My primary with my HMO was an RNP (Registered Nurse Practitioner), but she went toIraqa couple of years ago (Reserve) and has not returned (folks at the HMO tell me she’s doing fine, but they don’t know when she’ll return). So I chose another RNP. From time to time, she would order blood tests, I would go to the lab, and the results would come in. I never met the woman face-to-face.
OMG. Now this woman is self-admittedly “overweight” (her choice of words, not mine), and yet she is one of the most fat-phobic, weight-centric medical professionals I have had the misfortune to run into in a long time. Let me repeat. OMG.
She had me come in because my HgA1C has (finally) crept up into the diabetic range. Okay. I can deal with that. Diabetes is a condition that is treatable.
However, her explanation for everything going on with me is my weight. Not my age, not the hormones I was taking for 6 months, not the other prescription drugs I am taking, not my recently diagnosed sleep apnea, not my torqued pelvis. The answer to everything is lose weight.
I told her I was not willing to make weight loss a focus. I was not willing to diet. I told her, basically, what my husband told his doctor: I will focus on what I can control – my behavior; I will not focus on what I cannot control – how my body will react to my behavior. Her response was to try to make me promise that the next time I came in I would not have gained another pound. I told her no, I will not make that promise because, as I already had told her, I had experienced significant unexplained weight gain over the lest several months (her explanation for that was my metabolism must have changed – well possibly, but why?).
She would not admit that diets don’t work, and she kept saying she’s not talking about “diet” anyway – she’s talking about food choices – calorically reduced food choices to promote weight loss. Hello? Do I have stupid tattooed on my forehead?
As you can imagine, the sparks flew. We were together for an hour (the HMO only allocates about 15 minutes per visit), most of which was spent butting heads.
She kept telling me her own experience with her weight – which apparently has not been good, she has bad knees and hypertension. I explained that that was not my experience, that I was not her.
She also kept telling me horror stories of other patients who were “saved” by weight loss. I kept asking what would happen to those people in 5 or less years when they were fatter than ever? I also asked her if she thought it might possibly unethical for a healthcare professional to recommend a treatment with a 95% failure rate. (OK, low blow, but by then I felt like I was fighting for my sanity; and besides, low blow or not, it doesn’t make it an invalid question.)
When I left, I knew her weight, her husband’s weight (!), and the fact that the guy who cleans her house and does her yard work, who is a runner and quite lean, was trying to lose 20 pounds before his next race. I asked if she had pointed out to him that that might not be very healthy for him.
What I didn’t know was why the recent weight gain, when I should be using my glucosometer (my fingers are feeling and looking like a pin cushion), and what do the readings I’ve accumulated mean. I did not have a good blood pressure reading – because when using the machine, I get a reading that is about 20 points too high and she didn’t take a manual reading as I requested.
We had “agreed” that I would up my amount of exercise, that I would have referral to physical therapy for my pelvis (it was a battle to get that), and in 3 months I would have my blood taken and see how my body is doing. By “agreed”, I mean, I told her this is what I would like, and she complied (unhappily).
When I left, I knew that she was not about to change her approach to healthcare. She obviously had no interest in listening to what I had to say about my own body and had no respect for anything I could bring to the table.
Now, I have always advised people to get a new doctor if their current doctor is fat-phobic, weight-centric (you know, everything this RNP is). But I felt like if I fired her and chose a new primary, somehow she would “win”.
But after a night of worrying about it, I realized, if I keep going to her, I lose. Because it’s my health, and my wellbeing at stake. So I followed my own advice. My HMO lets you change doctors online, and you can read each doctor’s professional and personal bio. I chose a new primary, and sent her an e-mail letting her know what I am looking for; and you know what, if this isn’t a good match, I’ll keep looking because I am worth it.