Doctors, Heal Thyselves (reblog)
Originally posted way back in March of 2011. While there has been a lot of progress made when it comes to weight bias in health care, there is still way too much more that needs to be done.
It’s pretty rare that I read stuff on the Huffington Post… but this morning a link on Twitter from Dr. David Katz sent me to an item he wrote that was posted there. The article is called When Doctors Judge Their Obese Patients.
The article talks about a patient of his who had obesity, but had been avoiding seeing any doctor as much as possible because of the judgmental attitudes of pretty much all of them she had seen over the years.
As someone dealing with obesity myself, there wasn’t a single point in my life since about high school where I wasn’t conscious of the fact that I was “overweight”. And in later years, despite the kind protests from friends and such about how I didn’t look I was “all that heavy”, I was painfully aware (both physically and emotionally) of my obesity.
Sure, there were brief periods here or there I could bolster up a sense of denial by avoiding mirrors, photographs, and the like. But really, at 300, 350… heck 380 pounds, did I need anyone to tell me my weight was a problem? No.
She avoided our kind like the plague because we had been that virulent in her life. Across an expanse of medical encounters for an array of reasons across a span of years, a whole battalion of us had abused her. We had treated her not as a patient, but as a fat patient.
I had one doctor about 20 years ago that I liked… I felt he did care about me as a person. We did discuss my weight as it was a likely reason for me being on blood pressure meds at the time and also played a role in my knee pain. I was under 300 then… and I think he was looking beyond my weight, but he moved his practice and the doctors I saw over the next decade I never made a similar connection with.
Whatever her reason for seeking our care, whatever her acute need — we apparently never missed an opportunity to remind her that she was fat. And we made it plain: she was to blame.
That was what was sown in my patient’s medical history. What did we reap?
While I don’t think my interaction was as bad as what this woman experienced, it did play a role in my not seeing a physician as much as I should, including not being on medication for my blood pressure at times. Am I blaming those doctors for my reaching a massive weight of 380 pounds? No. But… (there’s always a but, no?) about 5 years ago I did go back to see a doctor… and I got lucky this time.
The prime directive of the medical profession is “first, do no harm.” In deriding patients for their struggle with weight, we are doing harm. In denying patients the compassion that was the hallmark of our profession long before the cutting edge of biomedical advance was quite so finely honed, we are doing harm. In driving patients away from the very services we are charged to provide them, we are doing harm — and violating our professional oath.
Dr. Rosenstein. Despite the rush ’em in, rush ’em out type of care you get in general these days, I didn’t feel like just a number on a file to him. And while I would love to say he gave me idea to have weight loss surgery, or he gave me any other sort of eye-opening ideas on how to lose weight, he didn’t. But what he did do was give me a place, a person I could turn to with my questions as I was looking for my own answers. And when that search for me did turn to weight loss surgery, he was receptive, honest and above all encouraging as well as encouraged that I was ready to take some action.
I don’t see my doctor every three months like I used to, when I needed to get my bp meds refilled. In fact I haven’t been in to see him since my 1-year post-op checkup about a year ago, though I have bumped in to him a couple times outside the office (I’m frequently in the building where his office is), and he’s always shown genuine interest in how I’ve been doing and was very supportive of my decision to pursue a career in nutrition.
I think I’ve been doubly-lucky in that I found an equally great surgeon at the bariatric clinic Dr. Rosenstein recommended me to. Maybe it’s because I have done some volunteer work through the clinic that Dr. Johnson remembers me so well, but he too has been nothing but encouraging of my progress (both in my weight loss and current career goals), as well as truly grateful for my participation in the talks and such at the clinic.
To react to the largely unmet challenge of weight control in the modern world with judgment and blame helps no one; harms many; and redounds to our profession’s shame.
I’m not delusional, I know this is a business for him and I know with the thousands of patients he has had it would be near impossible for him to remember a lot of specifics on every single patient, but I truly believe his interest and concern and pride in the success of his patients is genuine.
Go read the entire article Dr. Katz wrote – maybe even share it with your own doctors. If you want to find out more about Dr. Katz, his website is davidkatzmd.com – and he is also the founder of the TuTurn the Tide Foundation – a group who’s vision is a future in which obesity is no longer a major cause of chronic disease, no longer epidemic, and no longer a threat to our children. A modern world in which eating well, being physically active, remaining lean and enjoying robust good health all lie along the path of least resistance, and are simply routine.