The meme isnāt about that, Iāve read stories of some doctors refusing to perform surguries to overweight people, but other doctors doing the surgery anyway.
The same way a lot of women get told stuff is just from their period by doctors.
Iām a medical student and I have some direct experience with this. Sometimes, the difference between the surgeon who will do the procedure versus the surgeon that wonāt do the procedure is the availability of specialized facilities and equipment that they have access to. An elective surgery (i.e. not an emergency surgery) can go from routine to very high risk depending on the amount of adipose tissue the patient has.
And itās not just a matter of the fat tissue overlying the surgical site. Morbidly obese patients are much more likely to have things like sleep apnea which can make anesthesia more risky and might require more specialized equipment than a particular surgeon/hospital/anesthesiologist might have access to. The āmorbidā part of āmorbid obesityā also refers to the fact that people above a certain threshold of weight are much more likely to have other health conditions like heart disease that make anesthesia more risky.
This is what I came to say but wasnāt smart enough to put into words. Thereās a lot more factors than just being overweight of why a surgery canāt be performed. For a while an issue at my hospital was we were one of the few in the area that could do MRIs on larger patients. So bigger hospitals would transfer these patients to us just for an MRI because their MRI machine was too small or couldnāt handle the weight.
Sometimes. It depends why the first surgeon would be unable to do the procedure. If the problem is that the patient might not wake up from anesthesia because of problems with heart disease, lung problems, or other metabolic issues, then it doesnāt really matter what the surgeon has to say about actually doing the procedure because the anesthesiologist is the one saying ānoā. If itās an issue of too much adipose, sometimes it would mean that the surgery would take longer than itās safe for the patient to be under anesthesia.
Another possibility is that the first surgeon operates at a facility that doesnāt have access to more advanced technologies or other medical specialists in the event that something goes wrong. And there are some surgeons that are just more willing to accept the risk of a bad outcome, and I would argue that thatās rarely in the patientās best interest. There are alternative options that the surgeon should discuss with the patient as part of the informed consent process, and sometimes, the alternatives to surgery are just safer than the risk of the surgery itself, even if they arenāt as effective or are a long term treatment (ongoing) as opposed to a definitive treatment (cure). If the patient has a high risk of serious complications, up to and including death, then attempting the curative procedure might be more risk than itās worth compared to a long term medication that mitigates the disease.
Youāll see this with pregnant patients too. For elective procedures that have safer alternatives or temporizing measures (a holdover treatment until surgery is safe), those are generally preferred to putting a pregnant patient under anesthesia because of all the cardiovascular, immunologic, and other physiologic changes that happen during pregnancy alongside potential risks to the fetus.
The reason for that is that surgeons are rated based on their success percentages meaning theyāll recommend against risky surgeries.
The upside of this is that surgeons arenāt operating willy-nilly on people and will make a proper risk assessment. The downside is that overweight people have an inherently higher risk of complications from surgery, so some surgeons will pass.
Itās not because they think these people donāt need it, itās because they think itās too risky. Theyāre usually not wrong about that, you just need to find a surgeon willing to take the risk or, if possible, reduce the risk by losing weight.
Thereās also no point to surgeries if the people arenāt committed and are just going to eat even more and put the weight back on. Itās like consolidating debt to make one payment easier but keeping all the credit cards and building up the debt again. It just makes you worse off
Look. Shitty doctors exist, but when 1/3 of the US is overweight, there are underlying issues that need addressing. I only hear horror stories when an addict, alcoholic, or overweight individual in my life is feeling insecure or defensive about a prognosis. Too many people deflect and itās enabling a much larger issues. Our basic instincts are being exploited.
I have some horror stories about being a normal weight woman seeking medical care. Whatās that about then?
Americaās obesity epidemic is a function of our car culture. This is the only country on Godās green Earth that feels putting in sidewalks is a moral failure.
Obesity is a food issue, our reliance on cars and increasingly sedentary lifestyle may exacerbate the issue but itās not the cause
My mother had a doctor that refused to move forward with knee surgery because she was so depressed and refused to do therapy because it hurt her knee so much to move around.
I guess I understand, why go through the trouble of surgery if sheās just going to be a bummer couch potato afterwards and never change her ways?
But at least sheād be a bummer couch potato whose knee didnāt threaten to give out on her whenever she tried to do laundry in the basement.
If I take my car in for new brake pads, donāt refuse me service because the transmission is on its way out.
People are more complicated than cars, and surgeons are no magicians. I think your idea of the reason of your motherās surgeon for refusal might be a bit off:
-
Without adequate pre- and post-op physiotherapy, a joint will likely be worse after surgery.
-
If simple physiotherapy is already too painful, cutting into this overexcited tissue risks inducing a complex regional pain syndrome.
-
If someone suffers from both depression and from too much pain to do physiotherapy, they need a multimodal pain therapy to prepare for surgery.
So, based on the bit of info you provided, refusing surgery was very likely the right thing to do to avoid worsening your motherās situation. What I di hate is when doctors donāt explain themselves and just say āI canāt help youā, but do not point patients to someone who can.
Iām guessing thatās under the US health system, where doctors are incentivised to only perform surgeries with a low risk of complications
For a lot of doctors, the incentive to not do risky procedures is the fact that you have to live with the guilt of your patientās death, even if you did everything perfectly. Or, you do everything perfectly, but they still have a poor outcome because they werenāt healthy enough to go through the procedure and the recovery, and you get sued for millions of dollars because you didnāt spend 4 hours going through the informed consent with the patient to ensure that every single possible complication was adequately discussed.
Iāve worked in emergency medicine and Iāve had patients die in my care that we had absolutely no way of saving. The screams of their families still haunt me and I will carry those cries of anguish and loss to my grave. I would not perform a procedure that was not 1000000% necessary if the risks are too high because I have enough blood on my hands already, and I havenāt even finished medical school.
