Doctor refused obese patient - Page 3

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  1. Sep 19, '12 by
    Patients and providers alike have the right to choose whom they want to do business with. I have declined to do business with patients for sundry reasons. Weight/BMI hasn't been one, but I reserve the right to make it one if it becomes a meaningful use performance improvement criteria I'm going to be evaluated on in the future, lol.

    Most of the cardiologists in our area will not treat smokers. That is a real problem.
    Szasz_is_Right likes this.
  2. Sep 19, '12 by
    Quote from LCinTraining
    Trekfan, the difference is in the attitude. One can be obese and still try. Try to move, try to ambulate, try to do anything to not be complete and total dead weight to those entrusted to carry them. Looking at it from the perspective of the one who has to physically lift you without and mechanical assistance, is where I come from. Our bariatric litters were not electric. They were man powered. There was a time I was sent on an inter facility transport. Me and my partner. The patient was 475 lbs. I am 5 foot 2 inches and my max lift is around 200 on a litter. Not a single person would help us. Everyone in the facility refused for one reason or another. We got the litter up, but barely. And then the legs of the litter wouldn't retract. We had to lower the litter all the way to the ground and figure out how to get it back up from that point then. It resolved safely, but barely, for all three of us. The patient's reaction? Mad that we pointed out, he was simply too heavy for two people.This is the problem I have. Do not expect me to treat you like a 90 lb little girl who tries to bear weight, when you can cause me to become permanently disabled taking care of you. There are bariatric patients that do not have this attitude. They refuse to be transferred until they are sure there is enough man power there that no one gets hurt. I do not mind these patients. It is the ones that don't care if they cause me harm that get under my skin.
    You are right from that perspective . I have a question though why did you not call in the FD for more help ? You are right 450lb is to much for two people . Down here the FD use to come over to the house about 3 time a week and help move my 350 dead weight mom ? Also if ems came they would also call in the FD .
  3. Sep 19, '12 by
    Quote from Trekfan
    You are right from that perspective . I have a question though why did you not call in the FD for more help ? You are right 450lb is to much for two people . Down here the FD use to come over to the house about 3 time a week and help move my 350 dead weight mom ? Also if ems came they would also call in the FD .
    For emergency transfers that is standard protocol. For routine inter facility transfers FD is not normally called. However, we got smart after that and threatened FD if they ever hung us out to dry again. LOL
    Trinigal03 likes this.
  4. Sep 19, '12 by
    RNsRWe, I did just look at the article. I stand by my earlier comment. Yes, she is on the heavy side. But I don't think she is so obese or heavy that she couldn't lose weight. That picture in the article is her. I don't see her sitting in one of those scooters or anything, so she must walk. I guess if I was the doctor, I would explain my typical policy and the reasoning behind it. After that, I would offer to assist her in losing the weight. If she agrees, then I would welcome her to the practice. If not, then it was her choice. It would depend on the patient's attitude.

    I am very interested in public health and so, I am all about promoting healthy lifestyles and everything. But, you are not doing anything to tackle the problem when you pick and choose your patients; you're avoiding the problem. I don't mind taking care of someone who is overweight and doing health promotion with them and them start losing weight. That makes me feel like I have accomplished something with my patients. It's the patients that are overweight, have type II diabetes, hypertension, strokes, MIs, etc. and they have been educated about their eating habits and lifestyle choices over and over and they refuse to change. It's hard to take care of someone who does not care about themselves.

    People can become obese/fat/heavy (take your pick of words) for a variety of reasons; some out of their control. But, doing something about it is within their control. So, when someone says "hey, I don't care that I am obese and I am not going to try and lose the weight." Well, that's their choice. But many times, these people go to their physician for help to lose the weight; if they can't find a physician that takes obese people, I have no idea who is supposed to advise them.
    kythe likes this.
  5. Sep 19, '12 by
    I have a hard time seeing this as anything but a selfish decision on the part of the doctor. People don't just disappear just because a medical professional refused to treat them. If they don't have a PCP, they will show up in the ER whenever they have a medical problem. But in some way or another, they will be a part of the medical system. It's just passing the buck for one doctor to refuse to see patients over a particular size.

    The doctor in the article claimed her main reason was protection for her staff, but her second statement bothered me even more. "The rules, she explained, do not just protect her employees, but with a third of Americans classified as obese, also hope to motivate people to examine their own health and weight goals."

    Honestly, it doesn't sound that way. Anyone with a shred of self-esteem isn't going to be "motivated" by being shamed out of a doctor's office. People are motivated by being provided assistance and education in attaining realistic health-related goals from supportive people in their weight loss efforts. I hope the woman who was turned away is able to see another doctor who respects her as she is now, instead of expecting her to change before she is worthy of being treated.
  6. Sep 19, '12 by
    If the doc truly did it b/c the patient could not be safely accommodated in her practice, that seems reasonable.
    chare likes this.
  7. Sep 20, '12 by
    I guess I understand, but I don't share in, the outrage.
    It would stink to have that happen, sure! But would you even want to see a Dr. that had no interest in treating you? It's their perogative wether or not to enter into a relationship with a patient.
    There are plenty of other doctors.
    At least she knows WHY she was refused, was dealt with honestly.
    Szasz_is_Right and barbyann like this.
  8. Sep 20, '12 by
    quote "Honestly, it doesn't sound that way. Anyone with a shred of self-esteem isn't going to be "motivated" by being shamed out of a doctor's office. People are motivated by being provided assistance and education in attaining realistic health-related goals from supportive people in their weight loss efforts." quote

    Actually, there is no formula for what motivates people, it's a mystery.. It's not what the doctor did to the lady, but what the lady does with the experience that is most important.
    It doesn't sound like she was shamed out of the office either. Unless she felt ashamed herself. What, is weighing 200 lbs something to be ashamed of?
    Szasz_is_Right likes this.
  9. Sep 20, '12 by
    Quote from Mulan
    Doctor under fire for refusing to treat 200lb woman on grounds that too many staff are injured by obese patients | Mail Onlinequote 'Isn't there psychological and emotional harm done when a doctor - someone you're attempting to have an intimate, deeply personal relationship with - refuses to examine you because your body isn't thin enough?' quote sounds eerily like a woman complaining that a man finds her too fat to be sexually attractive
    Primary and specialty physicians can refuse a pt, but not ED docs. Some docs don't play with a lot of noncompliance. I am not saying the doc in the case noted here was right, but I can see why chronic noncompliance to the point of the pt jeopardizing her/his health is a problem. I think it's all in how the docs approach things with their pts.

    I disagree that there is necessarily more of a business relationship. I know plenty holistic docs, but they do set boundaries. As long as they are caring, set the limits, and have tried to be tolerant and patient, what's wrong with that? Geez, in parenting, we'd call it tough love.

    If a person enters drug and /or Etoh rehab, but tends to spit in the process continuously and cause trouble for others, they can be booted out of the program.

    In fact, I know a r/o cva pt, who was repeatedly noncompliant and resisted any reasonable treatment for her headaches, Tia's, and seizures. Both the doc and the insurance said, "OK. We are going to discharge you then." Out she went. It's a shame . We warned her that it could happen. She's just buck stubborn.
    Last edit by samadams8 on Sep 20, '12
    elkpark likes this.
  10. Sep 20, '12 by
    Oh and in saying the above, I wouldn't kick someone out of my practice for being 200 lbs. Come on. Anyway, in America, that's half your practice...if peds, it's becoming like 10-15%.

    I have never been obese, but I have seen the struggle it can be. I am not saying people aren't responsible for their calories and lack of exercise. But what I am saying is that for a number of different reasons, and some of them having to do w/ genetics, it's definitely harder for some folks than others.

    I have seen this with my own children. Two are ectomorphs, and one is mesomorphic w, a bit of a tendency toward endomorphic. He definitely has to work harder at keeping the weight down.
    Last edit by samadams8 on Sep 20, '12