Montreal is a beautiful city, and it’s been home base for me this week as I’ve covered the International Continence Society annual meeting for a client. It’s been interesting, to say the least. There have been several major themes here, notably the need to listen to the patient and take the patient’s goals and expectations seriously, along with the inevitable jockeying for position among products and strategies.
Guess what… obesity is a risk factor for incontinence. You knew that, I’m sure you did. You’re probably living it.
But what you didn’t know is the contempt with which some of these urologists and gynecologists view us. One young woman physician from The Netherlands presented a poorly designed study of risk factors for incontinence among women, and included cartoons of obese women in her presentation. Not only did she think them appropriate, she also concluded that ‘women need to take charge of their health,’ which she used as a euphemism for ‘stop smoking and lose weight or else.’
Isn’t consulting a physician when you’re ill considered ‘taking charge of your health?’ Not a single word about how she could help the situation, of course.
There was another poster, a floor display, that featured a cartoon of an obese woman as the background. The findings once again noted – as a single line item – that obesity was a risk factor. That single line item finding made up the entire design theme.
But perhaps the worst was the distinguished British physician who stood up and proclaimed that ‘obese people scared him,’ that ‘every time he had to examine one, he wasn’t sure that he’d get his hand back,’ and that the process was just ‘too difficult.’ His comments were met with laughter and agreement. Not a single word about developing techniques that would make the process comfortable and respectful for all parties. Nothing about having special equipment to make the obese among us comfortable, and to obtain the information needed to make the right diagnosis.
Now, I’m sure that there were physicians in this group who disagreed with these views, yet they were silent. There’s no real reason, of course, for them to speak up in this forum.
But I’m leaving you all with the warning that we have to be very, very careful with our medical care. It’s all too easy to find physicians who will treat us with contempt, who will not take us seriously, and who will make no effort to help us. Contrary to the conference theme of listening to patients, a significant proportion of them will turn their backs on us, and be pleased that they upheld their so-called principles.
Brains aren’t enough. Compassion and sensitivity need to go into the mix as well.