Sunday, June 10, 2007

Do overweight patients ignore overweight doctors?

I followed the link from #1 Dinosaur's post to an article which suggests that overweight doctors aren't very effective at counseling their overweight patients. #1 Dinosaur disagrees. So do I, but for different reasons.

OK, and some of the same ones, but I really think it boils down to respect. I can see myself having a productive visit with #1 Dinosaur -- or Fat Doctor(no longer blogging, I fear), for that matter. Both admit to being calorically enhanced (as I am). But that's not why I'd listen to them. From reading their blogs, I have concluded that they treat their patients with respect -- even the crazy ones. That is what makes me believe that I could benefit from having either of them as my personal physician.

Not that I'm ready to trade in my slim, athletic internist for anyone just yet. I always feel that she treats me with respect. She's frustrated with me at times -- and deservedly so. She empathizes, though. Her husband is a diabetic who shares many of my issues with managing diet and controlling weight. It helps her to understand me - and I think that I (and patients like me) help her to understand her husband. She is my cheerleader when things are going well and she offers well-considered advice and encouragement when they are not.

I've seen her partners too. One of them (also slim) gave me some of the best diet advice I've ever gotten. He looked at the weight I'd gained over the previous few years and noted that the calories in ONE extra slice of bread per day added up to those pounds. One slice of bread. When I'm actually THINKING about the food that goes into my mouth, it makes me realize just how little I have to change in order to lose weight. It also gives me the incentive to spend that extra couple of minutes at the gym when I go. Bottom line, he respected my intelligence and gave me information that has helped me to focus better on how I eat. There are many other factors involved, but that advice helps.

I'll be replacing my Gyn, though. There are many things I like about her, but her approach to weight management is to tell me that she wants me to lose X pounds and have my HbA1C at a specific number before I go back. It's not there. Oh, the HbA1C is, but not the weight. I don't feel like listening to another patronizing speech, so she gets fired. Dumb, maybe, but I really don 't feel like being patronized by someone 20+ years younger than me who has NEVER had a weight problem. There are other respect issues as well. I'd go into them, but it would turn into a real rant. (like this isn't?). I don't feel that respect from her. I don't feel the empathy that #1 Dinosaur mentions. She's good at what she does, but sometimes that's just not enough.


chris said...

I understand that side of the coin, but being an Exercise Science student (still in school..heh) it doesn't make sense to me why people would choose to listen to a heavier set person over a physically fit and active person; clearly the heavier person hasn't found out how to do it yet (regardless of respect, so pretend both physicians, the obese one and the fit one, are equally empathetic and respectful). I'm currently doing a research project involving this topic and all the studies I've found have indicated that patients are more likely to comply with exercise considerations and regiments if the health care professional communicating with them eludes a health and active lifestyle.

Again, I understand your side, I just think it is critical for health care professionals to remain physically active and take care of their health (I HATE seeing hospital staff smoking). I want to work as an Exercise Physiologist in a Cardiac Rehab setting, particularly in-patient, so this is an important area for me.

Judy said...

Did you actually READ before commenting? My internist, to whom I listen, is slim, active, and physically fit.

The doctor I fired is too, but she patronized me and didn't give any helpful advice.

Oh, and slim, active, physically fit people do not all "have it figured out." Some of them are naturally slim and just don't get it. My internist, on the other hand, understands, treats me with respect, and has actually managed to be helpful.