Weight Loss News and Current Events - Interesting Article: Doctors refusing to treat overweight patients




fattymcfatty
05-17-2011, 05:58 PM
This might need moved. Wasn't sure where to put it. What do you all think about this one?
http://www.cnsnews.com/news/article/report-doctors-refusing-treat-overweight


nationalparker
05-17-2011, 06:28 PM
Original story link here:
http://www.sun-sentinel.com/health/fl-hk-no-obesity-doc-20110516,0,333407.story
but it stems from the absurdly high numbers of lawsuits after difficult births caused by the patients' obesity.

stacygee
05-17-2011, 06:30 PM
This is very interesting. Although my OB didn't have a problem with me at all. She said she has "fluffy" patients deliver healthy babies ALL the time. Although my top weight was AFTER preganancy. I don't think I was past 240 when pregnant.

I would think it would be frustrating for doctors to treat obese patients. especially when so many of those afflicted with obesity have such a hard time managing weightloss at all. I speak from my own experience. i just couldn't get it together to stick to a plan for so many years.


fattymcfatty
05-17-2011, 06:35 PM
I know that obesity causes complications at times...but, I also wonder how many times a doctor clearly screws up and the patient happens to be obese and his/her obsesity becomes the scapegoat for the docs?

JohnP
05-17-2011, 06:48 PM
I know that obesity causes complications at times...but, I also wonder how many times a doctor clearly screws up and the patient happens to be obese and his/her obsesity becomes the scapegoat for the docs?

I would agree except we're talking about pregnancy here. How much can the doctor really screw things up?

berryblondeboys
05-17-2011, 06:52 PM
I would agree except we're talking about pregnancy here. How much can the doctor really screw things up?

You're kidding right? They mess up A LOT with pregnancy and birth. A LOT.

stacygee
05-17-2011, 06:54 PM
Even with pregnancy the most predominant dangers would be: gestational diabetes and high blood pressure and toxemia. All of these I see in regular weight people too. And your right John... aside from IGNORING SYMPTOMS and letting them go untreated I can't think of what the doctor would be screwing up...

berryblondeboys
05-17-2011, 06:59 PM
I was 220 with my first pregnancy and 255 with my second. Both were using nurse midwives in a hospital. With neither did I use drugs or eipidurals etc - completely natural. Both my babies were huge, healthy and perfect.

Where obese women run into problems is it's harder to get an epidural and there are more chances of C-section complications. And, of course, if you get induced, your chances of needing an epidural go up. If you get induced and/or you get an epidural, your chances of needing a c-section go up. So, what these doctors are probably seeing is taht the obese patients who are having c-sections and epidurals have more complications than skinnier pregnant ladies. But the question is - why are so many c-sections being performed when REALLY only 5% of women need them but at many hospitals nearly half all babies are born via c-section. (And most of these ladies think they 'needed' one - when they didn't. THey just believed their doctors which is mostly bunk, but how can you know? And who would risk their baby's life?) The ethics/principles of OB/Gyn in the USA is frightening.

JohnP
05-17-2011, 07:09 PM
You're kidding right? They mess up A LOT with pregnancy and birth. A LOT.

I agree. What I mean is doctors usually are not the cause of the complication they just deal with them as they arise which obviously was not clear at all. I was responding to a specific point of doctors first screwing up and then blaming the obesity as the problem which I personally don't think is the case.

I believe this is simply just doctors who based on their experience don't want to take any more chances with their livelyhood than they need to.

stacygee
05-17-2011, 07:15 PM
I was about 240 with both of my children. I had an epidural with both and had to be induced for the second (I didn't want to be- but I was two weeks overdue). I think the doctors are doing C-Sections as a control play and b/c it is easier for them.

I was thinking more of complications during gestation as opposed just labor and delivery. I think a lot more mistakes can happen during irregular labor and delivery. But even at my weight the epidural and the inducement were easily done with no complications.

Lovely
05-17-2011, 07:15 PM
It's disheartening to see.

I know I'm overweight, and am actively working on making that not so. However, goodness forbid I have a life while I'm still overweight and maybe get pregnant.

Hopefully it sticks to that small number of private practice doctors in Florida, and doesn't give my doctor's office any ideas.

sacha
05-17-2011, 07:30 PM
Birth: A History by Tina Cassidy.

I recommend that to anyone who thinks that birth in North America is straight forward and that doctors 'fix' complications as they arise.

My son almost died from severe shoulder dystocia brought on by a myriad of unnecessary interventions by OBGYNs. Upon further research into it, I am certainly not alone. The doctors apologized to me after.

And I was 160lbs at delivery and an athlete. For obese women or those with non-immediate life threatening complications (aka just high BMI, or standard gestational diabetes), the odds of unnecessary intervention is even higher.

kaplods
05-17-2011, 09:40 PM
I once read that OB/GYN's, far more than any other type of doctor, face the most malpractice lawsuits. That could mean that OB/GYN's screw up a lot, or that patients just think so, possibly because the potential results of complications are so severe.

sacha
05-18-2011, 04:12 PM
I once read that OB/GYN's, far more than any other type of doctor, face the most malpractice lawsuits. That could mean that OB/GYN's screw up a lot, or that patients just think so, possibly because the potential results of complications are so severe.

Like most things in life, I'm sure it's a bit of both. If the incident results in the death and/or injury to an infant, there is **** to pay and people will not let it go. Often, with other type of malpractice incidents, people are less willing to go into the lengths it really requires to conduct a malpractice lawsuit (that, and the ability to show direct causation is probably likelier). In this sense, I feel OBGYNs will be bigger 'targets' in terms of who will or won't file suit.

On the other hand, OBGYNs are just that, medical doctors who in North America now oversee even the most simple routine labours, something that really doesn't need to be in their jurisdiction. A midwife and doula is perfectly capable of supervising and conducting most deliveries, and have been shown over and over again to use less medical interventions with successful results.

OBGYNs, often reserved only for complicated labours (pre-E, gestational diabetes, transverse breech, multiples) in most countries, are forced to oversee and supervise routine births and IMO, tend to jump the gun and encourage medical interventions to speed things up/make it easier to manage.

With some labours, such as mine (I was 5'5, 160lbs, and in the gym the day I was suddenly induced), it can have disastrous consequences. I simply should have been left alone. But I trusted them, and my boy paid the price for it. She was a good woman, the OBGYN, but things should have been done differently from the start.

PaulaM
05-18-2011, 09:02 PM
I just came over here to post that article and saw you already had. I hope this is not going to start a trend for other specialties too. Boy if I wasn't already encouraged to lose weight this would do it for sure.

eclipse
05-18-2011, 09:21 PM
This is just wrong.

fitness4life
05-19-2011, 11:13 AM
I agree. What I mean is doctors usually are not the cause of the complication they just deal with them as they arise which obviously was not clear at all. I was responding to a specific point of doctors first screwing up and then blaming the obesity as the problem which I personally don't think is the case.

I believe this is simply just doctors who based on their experience don't want to take any more chances with their livelyhood than they need to.

Not to hijack this thread, but I want to give you an example of how my doc single handedly screwed up.

After giving birth to my 3rd child, I would not stop bleeding. It was bad. I was going into shock and I kept throwing up and when I did, blood would spray down to my feet. Sorry if TMI, but I want to put this into perspective.

I needed surgery but since my epidural was still working, all they did was put me in a twighlight sleep. I woke up in surgery. Don't worry, no pain, but I could hear and see. I saw the doc furiously "seaching" for the cause of the bleeding and then he said, "Aha! It's her cervix! I must have niched it when I broke her waters." I got several stiches and recovered fine.

The thing is, when he broke my water (like the 2 times I had needed with my other births) if freaking hurt! I told him that I never felt pain associated with that before and he sluffed me off.

He never told me it was his fault. I never told him I knew. I was fine, my baby healthy and I was a proud mama.

But my Doc did screw up all by himself with nothing to blame.

IsabellaOlivia
06-07-2011, 06:49 PM
Medical lawsuits are really difficult for doctors. If they get it involved in one it usually means their insurance premium goes up to such a level it drastically increases their salaries. And by keeping pasients with healthier weight it means it reduces their chances of getting sued. I think doctors are just human who have student loans to pay, mortages, children to support and they want to try to secure themselves against lawsuits.
I read one case where one doctor after being unlawfully sued had to pay 32 000 a year in insurance!!! So I try to see it from their side, which makes them look less 'evil'. Guys, don't take it as a personal offense that doctors want to secure themselves against lawsuits, if you were a doctor most of your would take the same precaution. I certainly would.

sacal96
06-08-2011, 10:41 PM
Medical lawsuits are really difficult for doctors. If they get it involved in one it usually means their insurance premium goes up to such a level it drastically increases their salaries. And by keeping pasients with healthier weight it means it reduces their chances of getting sued. I think doctors are just human who have student loans to pay, mortages, children to support and they want to try to secure themselves against lawsuits.
I read one case where one doctor after being unlawfully sued had to pay 32 000 a year in insurance!!! So I try to see it from their side, which makes them look less 'evil'. Guys, don't take it as a personal offense that doctors want to secure themselves against lawsuits, if you were a doctor most of your would take the same precaution. I certainly would.

I completely agree with you. People just want to take offense and say physicians are discriminating against fat people, but thats not the case. Like the article said, it may be their equipment has weight limit. And lets be honest... there are many more complications and factors to take into consideration when treating people who are obese. So if a Dr has a weight limit why let it make you mad... Find somewhere else. Why would you want to be treated by someone who isn't comfortable with it when you could find someone who is :]

And yeah you're right about the insane insurance costs.. very much so when its physicians with their own practices instead of being a part of a hospital.. I don't blame them one bit for protecting themselves. Especially when we live in such a sue happy society! haha!

ungluued
06-10-2011, 10:58 PM
As a sonographer in an obstetrics and gynecology office I have to agree and wish I could refuse to scan the very obese patients due to their weight hindering my visualization/diagnosis of their fetus. At times, we are forced to give up after three unsuccessful tries at ruling out congenital defects and they get sent to perinatology. We also have to dance around the reason to the patient because they get very offended if you say it is due to their weight. ( then they transfer out)

Patients do not have a clue how much their weight impacts the quality of their medical care. Obesity interferes with diagnosis as well as the actual execution of care. Just being obese increases your risk of infection after surgery, among other complications.

Many Obstetricians are no longer performing deliveries and doing GYN only because their malpractice insurance is ridiculously high ($ 50,000/ yr) People expect a perfect baby, regardless, and refuse to accept a poor outcome even when the OB performed to standard. The OB is damned if they do and damned if they don't. Everyone complains about the high rate of c/sections, but if a baby dies, or is injured during a vaginal delivery, the OB is sued for not doing a section. Shoulder dystocia is not always a foreseeable complication either. The OB is also stuck with assuming responsibility of midwives who withhold/delay neccessary interventions, because god forbid, your labor and delivery not be "natural". It's basically a Lose/ lose situation.

Eventually, I think we will see a shortage of OB's because it just won't be worth it for them to assume that much responsibility and pay exorbitant malpractice insurance rates.
Sorry, just my two cents.

ungluued
06-10-2011, 11:20 PM
Birth: A History by Tina Cassidy.

I recommend that to anyone who thinks that birth in North America is straight forward and that doctors 'fix' complications as they arise.

My son almost died from severe shoulder dystocia brought on by a myriad of unnecessary interventions by OBGYNs. Upon further research into it, I am certainly not alone. The doctors apologized to me after.

And I was 160lbs at delivery and an athlete. For obese women or those with non-immediate life threatening complications (aka just high BMI, or standard gestational diabetes), the odds of unnecessary intervention is even higher.

Sacha, I am so sorry you and your son had to experience that complication. However, I am wondering why you say interventions brought it on because shoulder dystocia is due to the baby's shoulders being wider than the head, and one gets caught behind the pubic bone after the head is delivered. How is that caused by the doctors actions?

theox
06-11-2011, 05:39 PM
I think this is simply another symptom of the US's corrupted healthcare industry. Like any other industry, it seeks to maximize profits and minimize expenses. Unfortunately, unhealthy and unwell people can be expensive to treat and are more likely to suffer from complications from treatment (more expense). That doctors (like health insurance companies before them) are declining to treat a some of those in need of their services because those people seem more likely to result in a net loss of revenue rather than a net gain shouldn't be surprising. But no, the US totally doesn't need healthcare reform at all....

*steps off soapbox*

sacha
06-12-2011, 11:38 AM
Sacha, I am so sorry you and your son had to experience that complication. However, I am wondering why you say interventions brought it on because shoulder dystocia is due to the baby's shoulders being wider than the head, and one gets caught behind the pubic bone after the head is delivered. How is that caused by the doctors actions?

The doctor explained to me after that a variety of problems contributed. The first OBGYN had broken my waters artificially but actually had not. Then the pitocin was not administered correctly. I explained to them over and over that I was not experiencing contractions but they said I just had a high pain threshold. When the next OBGYN came in 24 hours later, she was shocked and broke my waters again and re-administered the pitocin. There was no epidural until day 3 by then I was in agony.

The epidural had slowed the labour down so badly (my labour was 3 days active) that she believe it had caused him to be in a very poor position for vaginal delivery (he was also a large baby which increased his risk). She stated to me after (I pushed for 4 hours) that it should have been a C-section long before it got to that stage, due to the high risk of SD. The pediatrician later stated that he thought that the baby should have been a C-section.

The difference here may be that I am not in the United States and medical malpractice litigation is not nearly as common. So, my OBGYN (the 2nd one, who delivered him and broke his collarbone) was completely honest to me about what happened and she said they made mistakes. I can imagine that sort of honesty would not have come from an American doctor out of fear of slander and medical malpractice. As was said, damned if they do and damned if they don't. They're not God.

Don't get me wrong, I am very happy for what she did as she did save his life in the end, but it's an example of how when it rains, it pours, and too much medical intervention can contribute to problems. I admit, his labour was a fluke.

I myself work in emergency services so I am 100% understanding that these things do happen, that occasionally good professional people make mistakes, I've done it myself.

ungluued
06-12-2011, 05:02 PM
@ Sacha,

That makes a lot of sense now. I can tell you that in my office when we estimate a ten pounder by ultrasound a c/section is recommended /planned for delivery. Anything around nine plus would be consideration for c/section or early induction delivery depending on history of the patient. Here in the US, you need to be delivered within 24 hrs (usually) of ruptured membranes, and the limit for pushing is about two hours.

I also am confused about the contractions, did they not have the tocometer on you? Because the contractions and the frequency show up on the strip as well as the fetal heart rate to look for fetal decels/ distress so they would have known you were in fact not contracting from inadequate pitocin. ( BTW, pitocin is the devil, isn't it?) I had a failed induction with c/section, yuck.
Again, so sorry for that experience.

sacha
06-12-2011, 08:17 PM
Thanks ungluued! Mine was over 9lb 3oz and my waters had started leaking 4 days before my induction (which I put down to my own ignorance thinking I had peed, I was also GBS+). Yes they had a monitor and said that I was having contractions but I really, really don't think I was (there was no pain. at all. nothing. It went like that for over 12 hours before the other doctor came in and said something wasn't right). From my waters 1st leaking to his birth, was just over 6 days, a mess!

Overall they call it a clusterf*** (lol) I guess!!!

deetermined2
06-15-2011, 09:20 PM
My sister's OB-GYN told her that malpractice insurance was $500,000 per year, even though the doctor had never been sued. (that number is 7 years old with insurance premiums increasing all the time)

If the premiums are that high without incidents, I can't imagine what they're like if a doctor has been sued.

No wonder some of them are trying to minimize their risk.

shishkeberry
06-18-2011, 10:12 PM
That's ok, I wouldn't ever have an ob ever again if I have another child, regardless of my weight. I will never give birth in a hospital ever again. F that. If I ever go nuts and decide I want another baby, it,s unassissted for me.