Admittedly I have almost no experience when it comes to OB/GYNs. Unfortunately that will not stop me from commenting on a piece in Slate that criticizes OB/GYN practices in Florida for establishing 200 pound weight limits for their patients.
When I first read the headline, I was a little shocked. I thought, “Are these doctors turning these women away based upon their physical appearance? And do these doctors care that much about their patients’ physical appearance?”
But then I read the paragraph explaining the rationale for the weight restrictions, which included author Anna Resiman’s counterarguments:
Some of the doctors interviewed in the article opted not to care for obese women because of inadequate equipment. That’s pathetic: As I’ve said here before, they should buy larger exam tables, longer speculums, and bigger blood pressure cuffs, and do their best. Another reason for the ban, according to one of the office managers: The doctors weren’t “experts in obesity” and didn’t want to have to send patients to specialists if problems occurred. My take: Doctors should be adept at caring for patients of all sizes. Gynecologists don’t only do pelvic exams; a big part of their job is counseling. There’s no reason any should shy away from counseling overweight women, whether that entails diet and exercise recommendations or referrals to dieticians and bariatric surgeons. One of the doctors rationalized his decision as a way to decrease potential surgical complications and lawsuits; while this might make his work easier, what if all doctors in this part of Florida followed suit?
Let’s look at Reisman’s counter-arguments in order.
1. Doctors claim that they lack the equipment to deal with women over 200 pounds.
Reisman’s response: “…they should buy larger exam tables, longer speculums, and bigger blood pressure cuffs, and do their best.”
Really? Are doctors expected to purchase enough equipment to handle every patient who could potentially walk in the door? Does Reisman think that these doctors have piles on money in their closets, ready to be spent on whatever piece of equipment they need, regardless of the fiscal sensibility of purchasing the equipment?
Isn’t a doctor permitted to determine how often he or she might use a piece of equipment and then determine if the purchase is cost-effective? They are running a business, and it would seem to me that “they should just buy more stuff” implies that business decisions should play no role in medicine.
Perhaps in an ideal world, but rather naive in this one, I think.
2. The doctors weren’t “experts in obesity” and didn’t want to have to send patients to specialists if problems occurred.
Reisman’s response: “Doctors should be adept at caring for patients of all sizes.”
Really? Is medicine truly a one-size-fits-all model?
Is it unreasonable for a doctor to admit to not knowing everything?
Is it unreasonable to think that the needs of a 200 pound woman could be vastly different than the needs of 130 pound woman? Do we really want to tell doctors that they should know everything about their potential patients, regardless of their physical attributes, and not rely on experts in the field who specialize on particular patient attributes?
As a teacher, should I be expected to teach kindergarteners and high school seniors with the same level of skill? Like doctors, should teachers also be adept at teaching students of all sizes? If not, why?
As a writer, should I be expected to be able to write a textbook and a technical manual with the same skill as I write a novel? If I can write 120,000 words of fiction at a time, should I also be able to write a 5,000 word car manual?
The idea that a doctor should simply be able to treat all patients regardless of their physical differences is absurd.
There’s no reason any should shy away from counseling overweight women, whether that entails diet and exercise recommendations or referrals to dietitians and bariatric surgeons.
Sure there is. What if a doctor is not skilled or adept at counseling overweight women on diet and exercise? Do we really expect the doctor who specializes in obstetrics and gynecology to also be an expert on nutrition, exercise, weigh management, and more? If so, why do we have doctors who specialize in these fields already? Must we force doctors to become experts in multiple disciplines in order to cater to every possible patient who walks in the door?
3. One of the doctors rationalized his decision as a way to decrease potential surgical complications and lawsuits.
Reisman’s response: “…what if all doctors in this part of Florida followed suit?
Three points here:
First, did Reisman really just cite one doctor as an indicator of the industry’s rationale?
Second, if the decision to set a weight limit on patients does in fact reduce surgical complications and lawsuits, can we fault a doctor for making a valid business decision in order to remain profitable?
And doesn’t the increase of surgical complications for some doctors imply the need for expertise in this field?
Do 200 pound women want to be treated by an OB/GYN who experiences higher rates of surgical complications?
But it’s the last part of the sentence that contains the great degree of stupidity:
“…what if all doctors in this part of Florida followed suit?”
Ah, yes. The doomsday scenario. Always the sign of a rhetorical mastermind.
Does anyone believe in a free market economy that there won’t be doctors willing to treat the exploding population of obese patients in our country?
Does Reisman expect the reader to foresee a day when it will be impossible for a obese women to find an OB/GYN willing to treat her?
Or is it more reasonable to foresee a day in which some doctors are perfectly willing and appropriately skilled at dealing with the unique needs of an obese woman and some are not?