Mrs. Pound: "I don't know... I don't have a scale at home."
Dr. Grumpy: "Okay, then let's go over to the scale. I need to know what your weight is on the drug."
Mrs. Pound: "No, you don't need to."
Dr. Grumpy: "I'm sorry, I do."
Mrs. Pound: "No, I'm not going to. A good doctor should be able to tell my weight just by looking at me."
28 comments:
Did you end up getting her on the scale!!?
Sounds like a weighty problem. I hope your scale survives it if you eventually manage to get her onto it! Maybe you should guestimate (aloud) way above what you think she weighs - she may want to prove you wrong. Or be so furious that she decides to find herself another neurologist (which is what you are probably silently wishing for ?!?)
Didn't you do a carnival rotation in med school? You know, to learn the ever important skill of guessing a person's weight?
@anon 8:26 or worked summers on the boardwalk at the Jersey Shore.
Standard proper answer for any woman is, "I guess 115" Be safe or be real freakin sorry.
My carnival doctor (the one with the big red nose) is very good at guessing my weight and he doesn't charge as much. If he is wrong I get my weight for free!
the things we should have learned in medical school !!
perhaps we need to shut all medical school and assign med students to patients like yours for "training"
ask her if her pants/dress size has changed.....or if she is now in her "fat " clothes side of the closet.....
I'm always hesitant to step on doctor's office scales, though I can see why it's done. However, sometimes the results cause the doctor to be the one spewing the stupid.
Years ago some Dr put me on a medication and I started gaining weight. Her response was, "I've heard that this drug can make you eat more" and dismissed my claims that I wasn't eating any more than I had been before starting the drug. (Actually, it made me extremely groggy and nauseated, I was eating *less* than before.)
I spent an hour looking through medical journals (MAN! do I miss working for a University and having free access to the best of 'em) only to discover that a known side effect of the med was an increase in insulin resistance (which promotes weight gain). There were all sorts of warning not to give this drug to diabetics!
(I got off the damned drug and changed doctors.)
Anyway. When doctors use the scale as a tool to find problems, that's fine. When they use it as an excuse to do bad medicine, you become resistant to wanting to step on the damned things.
I like the fact that you mentioned Fukitol. I take that on occasion. ;)
Tell her that you are the kind of doctor that cannot guess her weight, but you will be able to recognize at 30 feet the distended neck veins and shortness of breath when she goes into CHF. TCG
Women are so often judged by their weight, and people are stigmatized for their body size and shape. She was sending signals about humiliation and embarrassment.
There are several ways medical offices can help with this. One is to have the scale in a room with a door that closes for privacy. Another is to assure the patient that the person taking the weight will simply write it and won't state it verbally. A third is to ask the patient if a staffer of the same gender is preferred to take the weight measurement.
And that exchange is an invitation to a conversation about body image, self esteem and a referral to nutrition counseling.
I feel badly for her.
"I can't do that, but I can guess your age just by listening to the sound of your voice."
There are days I run around my hospital with a magic wand. Is that unprofessional??
you need a really big scale under the examining table- calibrate it so that it subtracts the weight of the table.
alternatively, at the vet's I always get my dog to go on the scale by holding out a treat... I was going to say that your patients are too sophisticated to fall for a simple ruse like that... but maybe not all of them.
When we were dosing aminoglycosides my pharmacokinetics professor stressed that we actually obtain an accurate weight. I've developed a very good eye over the years.
Does she also expect her gyne to know her pap smear results without pulling out the stirrups and speculum?
This lonely lady seems to need a knight on a white charger more than a doc in a white coat charging her.....
translation: GAINED!!! lol
I always tell patients my crystal ball is at home in the dishwasher, so no, I can't read your mind today.
Nice!
Women (and I am one) can be ridiculous about their weight. While I understand that the temptation is to pretend your weight written on your driver's license at 16 is there for time eternal, your medical real actual weight changes and is an important indicator of your level of health. Lying about it can be dangerous. Particularly if receiving meds dosed per kg.
Which is why I prefer for patients to be weighed with an accurate scale and a trained witness.
As much as I'd like to make fun of her, because she's jeopardizing her health by refusing to be weighed, as a woman I understand where she's coming from. Weight is so much more than just body mass when you're a woman. It's your image, your self-esteem, and it's a lens through which everyone views and judges you.
Still, this woman was at a doctor's office, not on a date. Step on the damn scale and don't look at the numbers.
"you need a really big scale under the examining table- calibrate it so that it subtracts the weight of the table"-C
It sounds like you might be joking, but that's actually not farfetched at all. I've had my weight taken against my will and withot my knowledge during every one of my stays in a variety of hospitals, and this is essentially how they do it. Modern hospital beds (in the US, at least) apparently incorporate a scale.
Neurology is not my armchair field of specialization, but I'm going to assume it's similar to most specializations (because I have delusions that enable me to do so) in that it's not really common that a precise weight is actually required to perform imaginary medicine. So Grumpy, Pissy & Ed could theretically get away with investing only 16 bazillion dollars to equip a single exam room with a scale bed. Put the pregnant/psychotic/anorexic patients in that room.
The problem is not always that the patient doesn't want everyone to know their weight. It's that they don't want anyone to know their weight.
I like how this woman thinks! LOL
I hate these kind of weigh ins. I call them the "Seroquel Weigh-Ins". I am 20lbs. overweight and I am always waiting for a reprimand from the Dr. when I get off the scale.
Fukitol! Love it!
Oh but we learned to make accurate guesses on horse weights while I was in school because, as our clinicians reminded us, in private practice most vets do not have horse-sized scales. I'm quite good at horses, dogs, and cats as a result which is very helpful since we do dose most meds by kgs and I don't have a horse scale and I do have a few patients who want to eat me rather than be examined.....
sooo did you get her on the scale, or didja guess it?
This is just like the woman who wanted me to diagnose mammary cancer just by glancing at her dog.
If you're big enough to be ashamed of your weight chances are no one else really cares what the scale says.
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