Thursday, August 25, 2005

The blogosphere responds to Dr. Bennett calling a patient fat

Peevish . . . I'm Just Saying:
"Doctors tell you what you need to hear, whether you want to hear it or not and this woman's in some serious denial if she thinks filing a complaint is going to change her health risks.

It's about as smart as me filing a complaint about my doctor telling me to quit smoking, wouldn't you say? Quitting smoking or not quitting smoking is my personal choice, but it's my doctor's duty to point out the health risks to me."

The CultureGhost:
"He suggested in a professional manner it would be in her best interest to lose some weight. And her feelings got hurt. WTF? This guy does not sound like some malicious surreal Monty Python physician who spends his mornings plotting ways to verbally abuse his patients. And her feelings got hurt. WTF? She files a complaint because a doctor, a man with a medical degree and years of experience, states she might have a health problem. What next, pray tell . . .

. . . Not only have we become a nation of gluttons (recent report estimates 49% of the nation may be overweight), but we're getting dumber by the hour. Perhaps the most galling aspect is how this represents our inability to face the truth. We want to be lied to...often."

The Fifty Minute Hour
:
"Ultimately, I don't think this doctor committed an ethics breach in need of remedy by the medical board. But I find it a little disturbing that he is unwilling to admit he made a mistake. Even if he believes that the medical evidence supports a conclusion that obesity is dangerous ceteris paribus, he offered his patient no actual medical assistance in reducing that danger. Instead, he made her angry and upset, and therefore (the anecdote from his other patient notwithstanding) less likely to follow any other important advice he needs to give her. The doctor's actions weren't unethical, they were just unhelpful. It would be great if other doctors could learn from this story what their patient's reactions to statements like these are likely to be so that they can phrase their advice in ways that are more likely to succeed in getting patients to take better care of themselves. Because no matter what the reason might be, 'you're fat, go on a diet,' is not likely to help matters."

Sugar Shock! Blog:
"What's the matter with this kind of honesty? Every single bit of it is absolutely true! In fact, if anything, Dr. Bennett wasn't painting a scary enough portrait of what could ensue as a result of being obese! Being obese could lead to so many kinds of health complications and even an early death.

Well, apparently this particular fat lady -- who saw the doctor five or six times -- just couldn't handle her doctor's honest approach. It seems that she'd rather get her physician in trouble than take responsibility for her own actions and join a support group or quit quickie carbs, etc."

Far Right Wing:
"When a fat woman can endanger a doctor’s license for doing his JOB by telling her his best advice on her health, that’s when we as a society has lost it. The liberal people who want to put everyone in some kind of sensitivity training like this fat woman in New Hampshire is what is wrong with America. They are filing compliant against a professional for his professional opinion because the professional’s advice isn’t sensitive. People don’t go to a mechanic, a stockbroker or a doctor for their emotionally sensitive advice."

Medpundit:
"When did rudeness become a matter for attorneys general? And judging from this version of events, he is routinely rude to obese women. His goal, no doubt, is to get their attention, but it's probably better to confine comments to medical risks and not to venture into romantic risks. Still not a matter worthy of an attorney general, though, or of a medical board for that matter."

Captain's Quarters:
"Bennett did apologize to the patient in writing for offending her, but he points out that mild, politically-correct language offers too many excuses for people to disregard the medical advice. His bedside manner may be a bit too blunt for some patients, but that gets addressed by the market and shouldn't cause the medical board to reprimand him for his honesty. Getting the New Hampshire Attorney General involved is far more ominous, and far more ridiculous."

DB's Medical Rants:
"Saw the physicians (sic) interviewed on TV today. He is obviously intelligent and well spoken. He described his 1 year of fighting this battle as a Big Brother scenario, and then as Kafkaesque.

I like the Kafka concept. He was “reported” for telling a patient the truth. If we cannot tell patients that they are obese - and that they should do something about it - then can we tell patients to stop smoking, or stop drinking - or what about crack cocaine?

This story continues to confuse me. I really cannot believe that it is a story. What is the board of medicine thinking? Who called the attorney general - and why did he not just laugh it off?"


Comments:
If the doctor had simply told the woman that she was fat and outlined the medical hazards. However, he crossed a line. From the accounts that I've heard, he told her that if her husband died, nobody else would want her (and that's just his account of the coversation). There is no medical justification for being cruel.
 
I also posted about this:
http://www.healthyconcerns.com/2005/08/how_much_advice.html

Conclusion:
"Advising someone on their romantic chances? Or as one of Kevin's commenters suggests: their employment chances? Not a doctor's job. No way.

Still and all, would I sue about it? Also, no way. I'd just find another doctor."
 
"Advising someone on their romantic chances? Or as one of Kevin's commenters suggests: their employment chances? Not a doctor's job. No way."

Oh really? It has been my daily experience in practice that patients want me to decide when and if they can return to work based on my knowledge of their diagnosis and course of treatment. They want notes to their employers all the time. I also get asked to determine whether patients are too disabled to work and whether they are fit to drive. If I am expected to know whether their medical status renders them fit for work, that usually means employment, too. Not only am I asked to make these determinations, I am sometimes required to decide these things. So you are just plain flat wrong, there. And I work as a specialist; generalists are called on to make there decisions even more frequently.

From the story--and not your synopsis of the story--the doctor was telling the patient of the results of a study of widowed obese women, not merely opining about her prospects off the top of his head. Not that it mattered to his obese patient, she wasn't hearing of it either way, apparently.
 
Well, the "employment chances" part of my post was in reference to a commenter who said doctors should tell fat people that they'll have a hard time getting jobs, not because of fitness, but because of the "they will find you disgusting" argument that the doctor in question so charmingly used about the patient's romantic chances.

So your point is completely valid, but not really about what about I was specifically pointing to. You couldn't tell that from my excerpt though, of course.

I still just don't buy that the existence of some study that shows the majority of men prefer a non-obese woman is grounds for what he admits he told her. Sorry. I haven't read anything that says it was a medical study about obese women, but rather was a study of men's attitudes toward them.

But I reiterate: I do not think this is a matter for the Board or for the courts. If she didn't like his way of trying to motivate her, she should have just changed doctors and moved on.
 
"Conclusion:
"Advising someone on their romantic chances? Or as one of Kevin's commenters suggests: their employment chances? Not a doctor's job. No way.'

Also from the story, the obese patient had ignored his advice for an extended period, to the extent that she became hypertensive, developed diabetes and gastroesophageal reflux. No doubt she expected his interest and help in treating these problems. Now one might wonder why at this point an obese person who has developed these serious problems as a result of their obesity would not be motivated do more to help herself. Most doctors do. She apparently had little interest in applying the necessary discipline to her behavior to lose weight.
So according to the story, he warned her of the social consequences of a life of obesity, based on a study.

Someone coming to a professional for evaluation of their medical problems and advice about appropriate action to take, and getting told of the likely consequences of not taking action, sounds like a doctor's job to me. I'm guessing you aren't a doctor, though.
 
And, yes, obese people do have a harder time getting jobs. But that information is only from surveys of employers, not a medical journal. And unemployment, for those who would not wish to be unemployed is a significant stressor that worsens both the physical and psychological health of those
in that status. Should unemployment of a patient be a concern of a doctor? And by extension, should a reversible condition that might significantly impair a patient's employability be a concern to a doctor? I think it is. But what do I know, I'm just a doctor.
 
Almost every excerpt from med blogs listed insists that the woman complained about being told she was obese and needed to adopt a healthier lifestyle.

That isn't what the complaint was about, though it frames the complaint. Somehow the weight angle has been spun hard as "he just told the truth" and become the story.

This is not why the doctor was asked by the board to rethink his methods and take a sensitivity training class.

Taking into account ONLY his admitted version of events, In the light most favorable to the doctor he crossed the line of professional propriety. He saves this lecture for all his fat *female* patients - he offered, unsolicited, the prognostication that this womans husband would pre-decease her, and that she would be unlikely to find a new mate because her fat makes her undesirable to men.

He says he tells all female fat patients that men won't like them, and that's what he told her.

Do you not see that it is completely presumptuous of him to (leaving aside the issue of the tactless prediction od her mates death...which may or may not come to pass, and may or may not come before this woman's) assume this specific female WISHES to remarry, or that he has any idea of who in her circle might care for her and find her desireable?

Let me just give stern lecture of my own.
Physician, keep your opinions of my marriageability, sexual desireability or employability to yourself unless that opinion has been solicited. Those matters are not generally of your concern.

I have a right to be treated as an individual, not a statistic who statistically won't be "happy" - all I am paying you for is to get your opinion of my health and what I can do to improve it, keep it, restore it.
I have a right to called by my surname, I have a right to be treated truthfully AND with dignity, not haranged, bulllied or berated. The facts will do.

Questions about my personal life are appropriate when you are trying to diagnose/treat me or understand my habits directly affecting my health.

Your unsolicited opinion about when my loved ones will statitically speaking, kick off, are unwelcome and unprofessional, as is your opinion of whether your patients are hot or not.

"Your weight problem is serious, and one of/the chief reason for your GERD" is appropriate. "Men will find you unappealing" is NOT.

Not only was this doctor rude and inappropriate, he gave very little and rather poor advice (according to his own account) about what she might do to solve the situation for all its dire urgency and need for him to break out the "attention getting" fat shick lecture he claims to use.

He seems not to consider that somethimes women put on weight to AVOID the sexual attention of men.

Women patients are not little girls to be scolded for not looking lovely.
 
I like Applebees. But I don't like the local Applebees because of bad service I've gotten there several times. So I go to another Applebees. I didn't try to contact the Attorney General's office. Some people just have to much time on their hands.
 
The board is there to ensure doctors conform to standards of medical competence and professionalism that generally do not apply to Applebees fry-cooks and waitresses.

I've never gotten a demeaning harangue from a waitress, but I guess if I did I would report her.

I'm pretty discouraged that the folks who should be first in line to insist on profesinalism and a high code of conduct, that patients be treated as individuals with worth and dignity, are rising to defend their right to abuse patients without consequence.
 
The board is there to ensure doctors conform to standards of medical competence and professionalism that generally do not apply to Applebees fry-cooks and waitresses.

I've never gotten a demeaning harangue from a waitress, but I guess if I did I would report her.

I'm pretty discouraged that the folks who should be first in line to insist on profesinalism and a high code of conduct, that patients be treated as individuals with worth and dignity, are rising to defend their right to abuse patients without consequence.
 
The board is there to ensure doctors conform to standards of medical competence and professionalism that generally do not apply to Applebees fry-cooks and waitresses.

I've never gotten a demeaning harangue from a waitress, but I guess if I did I would report her.

I'm pretty discouraged that the folks who should be first in line to insist on professionalism and a high code of conduct for the practice of medicine, that patients be treated as individuals with worth and dignity, are rising to defend their right to abuse patients without oversight or consequence from the regulators of the profession.
 
"I'm pretty discouraged that the folks who should be first in line to insist on professionalism and a high code of conduct for the practice of medicine, that patients be treated as individuals with worth and dignity, are rising to defend their right to abuse patients without oversight or consequence from the regulators of the profession."

Did you ever hear the term "pick your battles"? I am an ER doc, 75% of the patients I see do not have doctors, do not have health insurance, can only get care when they are critically ill. They often wait 10 hours to be seen. This is what's left of U.S. Health care. But the legal sharks and the PC police are still out there, trying to pick up any remaining scraps they can get their rocks off on. Why don't you guys go after another profession for awhile, like Cops or firefighters? They're important too.

I get threatened with lawsuits every day, often get threatened with bodily harm. Is that called "being treated with professionalism and dignity?"
 
So, Doctor Anon, since some of your emergency patients are mean to you, no patient has a right to expect or demand decent treatment? Or, perhaps, no patient except one who is thin, well-insured and doesn't wait until he's messily sick to see a doctor. Everybody else can just take whatever they get and be grateful, dammit!

And, yes, I am a fat chick. One who, as a suicidally depressed young woman of 22, was told by a male nurse in a psychiatric hospital that I was "beautiful" but, because I was fat, I was neither "attractive" nor "sexy."

Does that seem appropriate? I'm sure the nurse would have said he was just telling me the truth.

That said, I think filing a formal complaint is idiotic. She should've changed doctors or just dealt with it herself. Geeze, lady, grow up.
 
You Took my comments completely out of context. I mentioned that 75% of my patients are uninsured to highlight how f'ed up and desperate most people are in seeking health care. I do the best I can in treating them. They have REAL reasons to complain. I feel like I work in a battlefield and this woman is filing complaints about how her "private physician" talks to her.
 
Louis, MD
I am an endocrinologist and I am obese, have diabetes, hypertension and dyslipidemia. I still have to tell my patients to lose weight, I tell them what they should do at the same time that I tell them I probably don't have the moral authority to ask them to diet. Most enjoy what I say and actualy appreciate the fact that I have the same proble. People tell me I know more because of it. From experience obese people need a reason to diet beyond health reasons. So, I try to motivate my patients the same way I try to motivate myself. If you lose weight you will feel better and look better. It´s a fact. Who are we trying to kid. Patients have told me they are upset that since they have lost weight they are being asked out on dates. I know it is upsetting, they are the same person, but lets face it, most women don't feel atracted to obese men and viceversa. This is a fact of life. Being slimmer at least will "open the door" for people to know you better, know who you really are. First impressions are important Ugly, slim men have better luck at love than obese men. This is a fact of life. If the doctor in question tried to motivate his patient on these terms, he did it because he cared. If you don't care you don't say anything. Let her be fat and die, die lonely, what do I care, understood? This doctor doesn't have a prejudice against fat people... he CARES. Now we have the president of some obese advocacy group saying that this doctor is doing a disservice to overweight people making them feel bad and that obesity is ok (I think she even said that ..if it was not for the stress people have to live with because of the discrimination they have to endure, they will live as much as normal weight people). This is not true. Obesity kills (just tell me how many obese 80 year olds you've seen arround). This I'm obese, so what attitude is going to backfire and hurt inocent people that may get the wrong impression and believe it´s ok to be obese. I am obese, most everyone in my family is but making it ok to be fat is not ok. Now because of this woman reporting her doctor to the medical board, more doctors are going to stop counseling their patients for the fear of "offending" someone and getting sued. Why is this doctor not apologizing.. because he has nothing to apologize specially to this hurtful person that did not care to report her doctor to the board of medicine after he was just trying to help by motivating her the best way he could. If he apologizes, she'll sue. There has to be a hungry lawyer salivating over this right now. I know I will be more careful after this, actually I am so seriously concerned I will just tell people they have to lose weight for their health, hand them a diet (insurances don't pay for dietary evals. for obesity) and thats it. If they lose wight ok if they don't, ok, its not my problem. Why should I care to go the extra mile counseling when I may just be putting my livelihood and that of my family on the line. Doctors are growing more callous because of these patients and then we complain that the doctor is not caring, "I'm in and out, no human touch". Are you crazy, you touch someone and you get sued. That's how it will have to be. You have a headache, ok, it's not a tumor so take an aspirin and don't bother me, forget about me trying to help you figure out what may be the cause or a contributing factor, someone may report me for asking personal stuff, private stuff. For Gods sake this is not the mailman asking you if you are having marital problems or problems with your boss, kids, whatever. It feels bad being a caring physician and seeing a colleague being bashed for just doing what he thought war right. Wasn't he. Why don't we pass some law saying it's ok to be fat and forget about paying the billions of dollars spent every year in the treatment of obesity related diseases.
 
Here's what I say about Dr. Bennett and the First Amendment:

http://christopher-king.blogspot.com/2005/10/youre-so-obese-only-black-men-will.html

Let's get a grip, here folks. Dr. Terry Bennett's comments, in lilly-white New Hampshire, are not the same as a doctor telling a skinny black woman, "you're so skinny only white boys will like you," and if you can't see that, or comprehend why it's different in a context like this, you may be cursed with another physical ailment beyond the Good Doctor's bailiwick: Myopia.

Having dated leggy blondes to short brunettes and women of many body compositions between 4'10" to 6'2" and in between, I appreciate all sorts of women. But apparently some white professionals in the "Live Free or Die" state don't appreciate black men appreciating white women in that way because he used it as a scare tactic. Well that's pretty scary to me, folks, so I'm gonna file a complaint with the Seacoast Branch of the NAACP later today. Peace.

PS: His speech is not entirely protected by the First Amendment, as mine was and is in Jaffrey, New Hampshire. He relinquished a degree of his First Amendment Rights by agreeing to be subject to a regulatory board -- and he may even be governed by commercial, rather than general, Free Speech doctrines. I, on the other hand, was exercising a Fundamental right as a free negro (or caucasian) citizen to seek redress for a man who faced three (3) drawn guns, arrest and a body cavity search from undercover police who rousted him and eventually charged him with "loitering," which he beat. See my 16 Oct. blawg, "Open Complaint to NAACP Legal Defense Fund," which still has not been answered substantively.
-c
 
One of the things I think that doctor's forget is that they are dealing with people,not statistics.I know that doctors see numerous patients in one day and all they might see are body parts, but I think they overlook the fact that it is not an easy thing to be completely naked with someone between your legs, grabbing your breasts or any other part like you're an inanimate object. Women who have been raped, have fought eating disorders, suffer body image problems or depression find it difficult to simply drop their drawers for a complete stranger and have that stranger pass judgement on their body. I say "pass judgement" because there's a difference between making commentary on someone's attractiveness or self worth and telling someone that healthwise it's in their best interest to lose weight.Doctor's should not lie or sugarcoat things for their patients, but this guy was a malicious asshole who obviously felt that he could get away with saying these things to her. Would he have pulled that shit with a man?
 
I agree with the poster that said" He wouldn't have pulled that shit with a man" Just what kind of ducker is he?
 
Good doctors are getting hard to come by.If you have one you'd better hang on to him for dear life,the pickings are slim out there!!
 
He should have conducted himself into a more professional approach,that was totally uncalled for,How would he have liked it if I were to tell him,well your ugly and I can lose weight.There is no cure for uglyness.Uglyness comes straight from the bones.And goes directly into the heart.Take a course on "How to treat your patients"They are available.They just cost money.I'm sure you can afford it though.
 
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