Health care and fatties. It is time to start listening.
Picture: Craig Borrow Source: Herald Sun
Today in the Melbourne Herald Sun, an incredibly brave woman Amanda Bell spoke out about the treatment she had received in hospital because of her weight.
Amanda (who has a medical condition which has caused her to be obese) described in the article how she was told by a member of the nursing staff to get her ”lazy fat arse” out of bed to have a shower.
The point of this post is not to go into detail about Amanda’s case. I wasn’t there, I have never spoken to Amanda and the hospital has conducted a review and said that the care was appropriate.
But I do think that Amanda should be applauded for speaking out. Because that is not easy.
The vast majority of people who percieve that they have been treated unfairly or inappropriately by their health professionals DO NOT SPEAK OUT. Most are too ashamed and embarrassed to speak publically about their experiences.
Instead, many people just stop going to the doctor - including for essential preventative health services like breast exams, prostate exams, and cervical smears.
Some have internalised the stigma they receive on a daily basis so much, that they even believe that they deserve to be treated badly by the people around them – including their family, friends, colleagues, and health professionals.
And who can blame them. Here are a few of the comments that were directed towards Amanda on the Herald Sun website:
Jac of Victoria: Ms Bell – if you help yourself, life will be much more pleasant for everyone that shares your life – including other patients and nursing staff. As a regular hospital patient for a genetic disorder – I’ve had to share space with patient’s like yourself and it impacts on my stay and care.
Elle of Warragul: OK, I feel sorry for this person if she was belittled, and that isn’t acceptable. However, try looking after anyone of that size. She weighs 220kg. How much weight is a nurse to lift? How many staff or what equipment is available to help? ….. Looking after obese patients adequately is a nightmare, with pressure care and hygiene very difficult to provide.
Jagger of Melbourne: “She decided to speak out because she wanted to prevent others being treated the same way?” What did she say, “Don’t CHOSE to become morbidly obese”? If so, good on her! If she said anything “Be nice to masochists who chose to become so disgustingly unfit that taxpayers must pay to hose them down, because they are precious snowflakes”, then I say fly her to Rwanda. Only western nations suffer obesity. You don’t see South Africans waddling down the supermarket hours, “suffering” from such a terrible affliction like obesity, crying out for society’s “understanding”
Doctors have been recently been told to pull no punches in bluntly telling their patients that they are fat and advising them to take part in commercial diet programs. Just a few weeks ago it was reported that British Doctors are not only financially incentivised for keeping lists of their obese patients, but would reap extra financial rewards for telling them to lose weight by joining commercial slimming clubs. Apparently, this is a successful way forward because according to the studies quoted in the article people who join these clubs lose more weight over a 12 week period than those who go it alone.
Obviously a serious case of Policy Makers: 1 vrs Insight and Understanding: 0
But I digress.
In other cases, doctors are just not prepared to listen to experiences. I gave a talk a year ago where a Professor stood up and stated that the research I was presenting (on how fat people felt they were stigmatised by their GPs) was unhelpful because in his words “I don’t think talking to highly stigmatised groups is that useful in informing policy and health care services”.
In 2003, Schwartz et al published a paper on the implicit weight bias of health professionals. Their results showed that:
Health professionals exhibited a significant pro-thin, anti-fat implicit bias… In addition, the subjects significantly endorsed the implicit stereotypes of lazy, stupid, and worthless.
Interestingly, those health professionals who had lower levels of implicit anti-fat bias were male, older, and who indicated an understanding of the experience of obesity.
No matter what you think about fat people, how they got to be fat, or what they should do about their weight, they deserve the same treatment as any thinner person within the health care system.
So here is what I think. Fat people should continue to be brave and speak out about their experiences. Not necessarily on the front page of the Herald Sun, but through other forums – blogs, twitter, in studies etc. And this includes not only the bad experiences, but the good experiences too. Frances at Corpulent has started the All Bodies Directory, where you can go and share the contact details of a health professional you thought was fat friendly.
More importantly, Health Care Professionals need to start LISTENING to these experiences.
Because surely you want a good relationship with your patients too?
Themocracy
Thank you Samantha. Some of the worst fat-hatred and bullying I have ever received has been from the very people I was paying to take care of me. I’ll say that again…
From the very people I WAS PAYING to take care of me.
Number 1. Where possible (and I acknowledge it’s not always possible to change providers), do not give a doctor or any other health care provider your money if they shame, belittle or bully you about your weight. That includes your tax money, in the form of Medicare payments.
Number 2. Doctors and other health care providers are people. Never forget that. They are not Gods, nor are they some kind of boss of everyone else’s world.
Number 3. You have every right to speak up if you are not receiving respectful, compassionate treatment.
Number 4. Even if you are somehow directly contributing to your ill health, you are still a human being who deserves basic respect and dignity.
I recently read a wonderful quote on the bottom of a fellow FA activist, Terri Weitze’s email, which I would like to share with you here:
“When our caregivers don’t listen to us, don’t believe us, don’t hear us, we are not receiving medical care. We are receiving veterinary care.”
I agree with Terri that if I am receiving veterinary care, I reserve the right to bite and pee on the vet.
“‘When our caregivers don’t listen to us, don’t believe us, don’t hear us, we are not receiving medical care. We are receiving veterinary care.’
I agree with Terri that if I am receiving veterinary care, I reserve the right to bite and pee on the vet.”
This is the best thing I have read all day. I want to quote it everywhere.
Kath your last sentence made me laugh, I would like to see that.
lol
This sort of thing makes me so angry I want to cry and reading this I nearly am. Thank you for being a shining light Sam and helping to encourage fat people to speak out against the apalling way they are treated in society, including the health profession.
As a health professional myself it makes me sick to think that not everyone is given outstandingly good care, especially in instances like this. It’s not ok. It’s not on.
Julie you are right it not ok and it’s not on. Glad that you are a health professional doing the right thing. thanks
While I’ve received terrible and biased healthcare in the past (including at Monash Medical Centre), I just wanted to say that the care I’ve had over the last year at Geelong Hospital has been absolutely magnificent. I’ve been having a series of treatments (from surgery to radiation and lots of scans) and interacted with many kinds of healthcare professionals and all of them have been wonderful. That should be the standard.
A brave woman and obviously smart enough to know that her treatment or mistreatment is not acceptable. It shits me that it is even necessary to speak up about something that should be every persons basic human right. Medical care is not just for those who fit a certain demographic.
And Sam I am really pissed off to read about that professors comment. Who the hell is he? What a bloody drongo. Who better to inform policy than those experiencing the discrimination?
Gee it makes me wonder what the heck goes on in some peoples heads.
Luckily I found two fabulous doctors in August last year and am so grateful for the care they give me, over and beyond what I would expect.
It is SO great when you find docs that support you. It feels like such a win!
Hey Dan how are you? I am so happy that I found these two doctors. My mum was dying and my sister went to a new doctor pleading to visit me at home as I was not too good. She came and continues to share the care with another doctor who visit me monthly in my home. I wish I could share with others in similar positions. They do not judge, actually listen to me and do tests, treat each problem that comes up. Sorry for blathering, I can talk a lot.
The research I have just finished looked at the experiences of fat women in General Practice. I have presented my work at quite a few conferences over the last few years, and have had really mixed responses from GPs and other medicos.
At one GP conference I presented my preliminary findings, focussing on the fact that fat women felt that they recieved negative body commentary from their doctors which was innapropriate and frquently hurtful, which in turn created a space where they felt very unsafe. I was SO nervous presenting this work – particuarly as a nurse – however after I finished one GP stood up and thanked me and then started a great conversation about the ‘right’ way to ‘manage obesity’ in clinical practice. Whilt some of the focus was not what I was referring to, it was an excellent conversation and people there were genuinely interested in hearing ways that they could talk about weight.
At the OPPOSITE end of the spectrum, I presented a poster at a very big Australian conference, and a Prof of Emergency Medicine approached me. He looked at my poster (it contained a large picture of a woman about a size 18 having the pinch test)and read some of the findings, which concentrated on the fact that women feel that they have to develop a range of strategies which they employ in order to manage the stigma they experience as patients.
He then stepped back and said ‘in my experience, all fat patients lie’. And I said ‘ok – what do you mean’ and he said ‘well let’s face it, you’re fat because you’re lazy or you eat too much. It’s that simple’. I was really taken aback so I just said ‘well that is one way of looking at it I guess, but I think what you just said is one of the problems that women experience’.
He then just raised an eyebrow, and went to walk off. However as he did he tured around and said ‘so is that you in that poster’ and then just left. BOOM!
Crikey Dan I would have put my foot out and tripped the drongo over. God where does he get his attitude from?
Obviously he has a far bigger problem than many of fatties do.
He certainly does! I forgot to add that I am NOT a size 18, and the woman in the poster very clearly kilos lighter than me!
[...] read this post from Dr Samantha Thomas over at The Discourse and I must say, while I’m absolutely disgusted [...]
Great piece. V interesting that older male docs most empathetic. And this is key. My mother has now had two different older male docs speak to her with great empathy about weight, and they both talked about their own struggles. It made all the difference to mum, took away the huge shame.
Michelle (mamabook)
[...] Samantha Thomas at The Discourse wrote about the article covered in the Herald Sun regarding Amanda Bell and the treatment she [...]