Letters to the Editor - July 18, 2011

Patients don't choose to be obese

Regarding: "Should doctors ever turn away obese patients?" (Article, May 30): The medical prejudice against obesity, like other biases, arises from ignorance.

Obesity is far from being the volitional disorder that many medical professionals believe. Nobody in a modern Western society chooses to be obese. Once the obese state is established, the body vigorously defends against negative energy balance via multiple dysregulated systems.

No matter what one believes, the indignity perpetrated on large patients by making them stand during visits or covering them with sheets instead of appropriately sized gowns is inexcusable; the damage to a patient's self-esteem only makes the situation worse. It degrades our profession.

Finally, remember that unlike many cancers, obesity is currently incurable. It can be treated and remediated, but it cannot truly be cured.

--Michael D. Myers, MD , Cypress, Calif.

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Halt and rethink the burdensome maintenance-of-certification process

Regarding "Abolishing burdensome regulations" (Editorial, May 2): With respect to regulation, we are our own worst enemy.

How can we complain against the burdens placed on us by government and insurers without similarly tackling the intrusive, costly, time-eating, and often irrelevant new maintenance-of-certification process?

The process is supposed to make us better physicians, but where is the proof that it does so? Our AMA should demand a halt to the process until its worth can be proved. It should do so until a simple, low-cost, online, relevant system can be put in place.

--Joseph Zanga, MD , Columbus, Ga.

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