Mass. Doctor Won't Accept New Patients Who Are Obese

I couldn't really believe the headline in Everyday Health when I read it this morning:

Doctor Turns Away Obese Patients
A Massachusetts doctor says she won't treat patients over 200 pounds because they put her staff at high risk for personal injury.

So I called Dr. Helen Carter to ask whether it was true.

Yes, she said, her office has instituted a new policy: no new obese patients who weigh over 200 pounds. "I had no other choice," she said. "It's self-preservation."

The Worcester-based internist, who has been practicing medicine for 20 years, says she's not discriminating against fat people, rather the policy is more related to safety. In the spring, Carter said, a physician in the practice got a serious neck injury while pulling out the exam-table foot rest for a 284-pound patient. The injury remains painful, she said, and now prevents the doctor from performing pap smears because she can't bend fully. A new electric exam table costs between $4,000 and $7,000, Carter said, which is at the moment prohibitively expensive.

Carter says she hasn't dismissed current patients in her practice who are obese. Indeed, she says, the new policy has been a motivating force for them to lose weight. "It gives them a goal," she says, adding: "The problem with obesity is it has become socially acceptable," with nearly one-third of Americans now categorized as obese and those numbers rising. (Not to mention the cost of overweight and obesity which was recently reported to be nearly $300 million annually).

As far as the new policy, Carter offered this comparison:

She doesn't treat people with addiction, she said, because she's not an addiction medicine specialist. Similarly, she's decided that obese patients in the region would be better served at a facility like the weight loss center at UMass Memorial with a full range of tailored interventions, including psychotherapy, nutrition and exercise counseling and surgical options.

Carter says she has focused on the long-term implications of obesity for several years. She says she gives her patients "a whole long list" of the health risks related to carrying around so much extra weight — from heart disease to diabetes and stroke. But even though they're at higher risk, Carter says they are not necessarily experiencing all of the downside of obesity yet and may not feel any urgency to lose weight. "It's an insidious condition," Carter says. "But in the end, the individual has to decide, "OK, I have to lose weight."

Or deal with the consequences.

Carter cites, for example, an obese friend who buys two seats when she flies in order to have enough room on the plane.

"But I can't charge double for an obese patient," Carter said.

In the end, she says, it comes down to a personal decision.

If they don't lose the weight, Carter said, "I'm paying the cost of other people's choices."

Readers, what do you think? This policy may sound harsh but is it simply a self-protective and rational response to the growing epidemic? Let us know.