Lawrence J. Cheskin, MD, Scott Kahan, MD, MPH, and Gail Geller, ScD, MHS
Many health professionals harbor negative biases toward individuals who are obese. Cultivating an awareness of our own biases is the best way to avoid acting on them.
The metaphor of the ED as a safety net works on many levels. It’s visual. It has heroic dimensions. Many physicians and nurses were drawn, and find great purpose, in this ideal. But does it stoke expectations that can’t be met?
James Mills Jr., MD, a founder of emergency medicine, believed he could have greater impact on medical care for the poor in his city by giving up his practice and working in the emergency room full time.
The guidelines for patients’ eligibility for bariatric surgery have not changed since 1991, although recent data suggest there may be indications for broadening application of the surgery.
A medical student’s desire to practice the specialty that he or she finds most interesting should not outweigh the right of patients in a pluralistic society to receive a full range of legal medical services.
The rationale for policy intervention to reduce obesity rates appears compelling. Justification for intervening in the case of children is particularly strong, and precedent suggests that society will more readily accept appropriate restrictions to youth behavior.
Residents can be better prepared to treat patients who are obese by understanding that care as an expression of the core principles of professionalism: responsibility, self-regulation, patient-centered care, and teamwork.