Tuesday, August 14, 2007

Doctors failing obese patients

Here's breaking news: Doctors are responsible for America's obesity epidemic. Did you know that? Well that's what the press in this country want you to believe. Here's the latest example. (image credit)

According to a study involving almost 10000 patients at the Mayo Clinic in Minnesota, only 20% of study subjects had their obesity formally documented. However, if this condition was documented, then patients were more likely to be given a treatment plan which included exercise and diet instructions. (Reuters)
Not surprisingly, [the principal investigator] noted, study patients who were severely obese were more likely to have a diagnosis and a treatment plan -- suggesting that doctors need to take a closer look at patients with less severe weight problems.
I have a few of problems with this. First, I never knew that I was responsible for the obesity epidemic continuing. Those of you conspiracy theory people out there probably even believe that docs are intentionally not treating obesity because it would decrease business for medicine. How ridiculous is that?

Second, this article appears to want doctors to label their patients as obese so that they can get the proper treatment. No one likes to be labeled. In fact, if I even hint at the word obesity with my patients, I know that they would leave my practice. Labeling is a big no-no - whether it's obesity, mental illness, or any other term with a negative perception.

Third, even if I give my patient a very specific treatment plan, am I responsible for them to follow it? Well, according to the concept of pay-for-performance, physician accountability is more important than patient accountability - meaning if the patient does not lose the weight, it is my fault and it will hit my pocketbook. I know you doctor haters out there don't care about this. But, I have an office full of staff and I care how much this would affect them.

So, now that I'm done rambling, this article is just part of my continuing frustration with the press in this country. Not that I care, but articles like this create a false perception. Perception is reality to some people. And, it is this false reality that makes it difficult for me to deliver adequate health care to my patients.


SuperStenoGirl said...

It's like smokers - you can't MAKE them quit. They have to WANT to.

The same goes for us obese types. You can't MAKE us thin and healthy. We have to want to make the change.

I hate this new age thing of passing the buck and pushing accountability onto everyone else. My doctor (not that I have one) is not accountable nor responsible for my life style. There's only 1 person in the world who is and that's me.

You can't start making doctors responsible for what their patients do. They are not their (patient's) keeper. They're not a babysitter. All you can do is offer the resources and options and make sure the patient is aware of them. Then the ball is in their court. If they don't want to follow through, then what the hell are YOU supposed to do about it?

Sorry. I just hate this no accountability bullshit that is so profound in our society. No one wants to take responsibility for their own actions so they repeatedly try to blame someone else.


Nikki Neurotic said...

People just do not want to take responsibility for themselves...as doctors are supposedly responsible for our health, it's easy to see how they can become the newest target of the obesity epidemic.

People have to start taking care of themselves. They must start becoming proactive towards their health. They need to start asking doctors for advice on how to loose that extra weight they have.

may said...

PLEASE. it's like blaming the nurses for lung cancer caused by smoking, because smoking cessation teaching was not given. truth is, most of the times, the teaching is given, but it goes out of the other ear.

a lot of things are said, not all of it are followed. in my opinion, you don't need a study to prove that. we all have our choices, it is irresponsible to blame somebody else for the unhealthy things we consciously CHOOSE to do.

coaster1robert said...

I wouln't worry about it,a doctor job,is to manage a patients health,it up yo the patient to fallow the doctors advice.that's it. and media is so corupt,they should be kicked out of the country.of course alot people problems with weight gain,is Genetics,medications cause weight gain.you know what makes me mad,the press that blames diabetics for their medical problems,when the majority of diabetics are diabetic because of genetics,like me.not to mention the weight gain from actos,and insulin. Robert

Anonymous said...

Dr A, everything gets blamed on the doctor in the end. It's a shame.
People in general cannot be responsible for their own actions. They have to blame someone, so why not the doctor?!

I think it's my doc's fault that the laundry is piling up too! *Sigh* Maybe I should sue him for malpractice. ;)

Hope you're having a great week, doc.

Anonymous said...

Time and stress are big issues for a lot of people. They don't have the time to spend on exercise - or at least they don't think they do. Many people are juggling two jobs to keep a roof over their heads. Commute times are going up. Many people are working extra hours without extra pay. Also, finding healthy food to eat is often difficult.

twilite said...

Hi doc! Kudos. Indeed, the press is a real pain and pseudo in understanding!

I'd been keenly following and interested in this subject for some time. I see a rise in obesity in Asia today.

I reckon one attributing factor is bigger helpings served (with the view to making more money by the food outlets and restaurants) and parents who do not know how to curb one's child from excessive eating? Is this a middle-class ailment?

So...I'm pushing the buck to commercialism and parenting huh? Just as bad and pseudo. Good day.

Empress Bee (of the high sea) said...

dang doc! that's good to know. it's your fault and not mine. i can rest easier now... thanks!

smiles (and giggles), bee

Ami said...

Here's another side of it... many, many doctors fail to really 'see' a patient if that person is overweight. It seems to be an automatic, "You're fat, that's why you're sick or in pain or ____."

It's unimaginable to me that anyone is dumb enough to blame the medical profession for obesity, however.

Barb said...

Well hello good doctor! I was doing a Google search and I found myself here. Long time, no see. :)