The weight of defensive medicine in South Florida

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Ob-gyn doctors in South Florida are engaging in some ethically questionable defensive medicine practices by refusing to see pregnant women who are obese. In a poll by South Florida’s Sun Sentinel, 15 out of 105 obstetrics-gynecology practices admitted to setting weight cut-offs for new pregnant patients, beginning at 200 pounds or based on their body mass index (BMI).

So why have some of these offices become more discriminatory? Most said the decision was made due to the inability of their exam tables or medical equipment to handle people above a certain weight, while others said the risk of complications associated with these patients is too high.

“There’s more risk of something going wrong and more risk of getting sued. Everything is more complicated with an obese patient in GYN surgeries and in [pregnancies],” Dr. Albert Triana, whose office refuses obese patients, stated.

While the doctors who have adopted such policies assert that this practice is not overtly unprofessional, some experts in medical ethics say it violates the principles of the medical profession and consider this policy unethical.

ACSH’s Dr. Elizabeth Whelan is sympathetic to the doctors who are faced with making such decisions, however. “These professionals do have to protect themselves against much frivolous litigation, especially in that region, and I don’t blame them for referring these particular patients to other specialists instead.”

“This is another clear example of defensive medicine,” says ACSH's Dr. Gilbert Ross. “By denying patients treatment based on their weight, you’re limiting their access to care, which only further burdens our health economy. Eliminating such policies in the future could be aided by effective tort reforms.”

ACSH"s Dr. Josh Bloom adds, “It is unfortunate that pregnant women today are suffering the fallout from the greedy behavior of predatory lawyers, who took any ‘imperfect’ baby in front of a jury and got huge awards. Independent of the weight issue, many doctors have dropped the OB part of their practice entirely, and with good reason: A 2003 study in Massachusetts found that 76 percent of ob-gyns have been sued at least once in their careers, compared to surgeons (15 percent) and internal medicine specialists (4 percent). Are we really supposed to believe that 76 percent of the ob-gyns in this country are incompetent? Please.”