Weight limits as office policy – Are you really a doctor?
A recent news story out of South Florida (read it here) has spurred some controversy in our community, and has grabbed the attention of the national media. It is a source of significant embarrassment for those of us who pride ourselves on our professionalism and our lack of discrimination when it comes to treating patients. I’m speaking of a recent survey of ob-gyns in our area, in which 15 out of 105 surveyed ob-gyn practices admitted to refusing to see obese patients due to a “lack of adequate equipment” or the fact that “they are too high-risk to treat, and need doctors with special skills.” Weight “limits” for these practices varied, but were as low as 200 pounds, above which new patients would be refused.
How outrageous! First of all, the very idea that a residency-trained, board-certified (or eligible) ob-gyn would have inadequate skills to be able to treat an overweight patient is utterly ridiculous. And while it is true that obese patients have greater health risks, particularly during pregnancy, which may present some challenges, this is not a reason to refuse care. If anything, it is a reason to try to provide more diligent care to these individuals.
As for the lack of adequate equipment – if an ob-gyn office doesn’t have an examination table which can support 200 pounds, it’s time to get a new examination table! At the very least – speak with the patient in private, explain the situation, and have a plan in place to accommodate these patients (i.e., referral to a medical facility that does have the appropriate equipment). We owe our patients at least that.
But perhaps the biggest problem with this new trend is that having a policy to refuse new overweight patients requires a judgement be made about a patient’s medical condition, before any medical interview or examination can be performed. If I see a patient in my office, interview and examine her, and I then determine that she has a medical condition beyond the scope of my training, I get help – this is why we have consultants. Simple as that. But to assume that a patient will be too complicated based solely on weight, before even seeing her, is discriminatory, unconscionable, and inexcusable.