Can You Fit Me In? Caring For Obese Patients
Are obese patients getting the right kind of health care? Can You Fit Me In? Our contributor, Doctor Jeffrey D. Breckenridge continues to educate us on the right way to treat overweight patients.
Caring For Obese Patients
“Until the pain of staying the same is greater than the pain of change, chances are we will not change.” Dr. Lloyd C. Blue (Dallas, Texas)
Although, this quote was originally made in a church setting, the human principle still applies; people will not change unless they are forced by discomfort.
In my previous post I shared my personal experiences with “Weight Bigotry” in the healthcare system. Understandably a few people found it shocking that doctors and nurses could pre-judge, criticize and even secretly make fun of their obese patients. But never forget; “All people are human!” including doctors and nurses.
Sadly, my bringing to light this issue of “Fat-Insensitivity” will not result in a country-wide change in attitude. America enjoys making fun of “fat people.” Look at syndicated television; we relish taking jabs at overweight people. From “Porky”, Timmy’s hungry friend on “Lassie”, to Mr. Bookman, the janitor on “Good Times” being called “Buffalo Butt” to uproars of laughter seems to be the order of the day. Even to today’s “The Biggest Loser” where obese contestants are “motivated” (AKA abused and exploited) to lose weight on television. Weighing the contestants in unflattering bikini tops (women) to men being topless to expose their redundant skin folds, as if the scales would not work with them fully dressed.
A study at the University of Pennsylvania of 600 primary care physicians demonstrated that more than half viewed obese patients as being awkward, unattractive and non-compliant (Ulene, 2010). Still another study at Yale University showed that, “24 percent of nurses said they are “repulsed” by obese persons” ( Puhl & Brownell, 2001).
The world will not change its treatment until we stop allowing them too. Dr. Martin Luther King, Jr. said, “A man can’t ride your back unless it’s bent.” Fat Americans have been playing the role of the “jolly, passive, side kick” far too long. Low self-esteem has been translated into learned powerlessness, to the point that we just accept what’s offered to us; no matter how humiliating, how offensive or how inadequately our needs go unmet.
Regrettably the idea of treating others the way you would like to be treated does not translate to thoughtful behavior in the United States. We as consumers have not only the right, but the obligation to educate providers if our needs are not being met.
If and when I do or say something right in the office I am frequently asked, “Why has no one taught me this before? or “Why didn’t my previous doctor tell me this? or explain that?” My answer usually is, “Maybe they didn’t know you didn’t know!” Many times patients get upset and just transfer their care. No one knows why; except maybe their immediate circle of friends. We do not complain until tempers have flared and people are walking out the door.
Offices must be taught what overweight patients need and / or desire. They must learn there are consequences to neglecting their overweight clientele.
In America, there seems to be no greater motivator than money. We as healthcare consumers have a say-so as to where our dollars go. Even if you have no intent of returning to the office, it is little effort to compose a respectful note to the office manager or physician stating:
- “It frustrates me when there are no armless or extra-large chairs in the waiting room I can fit comfortably.”
- “It embarrasses me when the nurse weighs me in the hallway and says my weight out loud.”
- “It is impossible for someone my size to give “a clean catch” urine, in a small cup, on a closed-end toilet seat. Is it possible to give me a toilet-hat to collect the sample without me asking?”
- “My being overweight is obvious. Discussing it every appointment is hurtful. Let’s talk about it if there are “new solutions”, but it is not necessary to point it out every visit.”
Suggestions such as these are honest, respectful and constructive. Although I am aware some providers do not like being questioned, any reasonable office manager or physician should acknowledge the legitimacy of these comments. If they don’t then the patent must decide whether to stay with that provider or not. The bottom line is that communication was attempted in regards to get your needs met, and an effort was made to maintain the doctor – patient relationship. Know this; some offices will never change until they feel the “sting” in their bank accounts, and that may mean finding another provider who will listen and provide the care you need.
We must do better when it comes to healthcare for obese patients. We are all humans regardless of our size or shape. Please share your suggestions in the comments section and we will add them to this commentary.
From contributor Dr. Jeffrey D. Breckenridge
Dr Martin Luther King Jr. (1929-1968). American Baptist Minister and Civil-Rights Leader.
Karen N. Peart. (2001, October 8). Obese People Suffer Bias from a Variety of Social Sources, Including their Own Physicians. Office of Public Affairs at Yale University.
Rebbecca Puhl and Kelly D. Brownell. (2001, December). Bias, Discrimintaion, and Obesity. Obesity Research, pp. 788-805.
Ulene, V. (2010, December 13). Doctor And Nurses’ Weight Biases Harm Overweight Patients. Los Angeles Times, pp. http://articles.latimes.com/2010/dec/13/health/la-he-the-md-weight-bias-20101213.