…what would it be?
A doctor reached out to me and asked me the same question, because she’s giving this presentation to medical students regarding patient-centered care and how to best help them… but I’m lobbing it to the family. If you could influence the way doctors treat Black women with health issues or simply women with weight issues in general, what would it be? I mean, certainly anyone could chime in here with their stories and tales, but it’s most important that these answers give insight to where health care has gone wrong and how we can improve it.
Here’s what my answer was:
That being said, if I had to provide one bit of advice to doctors, I’d tell them to not judge their patient by their perceived situation, or your individual perspective of who they are and what they are capable of. If there’s one thing I’ve learned in running this blog, it’s that there is a lot lost in translation – we’re often so busy waiting on someone to say what we’re expecting them to say, that we miss all the important things they’ve already said. For example – there’s a post on my blog that talks about “fat prejudice in health care,” and there are countless examples of women who have received neglectful care because they were fat. It was assumed that they were stupid, unable to care for themselves, lazy, and any number of other negative characteristics simply because they were overweight.
It is far too common, in this country, to find people who literally DON’T understand that fruits, veggies and lean meats are the most integral parts of a healthy lifestyle. That’s fruits, veggies and lean meats… not Lean Cuisine, not Marie Callendar, not ANY processed food. They think they’re doing it right, get no weight loss, and then wind up already feeling depressed because they can’t control it. When doctors treat them poorly, it only perpetuates the self-loathing which, as a post titled “self compassion is a key component of weight loss” might show you, does not help further a doctor’s goals of helping their patient.
I hope that helps a bit.
That was my answer… what’s yours?
15 comments
I’d suggest that physicians should support their patients and not judge them. It’s a tough call… I think they should not treat them poorly and suggest weight loss as the answer to all questions, but they should also not ignore the weight problem (if there is a problem).
I have seen so many doctors due to health concerns. I would say care enough to formulate a plan. I feel that during my 15 minutes and the rush to get in as many patients for their practice it’s more about billable hours than patient care.
Out of I would say ten doctors one doctor who was Russian lady attempted to discuss portion control. By mentioning to use your palm of you hand to gauge portions for nuts. Fruits and veges. Yet I don’t think they know how to approach the talk about your health. The fact is once you get your body back in balance and healthy, there is no need to see them for.
I feel that being unhealthy is a boom for too many doctors who like to operate and push pills. I got so sick of the pills. I decided to research meals and what will work for me. Since I wasn’t able to exercise a lot due to shortness of breath, high blood pressure, eating well was such a key for me.
So I would say care enough to refer me to a nutritionist, to explain the test results in detail and lets work together. Ask if there are any circulation issues, are my vital organs working well? Also if they are off why, also a plan.
I think the important thing is to at least PRETEND they care and treat each patient as an individual. There is no one size-fits-all form of treatment, no pun intended. Whether the patient is black, fat or otherwise, the treatment should be a reflection of the overall health of the patient, not based upon assumptions or general practice. Respect the patients requests, answer the patients questions and seek to build their trust. Dont just take the “I am god” position, and expect the patient to believe everything you say as a docotor. All their concerns are valid and rooted from some source, take the opportunity to educate your patient – not shut them down. Last but not least, be honest with the patient about your reservations regarding treatment or tests or their lifestyle habits that directly effect their health. Be honest about the time allowance for their visit and how much can be accomplished. Treat the patient like a partner in their overall health, not like an unwanted visitor that is wasting your precious time. and please Do NOT deny VALID requests for certain tests simply because you personally dont see a need. Several doctors have been wrong in my treatment and the treatment of my children simply because of their professional arrogance that was rooted in nothing more than pride and loathing. They didnt want me to tell them what I thought was wrong so the came up with something else! Completely ridiculous, especially after I told them my mother was a registered nurse for over 30 years.
What a tough question!
I wish it were easier to establish a relationship so the doctor won’t rely so heavily on generalizations. I remember being back in school, broke, in debt, and I really hated my program and all the competition and cattiness. My blood pressure went up each semester – and went back to normal when I graduated and got a job. The doctor told me to stop eating fried food and lay off all the salt (I was a vegetarian at the time that hardly ate fried food – like 1x every 3 months, and I NEVER added salt to anything) and that I’m black so I’m predisposed to hypertension. I was actually pretty offended that she wrongly assumed I ate fried or processed food and that she couldn’t put together hypertension is a lifestyle issue due to poor diet and lack of exercise, not race. I told her flat out I’m under a lot of stress, and she told me I was wrong and to lose 10lbs (I was at a healthy 23 BMI). She wondered why was I stunned at the end of our conversation. Let me think — you made a s***load of wrong assumptions about me and you’re basing my entire existence on racial stereotypes. Clearly eats fried chicken, needs to lose weight because she’s not 15lbs underweight like the other fashion students, and she’s not smart enough to know that it’s all the salty fried food and not the mountains of stress she’s under.
It is our job to be open and honest when we do see our physicians, but it would be nice if they asked questions instead of making assumptions because of our weight, color, or preconceived ideas about our social status. Simply asking what was going on in my life, actually looking at my chart and seeing that my blood-pressure when from normal to high over the course of the school year, would have saved a lot of animosity and distrust. I switched to another care practitioner after that. I’d say, ask questions and actually listen to the answer before rattling off something you read in a pamphlet 20 years ago.
A few years and 40 pounds ago, I had a new doctor tell me, in hushed tones at the end of my exam, that according to the BMI chart he kept pointing to I was 1 pound away from being marked as obese. He looked as me with such contempt. What made me angriest was that I was already in a place where I was deadlifting more than half of what I’m guessing he weighed in that lab coat and had just run my first 5k. He didn’t ask me what my journey was so far or what my lifestyle was like. He didn’t know I was already 15lbs down and counting. He didn’t know that that 1 pound keeping me from obese was hard earned and something I was hella proud of. When it became clear that I was getting annoyed with his handling of the situation, he basically just chalked it up to me being in denial. I never went back. I guess, I’d ask doctors to talk about the journey along with the current facts. Our health journey is more than just what they can read in a chart.
I guess I can help by talking about my own doctor. I have an incredible doctor. If you are a woman looking for a gynocologist with reproductive endocrinology as a background she is the person to see.
She is a black woman. She is an immigrant woman. She is a widow and a single mother of two young children. And now, she runs her own business. If anyone knows the stress of being a woman today, its her. She left a large practice to start her own– people come from as far away as DC to see her (I live in South Jersey).
The reason she’s amazing (besides helping me keep my ability to have children when a condition threatened it) is that she takes a holistic approach to health.
She really does sit down with each patient in her office for 20 minutes to half an hour and talk about what your chief complaint is… and then goes on to talk about what else in your life is affecting you BEFORE you even go into the exam room.
I especially love her approach to weight management. She does her own research rather than just jump on the latest trend. For me personally, she encourages my physically active lifestyle and give me tips for eating to fuel that lifestyle in a healthy and balanced manner. She’s not big on the numbers on the scale, because she knows that they don’t tell the whole story. That doesn’t mean she doesn’t pay attention to them… but she’s sensitive about how she approaches a patient’s weight gain… or LOSS (since not all weight loss is healthy– I lost a ton of weight when I was sick…. because I was near death).
A person’s health constitutes body AND mind AND soul and she makes it a point to at least address all those things. I’ve recommended no less than 14 women to her practice and they love her– because she treats each of them as a whole unique person. She also exceptionally well educated.
I understand about billable hours. I have 3 friends who are physicians who just completed their residencies and its true… the way the system is set up now, if you don’t bill, you don’t eat. Its messed up, but its true.
Conversely, if you want to build a patient base so you can stack billable hours, be the kind of doctor that people will readily recommend to their friends.
The HMO website will only tell you who specializes in what. The true testament of a doctor’s worth is from the mouths of their patients.
My suggestion is to bring up potential risks prior to them growing out of control. For instance don’t neglect the fact that your patient gained 15 pounds in a year, just because they are young. Or don’t bring to attention an increase in blood pressure simply because you think they will be “ok”. Say something early on so women aren’t dying prematurely or sick with major diseases that are preventable.
My current doctor has done a wonderful job being tactful and compassionate in regards to my health. After I gained nearly 30 lbs in under a year and half, we had a serious talk about my health. He asked me if there had been any big changes in my lifestyle that could have led to my weight gain. In fact there had. I’d started graduate school, gone through a bad breakup, and lost two close relatives in a very short amount of time. We talked about how those things were contributing to my weight gain and started planning possible solutions. Looking back, most doctors I’d had in the past had approached the topic of weight loss with very little tact. And no one had ever asked about the roots of my bad habits. They just assumed that I was lazy. My current doctor talks to me about ME first, and my weight second.
Be patient and listen, really listen. If I say I want a particular medication and not the one that the pharmaceutical rep just delivered a sample of, listen to my concerns and needs. And hey, if the bright shiny new med is the one that prescribe it, but respect me and my knowledge of my own body enough to explain why.
treat your patients like human beings instead of judging them according to stereotypes
Yes
When my weight started my affecting my health the first doctor I saw first recommendation was surgery..and she was gun-ho about it. I wasn’t feeling that so I asked for a less radical solution and she then proceeded to prescribe me weight loss pills (appetite suppressants). This women didn’t put any effort in to finding out why I was overweight. She just automatically assumed that I ate too much which was wrong because I actually wasn’t eating enough and slowed down my metabolism. I changed doctors quick. My new doctor did blood work ran test and sent me to several specialist like a real doctor should and I was finally diagnosed with polycystic ovary syndrome (PCOS) which a causes an onset of weight gain and a risk of diabetes. So now with the correct medication proper diet and exercise I’ve managed to lose 30 pounds. My risk for diabetes drop significantly and my PCOS is in check. I really wish some doctors wouldn’t automatically judge and assume things about you because you’re overweight. Take the time to get to know your patients and put some effort in to actually doing your job in curing your patient’s ailments instead of patching them up with a prescription band aid.
As if I know what I am talking about!!! I am not a doctors/hospital girl, meaning if my arm was falling off and I couldn’t find a way to put it back on my self, then I’d go see them. So trust me when I tell you my symptoms. After 1 year of going to the doctors crying because my breathing, sleeping, light headedness, lumpy throat feeling, seeing stars, in and out vision, massive headaches….etc became progressively worse to the point where I was panting after walking 10 feet as if I ran a mile and sleeping sitting up. I finally got an appointment with a Cardiologist that diagnosed me as having and I quote “the most common of the rarest benign tumors the size of an egg in my heart”. He then told me I had two more weeks before I would have suffered a major heart attack at the age of 37. WHAT????? After our conversation regarding the last year, he got in contact with every single doctor I had saw for a year and YELLED at them because he told me that everything I told them was the classic signs of a female with a heart problem and that he could hear the tumor plopping in and out of my heart. What I was told by other doctors was that I was over weight, stressed out and couldn’t balance motherhood with life. WHAT???? Yeah needless to say I yelled at that doctor as I was actually 11 pounds lighter when my entire vision went out when exercising, and 5 pounds lighter when I saw him. I stopped exercising because I knew it would kill me. All in all I had emergency surgery 2 days after being diagnosed and am a healthy 40 yr old now. What I didn’t like was no one listened to me. I went back time and time again crying and saying I will die if you don’t do something, as I could not pinpoint it, but I don’t go to the doctors. I even told them, check your records, I don’t come here unless its really bad. They had my blood work that said something was wrong with my white and red blood cells, yet they couldn’t pinpoint it either and made me feel as if I was just some fat chick that was lazy. Believe me I tried to loose what I thought was fat and ended up being bloating from my body trying to protect itself, so it didn’t go anywhere. I THANK GOD everyday for my cardiologist because I know he was put there for me. He was suppose to be on vacation that week and he came in because he said he just knew something was going to happen that day. Before that day we had never met and I had never been to his small practice. So DOC’s listen to your patients and really really look into their files, not everyone is a hypochondriac.
Last year when my husband went to the doctor, his blood sugar was in the low diabetic range and he was on medication for high blood pressure.
The doctor simply pulled out a pad and wrote him a prescription. No discussion about the role of nutrition and exercise at all.
I think there is a perception from some doctors that there is “no point” discussing nutrittion and exercise because most people would find it too difficult, or that if you are overweight then you would not stick with it.
Thankfully, my husband decided to make a real effort to change his eating and exercise habits. He went off his blood pressure meds and never took meds for diabetes. He also found a different doctor.
Don’t jump to conclusions! Ask questions. I have had 2 doctors (one a black woman like me) assume that because I wasn’t losing weight as fast as I wanted that I was ignorant, sedentary, and lacked motivation. They launched into these stupid f$&@ing canned speeches about not eating KFC all the time and getting off the couch. They wouldn’t do the blood work I requested until I whipped out my phone to show off my food and e exercise logs for the past weeks. In short, don’t be lazy or a lazy thinker. It offends me and makes me not want to come back when I’m not treated as an intelligent human being. Side note: don’t try to peddle weight loss quick fixes that even my non-medical behind knows conflicts with my pre-existing conditions. Just…no.
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