OBGYN doctors set weight limit for new patients

[AZRedhawk44]

http://www.cnsnews.com/news/article/report-doctors-refusing-treat-overweight

The commies are all up in arms over Doctors asserting their right to choose to pick patients or not.

These docs in this story are OBGYN's, saying they won't treat fat patients.

Now, that doesn't mean that they've said you have to be a size 6 or slimmer, under 30 years old with a perfect C-cup, either.   One drew the line at 200 pounds, and the other at 250.  That's still a BIG woman.

Anyone past those weight points presents all sorts of additional health concerns and risks for the doctor.

"Do no harm" doesn't mean that a doctor is compelled to treat anyone and everyone.  Doctors aren't cops.  They aren't employed by the government (taxpayers).  They haven't been drafted by the armed services.

[charby]

If the woman is 6' tall and big framed, 200lbs wouldn't make her fat.

[makattak]

If the woman is 6' tall and big framed, 200lbs wouldn't make her fat.

But it may still carry a greater chance of gynecological complications. (I'm not saying it would, just that it may.)

These doctors have a right to limit their exposure to risk. Sucks to be one of those denied care under their practice, but that's a result of our litigious society.

Related, I hope they don't get sued for this. (But they probably will.)

[MechAg94]

I think it is sort of a bad set of choices.  People want to hold doctors responsible, but they balk at letting doctors pick and choose patients.  We really shouldn't put ALL the burden on the doctor without giving them relief somewhere.

[MicroBalrog]

I think the problem will emerge when you have people with certain conditions have issues finding doctors if refusing to treat people with risky conditions becomes common.

[Matthew Carberry]

We'll just conscript Ron Paul. 

[Perd Hapley]

One drew the line at 200 pounds, and the other at 250.  That's still a BIG woman.

 

[Scout26]

"Do no harm" doesn't mean that a doctor is compelled to treat anyone and everyone.  Doctors aren't cops.  They aren't employed by the government (taxpayers). 

Yet. 

Obamacare is still comin'

[Tallpine]

So now what - fat women have to have a back-alley childbirth 

[longeyes]

They can get as fat as they want, but they can't get me to pay their med bills.

[brimic]

Seems like reasonable risk management to me. Aren't OB/GYN doctors sued more than any other class of doctors?

[MillCreek]

Seems like reasonable risk management to me. Aren't OB/GYN doctors sued more than any other class of doctors?

Speaking as the actual healthcare risk manager on this board, OB/GYN does rank pretty high on the list of most-sued specialties.

[brimic]

Speaking as the actual healthcare risk manager on this board, OB/GYN does rank pretty high on the list of most-sued specialties.

Thought so. Our family's OB/GYN/Pediatrician is retiring- in her early 40s. Said she's tired of the lawsuits. She's really good- which probably means she has taken on a lot of the more difficult situations.

[Matthew Carberry]

Speaking as the actual healthcare risk manager on this board, OB/GYN does rank pretty high on the list of most-sued specialties.

Well la-dee-dah Mr. Fancy-pants. 

[MillCreek]

South Florida is a pretty darn interesting malpractice environment.  Because of the cost of malpractice insurance, OB/GYNs and some other specialties there practice 'bare' or without insurance.  By state law, you have to have a placard on your office wall informing patients of this. 

Here is a snippet from the "Medical Liability Monitor", a trade publication that reports on malpractice insurance.  These quoted premiums are for $ 1 million in coverage:

Obstetricians and gynecologists in Los Angeles County paid an average annual medical liability premium of $49,804 in 2010, compared with $196,111 paid by OB/GYNs practicing on Long Island (Nassau and Suffolk counties), New York. OB/GYNs in Dade County, Florida, paid an annual average of $200,3773.

This information is bolstered by the Medical Liability Monitor’s Annual Rate Survey, 2010. The Liability Monitor reported that as of July 1, 2010, OB/GYNs in New York and Florida ranked first and second, respectively, in average annual medical malpractice premiums paid, while OB/GYNs in 10 Central and Northern California counties paid among the nation’s lowest rates.

The Liability Monitor survey found that Long Island OB/GYNs paid an annual average liability premium of $204,864, while OB/GYNs in the 10 California counties paid an annual average of only $13,4004!

In Florida, where the liability cap for non-economic damages is double California’s cap, OB/GYNs in Miami and Dade counties paid an annual average of $201,808, the survey reported.

[Scout26]

Speaking as the actual healthcare risk manager on this board, OB/GYN does rank pretty high on the list of most-sued specialties.

Two Words:

John Edwards

[MillCreek]

Mr. Edwards is well-known to us who do malpractice work.  He has made quite the pretty penny suing on cerebral palsy cases, alleging that a c-section, if done earlier, would have produced a normal baby.  The ironic thing on this is that in recent years, the medical literature is demonstrating that most cases of cerebral palsy occur prenatally, way before labor and delivery.  So a c-section probably would not make a difference in the outcome in cerebral palsy.  Many of the plaintiff lawyers still argue this, though, saying that the literature is biased and designed to shield bad doctors from the consequences of their poor judgement. 

[Northwoods]

The biggest problem with the tort system in this country is that we've done away with the concept of an individual being able to assume risk.  If you have a history of driving recklessly and I get in your car I am assuming a fair bit of risk that you'll wreck.  If I get hurt or killed my widow should be told "Hope he had life insurance" becuase I knew the risk and got in the car anyway.

All medical procedures carry some level of risk.  That you could lose the roll of the dice (especially if wasn't GROSS negligance on the docs part) should be part of the risk you assume by recieving that treatment.

Tort claims should be reserved for cases of gross negligance or willful misconduct.  Anything beyond that should fall under a risk that you assume by undertaking any given activity.  If you want to ensure some form of compensation to your heirs should you die or to cover your expenses related to injury or disability then you should have adequate insurance. 

[roo_ster]

South Florida is a pretty darn interesting malpractice environment.  Because of the cost of malpractice insurance, OB/GYNs and some other specialties there practice 'bare' or without insurance.  By state law, you have to have a placard on your office wall informing patients of this. 

Here is a snippet from the "Medical Liability Monitor", a trade publication that reports on malpractice insurance.  These quoted premiums are for $ 1 million in coverage:

Obstetricians and gynecologists in Los Angeles County paid an average annual medical liability premium of $49,804 in 2010, compared with $196,111 paid by OB/GYNs practicing on Long Island (Nassau and Suffolk counties), New York. OB/GYNs in Dade County, Florida, paid an annual average of $200,3773.

This information is bolstered by the Medical Liability Monitor’s Annual Rate Survey, 2010. The Liability Monitor reported that as of July 1, 2010, OB/GYNs in New York and Florida ranked first and second, respectively, in average annual medical malpractice premiums paid, while OB/GYNs in 10 Central and Northern California counties paid among the nation’s lowest rates.

The Liability Monitor survey found that Long Island OB/GYNs paid an annual average liability premium of $204,864, while OB/GYNs in the 10 California counties paid an annual average of only $13,4004!

In Florida, where the liability cap for non-economic damages is double California’s cap, OB/GYNs in Miami and Dade counties paid an annual average of $201,808, the survey reported.

Butbutbutbutbutbutbut caps on non-economic damages don't help!  It is just a fiction that lawsuits drive up the cost of health care.

[Tallpine]

Tort claims should be reserved for cases of gross negligance or willful misconduct.

I agree totally but the problem is that there are still plenty of those cases 

There is a risk to having a bad leg amputated but one of those risks should not be having the good leg amputated instead. 

We have a friend who has lost most of the use of her hands because the hospital ran a routine test, and then proceded without regard to the results of that test.  They finally paid them off with an "unspecified amount" to keep the incident out of the courts and the papers.

Doctor bring a lot of this on themselves: they act like "god" and then are surprised that people sue them when the miracle doesn't quite work.

[MillCreek]

I agree totally but the problem is that there are still plenty of those cases 

There are indeed.  I try to settle those cases as expeditiously as possible.  If you have a case in which the healthcare provider clearly screwed up, the best thing to do is to acknowledge this, apologize and try to come to an agreed settlement.  It does no one any good to drag out the process for a clear liability case.

[BridgeRunner]

So a c-section probably would not make a difference in the outcome in cerebral palsy.

 
Of course, a defensive c-section may well make a difference in all sorts of other ways, like long-term respiratory problems for the kid and a slew of reproductive and general health consequences for the mother.

Many of the plaintiff lawyers still argue this, though, saying that the literature is biased and designed to shield bad doctors from the consequences of their poor judgement. 

Meanwhile, the biggest problem I see with doctors' poor judgement stems from their tendency to not bother with obtaining informed consent.  Or consent.  They'd rather rely on boilerplate somewhere where a patient purportedly signed away all rights to any self-determination at all on pain of being denied any treatment at all.  And ob/gyns are particularly guilty of this.

Haven't there been all kinds of studies and surveys demonstrating that a doctor's likelihood of being sued has far less to do with how he practices than with how he talks to his patients?  I have no cites handy, though. 

[MillCreek]

There are indeed studies looking at litigation risk as a function of how the healthcare provider comes across.  When I lecture on this, I call them the 'Marcus Welby' studies.  In brief, the warmer and fuzzier you are perceived by your patients, the lesser complaints and lawsuits you tend to have filed against you.  Medline has cites up the wazoo if anyone is interested.

[Jamisjockey]

Oh sweet jeebus.  200lbs of woman is fat?  Broadbrushing much?  Women, like men, come in all sizes and body shapes.  You might find a 200lb woman to be reasonably fit, and a 150 pounder to be a nasty fatty, depending on body shape and height. 
However, I see no reason a doctor, or anyone else, shouldn't be able to turn away customers.

[De Selby]

Tort claims should be reserved for cases of gross negligance or willful misconduct.  Anything beyond that should fall under a risk that you assume by undertaking any given activity.  If you want to ensure some form of compensation to your heirs should you die or to cover your expenses related to injury or disability then you should have adequate insurance. 

These attitudes are the product of widespread and fundamental ignorance about how the tort system works.  Assumption of the risk is alive and well - you must be aware of a risk to assume it.  In many cases, things happen in medicine that a non-doctor couldn't possibly have foreseen.  That's why we have rules about informed consent.

Suing a doctor is one of the toughest, most expensive, least lucrative things a lawyer can do.  When you read about those big judgments and settlements, it's because something horrendous happened.

It's inefficient and unfair to ask individuals to carry insurance against the mistakes of highly trained experts, who are themselves the only people in a good position to understand the risks.