There’s been a fairly hot story in the news this week about a Shrewsbury, MA doctor who has publicly stated that she will not treat patients who are over 200 pounds.  Dr. Helen Carter claims that several of her medical staff were injured treating larger patients and that she doesn’t want to see anyone who weighs more.

The story broke after one patient, who had actually come in for her second appointment had been sent home.  Ida Davidson was very surprised when she came in for her follow-up appointment and was told, that she would no longer be accepted as a patient since she weighed over 200 lbs.  Dr. Carter said she did not feel equipped to deal with Ida’s needs.  She stated, “There’s an obesity center over at UMass that is much better staffed and has more resources than I do.”

Now first, let me state for the record, Dr. Carter’s decision is not illegal.  Doctors can choose to take on patients or not take on patients as they see fit.  But is it ethical?  Is her response even logical?  She refuses to provide any detail about the injuries to her staff workers from working with patients over 250 pounds.  And really, it seems the vast majority of medical offices out there routinely handle patients of that size and much larger without any injuries to medical staff.  One might question what these med techs were doing in a traditional doctor’s office to cause such problems.  And to be frank, me thinks the doc doth protest too much.  I’ve talked to a number of med techs who point out that the sort of routine care offered in a typical doctor’s office should not result in injuries to the staff of any kind, if the med techs were properly trained and following reasonable procedures.

While Dr. Carter may state that she is looking after her staff with this decision, I can’t help thinking that there are other motivations at work.  Maybe Dr. Carter just doesn’t like fat people.  Ida Davidson makes it clear that she felt outraged and humiliated about the way the whole thing was handled.  She felt the doctor had engaged neither tact nor compassion, and I quote, “She didn’t care about my health that day.  I think she just cared that I was a liability to her, maybe, and that I was too much work.”

But I also have to wonder if greed plays a part in Dr. Carter’s decision as well.  Increasingly, doctors are seeing financial bonuses from insurance companies and medical groups for keeping their patients within certain metrics.  In many cases, those metrics include BMI.  So I have to wonder, is this decision really about protecting her staff or filling her bank account?  And I also wonder, where will this end?  Will doctors ultimately decide we are too expensive to treat?  Will they stop seeing average-size or larger people at all?  Will they only agree to treat people who they deem healthy and avoid those with expensive problems?

But perhaps most alarming to me is the question of whether or not fat people will be so humiliated and stigmatized by their doctors that they will stop going altogether.  I’m far more frightened about the patients that Dr. Carter has turned away who are not brave enough to talk to CNN.  What about the patients who simply internalize the shame, and don’t go to see the doctor at all any more.  The Rudd Center has done a lot of work in documenting weight bias among medical professionals.  It is real, and it has a profound effect on the health and well being of people of size.  As the Rudd Center points out: people who are the victims of weight bias by medical professionals “are reluctant to seek medical care, cancel or delay medical appointments, and put off important preventative medical services.”

My dear Chicklettes.  I have experienced weight bias from doctors in the past, and I have allowed it to keep me from going to the doctor. I have allowed myself to feel sad and worthless by men and women in white coats.  I have suffered needlessly with medical conditions that would have been far less severe if I had gone to the doctor sooner.  So learn from my mistakes.  Make sure to find a doctor who treats you well.  You deserve to be treated with respect.  You deserve to receive competent, compassionate health care no matter what your size or shape or age or ability.   Please remember you are not a liability.  You are a unique and amazing person.

Love,

The Fat Chick