Every month, our team sees dozens of referrals from Melbourne GPs who generally do a wonderful job in getting patients thinking about – and acting on – their metabolic health. 

While most referrals are thoughtful and well-intentioned, occasionally, some easily fixed gaps can slow things down for patients.

As bariatric workups are extremely time-consuming for GPs and referral pathways are more documented than many other specialties, the ‘gaps’ are often easy to miss. 

Dr Jason Winnett, Melbourne Bariatric and Laparoscopic Surgeon, offers his top tips for avoiding common pitfalls when referring metabolic and bariatric patients. 

• Provide a clear reason for referral

The trap 

Dr Winnett says, ‘Making general statements like “The patient has tried to lose weight for years without success” is something I see surprisingly often.’ 

But a few details are missing.

‘This is a completely understandable shorthand, but on paper – and to hospital admission departments – it can read as “undocumented”.’ 

Try this instead

‘A method, duration and outcome list works well,’ says Dr Winnett. 

For example: ‘Dietitian-supervised low-energy diet Jan-Jun 2024, lost 4kg, regained on cessation, weight-loss medications for six months but regained 6kg more on cessation. Comorbidities include Type II diabetes (oral insulin) since 2021.’

He says a well-built referral doesn’t just move faster through triage. 

‘It gives the surgical team what they need to act on with confidence from day one. And for patients who are extremely unwell or experiencing obesity especially,  it provides a smoother, faster start to a process that’s often already been years in the making by the time they reach the point of having surgery.’   

2. Perform an Obstructive Sleep Apnea (OSA) early  

The trap

‘It’s easy to overlook sleep studies in a weight-loss consult, which has a lot of workup,’ says Dr Winnett. 

‘But a sleep apnoea screening is one of the most time-critical parts of the bariatric workup, and a missing sleep study is often the single biggest reason a referral takes longer than it should. 

‘It’s also worth noting that some hospitals may also bounce back a patient admission without an OSA test.’

Try this instead 

‘Run the STOP-BANG and Epworth Sleepiness Scale at the surgical referral appointment,’ says Dr Winnett

‘If the score is elevated, order the sleep study then and there, rather than waiting for the bariatric team or hospital to request it, as it can save the patient weeks or months.’ 

3. Order an extensive panel of pre-surgical bloods 

The trap 

‘Full Blood Examinations and Urea & Electrolytes tests are a great start, but our pre-surgical workup needs a broader picture – nutritional markers especially, which routine bloods don’t always capture,’ says Dr Winnett.

Try this

A one-off comprehensive panel at referral saves a return visit later. This should include: 

• HbA1c
• Fasting insulin
• Lipids
• B12, folate, iron studies, B1 (if alcohol use) 
• Thyroid function
• PTH and vitamin D 
• All alongside the usual FBC/U&E/LFTs.

Dr Winnett says a good referral may also be bundled with:

• Pregnancy test if relevant 
• Sleep apnea screening referral 
• Cardiac or respiratory assessment if indicated 

4. Describe comorbidities in detail

The trap 

Dr Winnett says, ‘When a GP writes “patient has diabetes and sleep apnoea”, that tells us the problem, but how it’s being managed in detail shapes how quickly we prioritise a patient, so a little more granularity goes a long way.’

Try this instead 

Briefly mention the following: 

• Is diabetes diet-controlled? 
• On oral agents or insulin? For how long? 
• Is OSA CPAP treated? 
• What’s the current mobility status? 

Dr Winnett says, ‘These specifics help us fast-track patients with significant weight-responsive comorbidities, as well as alcohol intake, smoking status/cessation attempts and psychological comorbidities.’

5. Give a clear history of previous bariatric surgery

The trap 

‘For patients returning with issues after a previous procedure,’ says Dr Winnett, ‘the words “previous gastric band” don’t give us enough detail to triage urgency. Dysphagia versus uncontrolled vomiting are two very different clinical pictures.’ 

Try this 

Include a quick, specific note, such as procedural type, hospital year and current symptoms with a timeframe.

For example: Lap band, Name of Hospital, 2022, dysphagia to solids over 6 weeks, unable to tolerate fluids for the last three days. 

‘This is the difference between a routine and an urgent slot,’ says Dr Winnett.

A strong referral means a faster track to health for your patient 

None of this requires a longer consult. Just a slightly more structured one. 

‘The referrals that move fastest through our clinic are the ones that read like a checklist rather than a letter, simply because that’s how our multidisciplinary team has to triage them,’ says Dr Winnett. 

If you’re unsure whether a patient meets criteria or whether a referral is ready to send, get in touch with Winnett Specialist Group. Our Practice Manager, Vivienne, would be happy to help.

We’d always rather have a two-minute conversation than send a form back.

 

This page was reviewed by Dr Jason Winnett in August 2026, AHPRA No: MED0001155541 

General information only. Not medical advice. All procedures carry risks and results are individual. Consult your GP and a specialist surgeon, or seek a second opinion before proceeding.