Over 600 bariatric patients were asked, “In thinking about how doctors treat their weight loss surgery patients, what do you wish your doctor would have done differently?” Their responses reveal that we have many opportunities for improvement, and little details make all the difference.
Physician Sensitivity is Critical to Patient Satisfaction
The bariatric population is a special one; after years of being exposed to stigma and discrimination, many patients are emotionally raw and sensitive. As a physician, if your goal is to achieve the best outcome for your patients and your practice, try implementing these small steps to make sure your patients feel comfortable.
Choose your words carefully.
Bariatric clients are especially sensitive to language. After enduring years of jokes and jabs, they critically analyze conversations for hints of negativity or judgment. Therefore, how you word a statement may make the difference between bonding with a patient or pushing them away. Choose descriptors and adjectives that have a more positive connotation; avoid anything that has a negative thrust. For example, describe something as “oversized” or “extended” as opposed to “giant” or “huge.”
Select credible and approachable staff.
A young, attractive, super-slim nutritionist who has never had a weight problem will be viewed as less credible than an experienced staff member who can share real life experience and advice for dealing with the challenges of weight loss. Most bariatric patients report feeling comfortable when there is at least one person who works in the office who is also overweight.
Meet new patients in your office first, then take them to the exam room. Look your patients in the eye. Talk carefully about their health history and ask questions empathetically. Offer to answer any questions and ask if there is anything they do not understand. Often, a little encouragement will give your patients the confidence they need to ask questions they have. One WLS patient explained, “My surgeon sketched a picture for me of what exactly he was going to do. I know I had previously seen diagrams of the pouch, etc. … but it really helped me to understand visually as he was explaining things.”
Have appropriate and comfortable equipment.
Furniture for bariatric patients should be solid, sturdy, comfortably-sized, and safe. Select equipment and office tools that are appropriate for this population for every area of your office your patients will go. One bariatric patient wrote: “Did you know that I purchased my own weight extender for the standard bar slide scale that most doctors use. The cost? Around $60. Even if I’m your only ‘oversized’ patient, isn’t my health and well-being worth $60 to you?”
Develop scale sensitivity.
Invest in a bariatric scale or equipment that allows your scale to accommodate overweight patients, weigh the patients in a private area, and never, ever yell out a patient’s weight to other office staff members. A recent WLS post-op wrote: “Scale sensitivity would be a plus not just for bariatric offices but for all offices. Last week I got on the scale and the nurse yelled out, ‘225 pounds.’ I teach in a small town and one of my students was in the waiting room, so now all my students know how much I weigh. Just weigh me and write it down in the chart, thank you.”
Don’t send mixed messages.
You can’t get away with saying “I really care about your difficulties with weight and I know how hard it is for you” when you have posters of nearly-perfect models all over the place. Make sure your staff, office dÃ©cor, and imagery reflect caring and consideration. Case in point: a bariatric client went to a physician’s office and reported the following: “When I went to my doctor’s office I already felt like a cow. I looked around and saw all California beach blonde types. This made me know they had no clue; they had no idea what I had experienced, and I felt fatter and more uncomfortable.”
Train your staff to do the same.
As you are not likely to be the first person your patients encounter, your entire office needs to be trained to be sensitive in the ways described. Most patients report that their first impression of a physician came from his or her receptionist. Therefore, we must make sure everyone in our offices understands that every patient is our concern, that no patient should be ridiculed or treated as unimportant.