June 7th, 2011 by Lucy Hornstein, M.D. in True Stories
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Say you’re a bariatric surgeon. You’d think Americans would be beating a path to your door. After all, this is the land of Instant Gratification! Who wants to just eat less for the better part of a year to lose 50 lbs when one can be cut open and have one’s gastrointestinal anatomy rearranged — resulting in the necessity of eating less, but why quibble — to lose that same 50 lbs (or more)? Changing lifestyles is boring; surgery is exciting!
Funny how it turns out that in order for the surgery to succeed long-term, patients have to commit to lifestyle changes anyway. In fact, before any reputable bariatric surgeon will operate, patients have to demonstrate their dietary commitment by actually losing some weight on their own, prior to surgery. What I don’t understand is why people then go ahead with the damn surgery anyway? Logically, it’s almost like you have to prove you don’t need it before you can have it. Hey, I’ve never said I understand people.
Perhaps overcoming this paradox is the explanation for the behavior of a certain bariatric surgeon, brought to my attention by a mutual patient. Read more »
*This blog post was originally published at Musings of a Dinosaur*
May 31st, 2011 by Linda Burke-Galloway, M.D. in Opinion
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How does one teach compassion? Either you have it or you don’t. A recent article in the Los Angeles Times made me cringe. In South Florida, fifteen ob-gyn practices out of 105 polled said that would not take care of a pregnant woman who weighed more than 200 to 250 pounds. The article goes on to describe two ob-gyn business partners who cited malpractice issues and fear of being sued as a reason for excluding obese women in their practice. So, what’s next? Will pregnant women be denied access to care based on bank accounts or zip codes? Where their children attend school? Whether they own a pet? Where do we draw the proverbial line?
One of my most frustrated moments in clinical practice was dealing with an imaging center who had cancelled my patient’s ultrasound procedure because they were “afraid she was going to break their table.” The patient was excited about her first pregnancy and wanted to do everything in her power to have a healthy baby. The first time I met her, she was almost apologetic about her weight. Most obese patients are. My staff had to locate an imaging center that was not only willing to accept the patient but her Medicaid insurance as well. No one should not have to endure that level of humiliation.
Whether we like it or not, Americans are obese and as physicians, we have done very little to reverse that process. I learned more about nutrition from Weight Watchers® then I did in medical school. Read more »
*This blog post was originally published at Dr. Linda Burke-Galloway*
