Patients weighing 204 kg or more face barriers and discrimination when scheduling or attending appointments with specialists, according to a new Northwestern Medicine study.
Using a secret shopper method, researchers attempted to schedule appointments for a hypothetical patient weighing 220 kilograms at practices in five specialties (dermatology, endocrinology, obstetrics and gynecology, orthopedic surgery, and otolaryngology) in four metropolitan areas (Boston, Cleveland, Ohio, Houston, and Portland, Oregon). Each hypothetical patient was able to walk and did not require assistance getting on or off the examination table.
The researchers wanted to find out if the clinics met the basic standards of care for bariatric patients. In their view, these include an examination table or chair with a sufficiently high weight limit, waiting room seating, sufficiently wide hallways and doors, and gowns that are large enough.
Breakdown of results:
Of the 300 clinics studied, 52% lacked basic care standards, and 41% refused to schedule an appointment. Otolaryngologists (ear, nose, and throat doctors) were the least likely to schedule an appointment with the patient (only 48.3% scheduled appointments, compared to 59% overall). This was despite researchers providing information during the appointment scheduling that strongly suggested the patient had cancer.
Only 117 practices (39%) were fully accessible according to the study, with endocrinology practices being the most likely to schedule appointments and meet basic care standards.
An additional 16% of practices in the study that were willing to schedule the patient had a non-standard treatment plan that included workarounds for limited accessibility. For example, patients were told they could come to the clinic but would have to stand during the examination or cover themselves with a sheet because there were no gowns that fit.
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