been approved for out of country surgery and have selected the Cleveland Clinic as your preferred provider, you will contact our clinic at 416 507 6674 and our Bariatric Coordinator will walk you through the process.
To begin you will be asked to complete a thorough questionnaire of your medical history. Our Cleveland Clinic surgical team in Cleveland, Ohio will review your questionnaire and determine necessary evaluations and tests to further determine surgical readiness. We will then arrange an initial assessment at our clinic in Toronto. For your convenience, we offer a medical concierge service to assist you and your family with travel and lodging arrangements for the trip to Cleveland for surgery.
Ensuring your body is prepared for bariatric surgery is our first priority*. Our comprehensive program consists of:
- Comprehensive health history questionnaire
- Blood tests to monitor the effects of obesity
- Nutritional evaluation
- Psychological evaluation
- Medical evaluation
- Metabolic blood work panel
- Chest x-ray
- ECG
- Upper endoscopy
- Abdominal ultrasound
- Referral consultations as required and determined by surgeon
*If any component of your health is compromised and presents a risk to surgery, we will create a customized plan to address the issue.
Following your consult in Toronto, you will travel to Cleveland Clinic, Ohio, for your bariatric surgery.
You’ll arrive 3 days ahead of your surgery date to undergo final pre-op evaluations, testing and treatment plus spend an additional 2-3 days in surgical recovery.
In total, you are required to stay in Cleveland 7-10 days following your surgery to ensure your body adjusts favourably.
Your post-operative monitoring includes all members of the bariatric team. All follow-up meetings will either happen at our clinic in Toronto or when possible, from the comfort of your own home.
- You will have weekly phone meetings with our nutritionist to ensure your eating patterns are on track.
- You will meet with our psychologist to address any barriers or old habits that are concerning you.
- You will have a one-month post-op ‘virtual visit’ with your surgeon
- Additional follow-ups will occur in three-month intervals following surgery to monitor your progress and reinforce learning to facilitate a positive outcome.
