OB/GYNs Shouldn't Turn Away Obese Women

The XX Factor
What Women Really Think
May 20 2011 2:42 PM

OB/GYNs Shouldn't Turn Away Obese Women

According to South Florida’s Sun Sentinel , 15 of 105 OB/GYN practices in the area have created weight limits for new patients starting at 200 pounds . Overweight women want to lose weight for many reasons, but having to shed pounds to get an appointment with a gynecologist is preposterous. Whether or not these policies are illegal, they smack of discrimination. The American Medical Association states that doctors cannot decline patients based on their race, color, religion, national origin, sexual orientation, gender identity, or "any other basis that would constitute invidious discrimination." Refusing to see obese patients, particularly at a time when one in three Americans are obese, sounds pretty invidious to me. No one should be punished for being overweight-not those with limited access to healthy food options and safe places to exercise, not those with medical conditions that make it hard to lose weight, not those who take medications that trigger weight gain, and not the rest of them, either. If anything, gynecologists (and all doctors) should be welcoming these patients with open arms: It’s an opportunity to make a dent in the obesity epidemic.

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?

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Doctors have the right to superspecialize, in effect turning away certain patient populations. But it doesn’t seem right to be sneaky about it. A doctor who specializes in diseases of the liver has every right to refuse a patient who shows up asking for an evaluation of an ingrown toenail. And Florida gynecologists who chooses to "specialize" in normal-weight women should be expected to call themselves "normal-weight gynecologists". It would be false advertising to do otherwise.

Anna Reisman is a physician in Connecticut. You can follow her on Twitter: @annareisman.

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