Fat Doctor Thin Doctor, as a patient do you care?

Can an Obese Doctor Promote Healthy Lifestyle Choices?

A central rationale for this policy is the belief that an obese physician isn't an appropriate role model to teach patients about healthy behaviors, such as good nutrition and exercise.
Readers who agreed with the hospital's decision stated that, in the words of one physician, "It would be dishonest of me to counsel patients if I myself have issues." Another noted, "The reason why the American population is fat and unhealthy is because American physicians are fat and unhealthy. Physicians are supposed to be the role models for healthcare. Who is going to take their physician seriously if he weighs 300 pounds and eats Lays potato chips?" A third argued, "All studies [that have been] done show that people sometimes do as you do. They rarely do as you say."
Proponents of this position also said that obesity is regarded as "normal" in our society and that obese physicians are implicitly condoning -- thus normalizing--obesity.
But other readers vehemently disagreed. "As an overweight nurse, I can honestly tell you that people respond better to me than to thinner nurses when we talk about weight and diet." A healthcare provider, also overweight, said that "being advised by larger nurses or doctors helped me because I felt they truly understood the battle I have with my weight."
Another questioned the alienating message given to obese patients. "Patients often avoid health care out of fear that they'll be judged for poor health habits and this policy would likely only further perpetuate that concern."
Does a trim physician really serve as an inspiration to patients to improve their diet and lose weight? No, said some readers. "Just because I don't drink alcohol or smoke doesn't make my patients quit smoking or drinking. How ridiculous!" said one. Another concurred: "I don't believe that patients look to the healthcare staff as 'role models.'"

Do Patients Choose Doctors Based on Weight?

Doctors who agreed with the hospital's decision suggested that trim, healthy clinicians will be more sought out by patients. Opponents disagreed. "I'm more concerned with the competency and knowledge of those caring for me and my loved ones, rather than physical appearance," said one reader.
Another said, "My own primary care provider is huge and I'm slender. I don't care that she's overweight; that's her business. She's a great doc as far as I'm concerned." One reader summed up this position: "Weight does not matter in the least to patients selecting a healthcare practitioner. Excellence in practice and compassion are much preferred."

 

Is This Discrimination?

In his video, Dr. Caplan noted that the hospital's decision does not technically constitute discrimination, according to Texas law. Quite a few readers agreed. One added, "It is the right of an employer to make any terms he likes."
However, many others regarded it as "discrimination in every possible way." One reader stated, "Discrimination does not solve the problem of obesity." Some felt that would-be employees who were denied employment due to weight had the right to sue the hospital.
One reader noted, "Overweight people are already discriminated against; we just don't discuss it. Yes, it's the hospital's right not to employ overweight people. Fine. But does that make it ethical?"

Should Doctors Be Blamed for Something Not in Their Control?

Numerous contributors noted that obesity can be caused by thyroid disorders, medication side effects, genetic abnormalities, menopausal changes, and metabolic conditions.
But a significant number of contributors regarded medical explanations as mere excuses. One wrote, "Seriously, people, admit you're overweight because you aren't making the best choices...be honest with yourself, get off the couch and exercise, eat better, and do yourself a favor. I'm so sick of people trying to justify being overweight when in reality they're just plain lazy." Another commented, "Fat is ugly and unattractive and the message that's sent out is 'I'm unable to take care of myself, so I cannot take care of you.'"
Opponents of this viewpoint reacted with outrage. "Shame on them for feeding into the old stereotype that overweight people just sit and eat, eat, eat! What about those of us who are overweight from medical issues, like me? Are we to be punished for something beyond our control?" Another stated, "Obesity is a disease, not a moral failure."

Are Obese Healthcare Providers Sicker?

Because obesity is known to contribute to multiple illnesses, some claim that nonobese healthcare providers would be healthier. Several readers attributed their own good health to their trimness, a result of assiduous adherence to a diet and exercise regimen. Others, however, pointed out that "'Thin' does not necessarily equal 'fit' or 'healthy.'"
Another wrote, "I know a lot of anorexics who will have a heart attack long before the weight affects those who are overweight. But I don't hear this hospital saying it won't hire someone too thin." Several readers observed that overweight individuals who exercise regularly may be healthier than thin individuals who are sedentary and eat junk food.
One overweight reader said that she regularly works out and eats healthy foods. "I feel vibrant and healthy because I do have a good lifestyle, overweight BMI or not, and usually have more mental stamina than some of these thin 20-year-olds who act like they're already in burnout mode."
Another reader agreed. "I know a lot of overweight, hard-working caregivers who are very healthy. No high cholesterol, no diabetes, no high blood pressure....On the other side of the coin, I know a lot of young, thin, hard-working caregivers who are already dealing with high blood pressure, high cholesterol, and diabetes."

The Hospital Should Make Some Changes

Some readers urged hospitals to develop policies that promote a healthy lifestyle in their employees. "Obesity is a problem for all Americans, but especially for our healthcare workers. They work long hours, often with nothing to eat but what they can scrounge from the break room or vending machines. Let's band together and get some healthy food into hospital staffers so that they have the opportunity to eat something out of choice and not out of sheer desperation for food! There is a McDonald's in every hospital in which I've worked. Need I say more?"
Several suggested offering programs (such as yoga or Pilates) or facilities (such as a gym) in which providers can exercise, as well as creating reasonable schedules that make exercise feasible.
Many readers were turned off by the absence of compassion in the hospital's stance. One said, "Obesity is a very complicated disorder, not just a failure of will and intention. Why would anyone go to a hospital that judges on appearance rather than knowledge of a disorder? I wonder if their patient care reflects superficiality over knowledge."
Another reader provided a succinct summary of this position: "Personally, I'm glad that I don't work at a hospital with these kinds of values. I want to be judged professionally, based on my knowledge and abilities, not my weight. Good healthcare should be patient-centered, holistic, and nonjudgmental."
One interesting consideration that some readers brought up is that certain specialists (eg, pathologists and radiologists) don't counsel patients about weight loss and fitness. A blanket decision to bar all obese practitioners is unfair to those whose specialties don't involve lifestyle counseling.
Editor's note: Citizens Medical Center has since rescinded its weight-based hiring policy.
To join the discussion and give your opinion, go to Can a Hospital Say, "Only Thin Doctors Can Work Here"?