Time for a Change in the Medical Care of Patients with Obesity
The CDC has determined that obesity represents a public health crisis. According to CDC data complied from 2015-2016, approximately 93.3 million adults are obese. This represents almost 40% of the adult population in the United States during that time frame.
Individuals who struggle with obesity comprise a significant patient population. These patients seek treatment and medical procedures in the attempt to reduce their weight and live healthy lives, but the approach taken by some medical professionals actually can prevent them from getting the care they need.
In Jared Bilski’s article titled “Caring for Patients with High BMIs,” published in Outpatient Surgery, Mandy Pate, an RN and CBN, recounts her experience as a patient rather than a caregiver, which led her to advocate for a more responsive approach to patients with high BMIs. In her eyes, “It is time to change the outdated mindset and protocols in order to provide safe and satisfying care for this growing patient population.”
A Difficult Patient Population
Many hospitals will not perform procedures on patients whose BMI is greater than 25 (a BMI over 30 is considered obese by the CDC). This approach may be over-simplified and can deprive patients who most need care.
Dr. Ashish S. Sinha, professor and vice chairman of the anesthesiology department at Temple University Lewis Katz School of Medicine, believes that surgeons must consider other factors before deciding if outpatient surgery is in a patient’s best interest. This is much more in line with the approach we at The Eisen Law Firm prefer. A case-by-case approach allows surgeon and patient together to consider the patient’s individual risks, including but not limited to obesity, along with the potential benefits of a procedure.
Obesity predisposes patients to other diseases such as diabetes, hypertension, and sleep apnea. Therefore, these issues must be considered and addressed by health care providers. We at The Eisen Law Firm believe that it is precisely because of these increased comorbidities that doctors must tailor their approach when it comes to recommending or performing outpatient surgery for obese patients. We recommend thorough communication between patients and their health care team, in order to assess risk and determine the best approach to treatment.
Sensitive and Considerate Care Should be the Standard For All Patients
Patients who do have surgery deserve appropriate treatment by health care professionals. Unfortunately, caregivers often make inaccurate assumptions about patients with obesity that can interfere with the success of a proposed surgery or recovery from that surgery. As an example, Pate shared that her nurses would not let her get up to go to the bathroom after her surgery, even though post-surgical movement is recommended, and she was not restricted by doctor’s orders from doing so. The nurses simply assumed that she could not get up or did not want to put in the effort needed to assist a larger woman.
What causes health care providers to treat patients with obesity differently? Put simply, bias. As Ms. Pate reflects in the article, “’I think for a lot of people, even some within the medical community, obesity is seen as a character flaw.’” At The Eisen Law Firm, we have seen such biases crop up in many jury focus groups. Mock jurors (and real jurors, too) often harbor unintended biases against obese patients. We hear comments from time to time about why someone injured by negligence “really let herself go” or just needs some “willpower,” even when obesity is not related to the negligence. That’s why we very carefully question jurors during voir dire about such biases when we represent high-BMI patients, because even when obesity isn’t an issue in a medical negligence case, it can be an issue in the jury room.
A lifetime of being judged leads many patients with obesity to suffer from fear and anxiety, especially in a medical setting. It is imperative for health care providers to not only be aware of the emotional challenges these patients have, but also to act with sensitivity and respect. Even changing the terminology, which is considered outdated, from “obese patient” to “patient with obesity” better represents the idea that obesity is a disease, not a lifestyle choice.
Making a concerted effort to put patients with obesity at ease physically is also an important feature of compassionate care. Making patients feel more comfortable in a medical setting includes accommodating their physical needs with oversized furniture, gowns, blood pressure cuffs, and exam tables. When physicians know they will be seeing a patient with obesity, compassionate care includes having oversized items out and ready for use, so that the patient doesn’t have to first try a gown or table that clearly is not going to work.
Guidelines for Clinical Care
Since patients with obesity have an increased incidence of various medical challenges, health care professionals need to identify those challenges and be prepared to manage them to the best of their ability. There are known, practical solutions for many areas of concern that can improve the experience and the outcome for patients with obesity:
A Big Step Forward in Patient Safety
One successful example of this approach comes from Einstein Medical Center in East Norton, PA. They use a simple identification method – a different colored bouffant cap for surgery – to alert health care professionals to the increased risk these patients have of pressure injuries. Since adopting this practice, the medical center has not had an incident of skin-related harm in two years.
Relatively simple to implement, these kinds of solutions have the potential to make a big difference. It is clear that with a little communication and some common sense, there are ways to be prepared and to provide appropriate care to this special population. Patients with obesity need not be vulnerable to any additional risk of preventable harm.
Mistakes happen in the operating room and in postoperative care. They happen to people with obesity and to people without obesity. If you or someone close to you has been injured because of a medical mistake in the perioperative period (before, during, or immediately after surgery), The Eisen Law Firm can help. Call our experienced Cleveland malpractice lawyers to discuss your options for legal recourse and for obtaining the compensation you deserve. To schedule your free consultation, call 216-287-0900 or contact us online today.