Why Doctors Don’t Dig Deeper When You’re Fat
In this article from the New York Times, Julie Weed reports on a minor rebellion among primary care physicians, who are radically changing the way they do business so they can see fewer patients each day and spend the time it really takes to offer them quality care. It involves things like reducing office staff and going to web-based appointment management. It also means freeing themselves from the yoke of insurance companies, which have huge paperwork requirements (forcing doctors to hire office staff) and puny payouts.
This got me thinking. This movement is both small and young. The overwhelming majority of doctors still practice rapid-fire, assembly-line medicine, where nurses or medical assistants line patients up in rows of little examining rooms and doctors move along the hallway, popping into each room for as little time as possible, just long enough to order some tests (all of which must be performed off-site, natch), or make a diagnosis and write a script, dictate a few notes, and move on.
If you were one of these doctors, why would you take the time to dig deeper when you could just say, “It’s because you’re fat. Lose weight. NEXT!”
I’m not saying they’re right. I’m saying that type of environment breeds this type of behavior. Fatness is the low-hanging fruit. The easy explanation. And a harried doctor under pressure to move fast probably just can’t help herself after a while.
In fact, the more fat people a doctor has on her schedule in a day, the more money she can make. She can practically run down the hall, pausing momentarily at each door just to peek in and say, “It’s because you’re fat! It’s because YOU’RE fat! It’s because YOU’RE fat TOO!” That leaves a lot more time to ponder the real mystery cases– like when thin people develop medical problems they think only fat people get. Thin and got heart disease? Well, we’ll actually have to look into that, won’t we?
It’s in everyone’s interest to reform the way modern assembly-line medicine is practiced. But I’m thinking maybe it’s especially in the interest of those of us whose larger bodies offer doctors an easy way out.
