Last August, a primary care physician made headlines because he refused to treat a woman because he said she weighed too much. Several months before OB-Gyn physicians in another state made similar headlines. In fact, in a survey conducted by a local newspaper, 15% of the area OB-Gyn physicians had set weight limits for taking new patients. Many were setting the cutoff at 200 pounds. The reasons for this were cited as the risk for complications that are concurrent with obesity and with that the risk of being involved in litigation.
The prediction is that approximately 42% of the United States population will be obese by 2030. Some predictions are higher. Who will treat these patients? Are we stigmatizing the patient who is over weight? Is a cutoff at 200 pounds fair to the patient? Is this punishing the patient?
Some facilities have undertaken to make accommodations for the obese patient with special wheelchairs, plus-sized doors, oversized beds, oversized lobby chairs, and reinforced floors. But this is expensive. New table limits for CT and MRI scanners with increased gantry size have been designed for radiology to image these patients. The distance has been increased between the fluoro towers and the table to allow imaging of larger patients. However, many patients are receiving interpretations of their images that say they are insufficient quality. A large percentage of our emergency rooms are not equipped to handle patients that reach the 300 pound limits.
It takes experience and careful consideration to image a bariatric patient and be successful. The social question of whether the medical community has the right to decide who is and who isn’t going to receive medical services is quite complicated.
