Monday, March 06, 2006

Fat patients "too much work"

…Writing in the Wall Street Journal (Feb 28), Gautam Naik sez overweight patients’ demand for hip and knee replacements is growing—while the number of docs big-minded enough to take on the cases is shrinking.

…Yes, obviously, larger patients can have more trouble with breathing, going under anesthetic, having fat layers stitched together, etc.

…It takes time for joints to wear free of cartilage and scrape painfully, so many of these patients may also be older.

…But--because of their weight, these patients may need joint replacement more than thinner types.

…What to do, what to do.

…The docs interviewed, many of them, said they told patients to lose weight (hey, drop 50 and we’re in business). Don’t you think that if these patients could lose those amounts, they would have? And it’s even harder to do if you can hardly walk, much less exercise.

…HA knows a woman who has been put off her needed back surgery for years until she lost 35 pounds. She is hurting!

…One doc said if a thousand obese people went and sat on the White House steps maybe this would change. (Watch the turnip truck drive away.)

…Or here’s a better idea. These doctors are trained to take care of people. If they need special guidelines as are being proposed, then get them. Get more practice, too!

…The healthism implicit in this could also go: The attitude that you aren’t healthy, in our opinion, so whatever happens to you, well, whatever, you brought it on yourself. So sad, too bad.

…One doctor specializes in these surgeries. Yes, they take two hours instead of one. Yes, he gets the same reimbursement from the insurance company.

…He looks at the difficulties as a challenge. Not an excuse to send someone limping and grinding out of his office without much-needed care.


Bill Thomasson said...

"Don’t you think that if these patients could lose those amounts, they would have?"

Sometimes it's a matter of motivation. There's no motivation like knowing you now need a hip replacement. But even with motivation, a lot of people need help -- and especially if they were really, really heavy to begin with. So, "Go home and lose weight,"doesn't quite cut it.

Not sure if that's what you were saying.

Star said...

That is exactly what I am saying.
If all this "you're going to die any minute" stuff doesn't make people lose weight for about the 20th time, withholding of medical care and being plunged into pain for the foreseeable future should really work!

Mignon said...

Excellent point. A relative was in so much pain he could barely walk and gained a bunch of weight. Got a hip replacment, and is now skiing every day, and of course is losing the weight.

It's a no-brainer that if you can't move without being in pain, you're going to gain weight. I guess my relative was lucky in finding an "enlightened" doctor.