These are great options for a reality check for the clinician! To be honest, the "white coat authority" is infused in doctors throughout our training -- any time we admit we don't know or get an answer thrown at us wrong, we are publically shamed (this process is appropriately and ironically named "pimping" -- a medical rape culture term, of course. And I vividly remember EVERY SINGLE OCCASION when this happened to me.). This is so ingrained that I would still be, even though I've worked for years to unlearn and relearn (from patients), taken aback if someone used these phrases during visits with me.
However, I did recently have a patient who "confronted" me about my approach to her. And I believe she taught me things much more valuable than this "fake it until you make it" attitude medical education taught me.
All this is to say -- I know it must be scary and uncomfortable to voice your concerns and exhausting to have to advocate for yourself (also totally unfair that you have to, and you have every permission to choose not to carry that emotional burden). But, sometimes, and you never know when it will be, it might just train a clinician out of their old ways and make things better for future patients!
Wow that poor ortho patient. My favorite (not really) thing is when doctors try to say that thin people don’t get the condition/symptom in question. I can’t imagine having all that doctor schooling and genuinely thinking that thin people don’t get [any condition ever].
My grandma was a tiny little toothpick of a woman her whole adult life. (The only time she was over 105 was when she was pregnant or retaining fluids.) She had her first stroke at age 33 and her first heart attack a few years later. So doctors see that in my medical history, see me in all my fat glory, and assume she was fat like me and her fatness is what caused those problems in her, and weight loss will prevent those problems in me.
"I can’t imagine having all that doctor schooling and genuinely thinking that thin people don’t get [any condition ever]." LOL good point! I can't imagine having all that doctor schooling and STILL genuinely not having the ability to examine our biases. Wait -- maybe that's exactly why some of us don't have it. 😅
In the UK, where the NHS is free but wrecked by the last government over 14 years, we don’t have any options to write in our own notes. They are often on paper and unless you submit a formal request (and I am unsure exactly what you’d see). I did this for my GP’s notes and all that each appointment said was a code number of the issue I’d come with, no opinions.
A Consultant’s notes (if you can get referred to one, not our choice as it’s free and heavily gate kept) are usually on paper. I see several consultants as I have autoimmune disease and bowel issues. I don’t have any options to write in those notes. All I can do would be to keep my own separate notes.
I will eventually need a hip replacement after childhood SUFE. The surgeon whom I see infrequently, is the only doctor who ever brings up my weight. Last time, I didn’t comment on weight at all, yet in the follow up letter he wrote that I’m “still trying to lose weight” which I’m not. After years of eating distress and bxlimia, I’m very happy to be at a stable albeit higher weight.
I just wanted to give a UK perspective of the NHS. I have no experience of private healthcare in the UK.
my current health care provider has been good about not pushing the weight loss idea, but this is always a good conversation to remember for when I need it. In the meantime, while I don't do New Year's resolutions, my intention this year is to keep wearing my "The BMI is Trash" t-shirt from Aubrey Gordon's Maintenance Phase store to each and every medical appointment I have. The nurses at my Gyn appt loved it. :D
One time back in 2019, upon getting my wife settled in an exam room at the orthopedic surgeon's office, I was dismayed to see a big, colorful BMI chart on the wall right across from where the patient sits. Nothing fancy or laminated, literally just printed out and then stuck on the wall... right above a giant trash bin. <light bulb!>
So I stood up, marched across the room, tore that sucker down, gleefully crumpled it into a ball, and tossed in the well-placed trash bin. As my wife stared at me with surprise, I said, in a loud, unaffected monotone: "OOPS! GOSH, I AM SOOOOO CLUMSY. I SHOULD REALLY WATCH WHERE I'M GOING, I COULD HAVE REALLY DAMAGED SOMETHING. OH WELL!" She burst into giggles and it was the first time I'd seen her laugh in months, because she was in so much knee pain 24/7! This was the 4th surgeon in 4 months of desperately trying to get her a double knee replacement - the prior 3 all happily took her money and put her through a painful exam, only to then say her BMI was too high to operate, regardless. So yeah, I took it out on that BMI chart and have zero regrets! To our utter shock, surgeon #4 was wonderful, didn't give a hoot about her weight, and did both knees in a single surgery only a few weeks later. :-)
(side note: I took a picture of the wall before/after and shared it with the "oops, I tripped!" story in a fats-only FB group I moderate, just for laughs. I found out a few days later that some JUDAS inside the group took it and shared a screenshot of the pics/story to a gross fatphobic subreddit. grrrrrr!)
These are great options for a reality check for the clinician! To be honest, the "white coat authority" is infused in doctors throughout our training -- any time we admit we don't know or get an answer thrown at us wrong, we are publically shamed (this process is appropriately and ironically named "pimping" -- a medical rape culture term, of course. And I vividly remember EVERY SINGLE OCCASION when this happened to me.). This is so ingrained that I would still be, even though I've worked for years to unlearn and relearn (from patients), taken aback if someone used these phrases during visits with me.
However, I did recently have a patient who "confronted" me about my approach to her. And I believe she taught me things much more valuable than this "fake it until you make it" attitude medical education taught me.
https://drzedzha.substack.com/p/the-uncomfortable-patient
(sorry about the shameless self-promotion😅)
All this is to say -- I know it must be scary and uncomfortable to voice your concerns and exhausting to have to advocate for yourself (also totally unfair that you have to, and you have every permission to choose not to carry that emotional burden). But, sometimes, and you never know when it will be, it might just train a clinician out of their old ways and make things better for future patients!
thank you for the shameless self-promotion, I've now subscribed to your newsletter too. :)
Thank you so much for this!
Wow that poor ortho patient. My favorite (not really) thing is when doctors try to say that thin people don’t get the condition/symptom in question. I can’t imagine having all that doctor schooling and genuinely thinking that thin people don’t get [any condition ever].
My grandma was a tiny little toothpick of a woman her whole adult life. (The only time she was over 105 was when she was pregnant or retaining fluids.) She had her first stroke at age 33 and her first heart attack a few years later. So doctors see that in my medical history, see me in all my fat glory, and assume she was fat like me and her fatness is what caused those problems in her, and weight loss will prevent those problems in me.
This shit is exhausting.
Thanks for what you do!
"I can’t imagine having all that doctor schooling and genuinely thinking that thin people don’t get [any condition ever]." LOL good point! I can't imagine having all that doctor schooling and STILL genuinely not having the ability to examine our biases. Wait -- maybe that's exactly why some of us don't have it. 😅
In the UK, where the NHS is free but wrecked by the last government over 14 years, we don’t have any options to write in our own notes. They are often on paper and unless you submit a formal request (and I am unsure exactly what you’d see). I did this for my GP’s notes and all that each appointment said was a code number of the issue I’d come with, no opinions.
A Consultant’s notes (if you can get referred to one, not our choice as it’s free and heavily gate kept) are usually on paper. I see several consultants as I have autoimmune disease and bowel issues. I don’t have any options to write in those notes. All I can do would be to keep my own separate notes.
I will eventually need a hip replacement after childhood SUFE. The surgeon whom I see infrequently, is the only doctor who ever brings up my weight. Last time, I didn’t comment on weight at all, yet in the follow up letter he wrote that I’m “still trying to lose weight” which I’m not. After years of eating distress and bxlimia, I’m very happy to be at a stable albeit higher weight.
I just wanted to give a UK perspective of the NHS. I have no experience of private healthcare in the UK.
Thanks so much Lorna, this is really important information. I've edited the piece to be more clear about this.
my current health care provider has been good about not pushing the weight loss idea, but this is always a good conversation to remember for when I need it. In the meantime, while I don't do New Year's resolutions, my intention this year is to keep wearing my "The BMI is Trash" t-shirt from Aubrey Gordon's Maintenance Phase store to each and every medical appointment I have. The nurses at my Gyn appt loved it. :D
I'm glad that your current HCP has been good and I LOVE THIS INTENTION!
I NEED THAT SHIRT hahahaha!
One time back in 2019, upon getting my wife settled in an exam room at the orthopedic surgeon's office, I was dismayed to see a big, colorful BMI chart on the wall right across from where the patient sits. Nothing fancy or laminated, literally just printed out and then stuck on the wall... right above a giant trash bin. <light bulb!>
So I stood up, marched across the room, tore that sucker down, gleefully crumpled it into a ball, and tossed in the well-placed trash bin. As my wife stared at me with surprise, I said, in a loud, unaffected monotone: "OOPS! GOSH, I AM SOOOOO CLUMSY. I SHOULD REALLY WATCH WHERE I'M GOING, I COULD HAVE REALLY DAMAGED SOMETHING. OH WELL!" She burst into giggles and it was the first time I'd seen her laugh in months, because she was in so much knee pain 24/7! This was the 4th surgeon in 4 months of desperately trying to get her a double knee replacement - the prior 3 all happily took her money and put her through a painful exam, only to then say her BMI was too high to operate, regardless. So yeah, I took it out on that BMI chart and have zero regrets! To our utter shock, surgeon #4 was wonderful, didn't give a hoot about her weight, and did both knees in a single surgery only a few weeks later. :-)
(side note: I took a picture of the wall before/after and shared it with the "oops, I tripped!" story in a fats-only FB group I moderate, just for laughs. I found out a few days later that some JUDAS inside the group took it and shared a screenshot of the pics/story to a gross fatphobic subreddit. grrrrrr!)
I love that story! and glad that it helped her laugh and feel better even before the good appointment with that 4th doctor.
https://www.teepublic.com/t-shirt/23829899-the-bmi-is-trash?store_id=1196791 here is the direct link for it if you want. I hope the size range is enough, I have the classic fit male in 3x and it goes up to 5x in that one.
Thank you! I love the design and definitely need to get one. 😊