Some Ob-Gyns Say Obese Patients too High-Risk

VIDEO: University of Vermonts Dr. Robert Macaulay comments.
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Obese pregnant women, already at higher risk for health complications, have had another setback: a survey conducted last week by South Florida's Sun Sentinel revealed that several ob-gyns there refuse to treat overweight and obese women.

Some doctors who admitted they refused obese patients in the survey said that they did not have adequate equipment to treat women over a certain weight. Others said they refuse obese patients because they are too high-risk to treat, and need doctors with special skills.

"I think this is unconscionable," said Dr. Robert Kushner, professor of medicine at Northwestern University's Feinberg School of Medicine. "This is a form of discrimination in the worst way."

Drs. Jeffrey Solomon and Isabel Otero-Echandi, private practice ob-gyns in Plantation, Fla., were among the 15 who admitted they reject new patients who weigh more than 250 lbs, according to the Sun Sentinel.

The office manager said the doctors had no further comment.

Obese pregnant women are at an increased risk of gestational diabetes, preeclampsia and postpartum infection, among other complications.

Turning down obese patients is not illegal. Doctors are allowed to drop or refuse patients if they feel a patient's condition is outside of their skill set, and it is not based on race, sexual orientation or gender.

But Dr. F. Ralph Dauterive, chair of obstetrics and gynecology at the Ochsner Clinical Foundation in Baton Rouge, said that he not only disagrees with doctors who exclude overweight patients from an obstetrics practice, but he rejected the excuse that physicians' medical training would make them unable to care for obese patients.

"The medical risk to the pregnancy is greater, but the obstetrical trained M.D. should be capable of management," said Dauterive. "We have an obligation to care for patients based upon our training. We really do owe that to the community in which we live."

And that community is growing. According to the Centers of Disease Control and Prevention, 26.1 percent of U.S. adults were obese in 2008, up from 25.6 percent in 2007.

Many experts say that's too large a population simply to deny, especially because complicated pregnancies are the ones that require the most preventive and vigilant care.

James Zervios, director of communications for the Obesity Action Coalition, said that this likely happens a lot more than people think.

"We've heard this going on with other doctors in the past," said Zervios. "I find it hard to believe that doctors don't have tables and equipment to accommodate overweight patients with 93 million Americans affected by obesity."

"This goes against the basic principles of health care," continued Zervios. "They're there to improve the quality of life for those they serve."

Because of fear of discrimination and belittling, Zervios said many obese people avoid the doctor altogether, even though a trusting relationship between a doctor and patient would offer a perfect time to discuss necessary lifestyle changes. It's a missed opportunity that could address issues that are affecting one quarter of Americans, said Zervios.

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