OBGYN Practices Refuse Obese Patients. Should You?

May 18, 2011

Some obstetricians are turning away obese patient, wary of the higher risk of complications and about the safety of patients on their exam tables. Radiology struggles with similar issues. Is it time to set limits?

Some obstetricians are turning away obese patient, wary of the higher risk of complications and about the safety of patients on their exam tables.

According to a recent article in South Florida's Sun Sentinel, 15 out of 105 OBGYN practices polled by the paper have set weight cut-offs for patients.

Certainly, obesity is a concern for radiologists, too. Quality can be compromised when imaging obese patients, whether in X-Ray, CT or MRI.  Plus, some patients simply can't fit into standard equipment, creating workflow problems and questions about when to invest in newer, larger apeture equipment. Toshiba, GE, Seimens and others all have released equipment with larger apetures and made to support heavier patients.

A 2004 study reviewed radiology reports filed between 1989 and 2003 that were labeled as "limited by body habitus," meaning limited in quality due to the patient's size. The percentage of limited reports nearly doubled over the 15-year period, from 0.10 percent in 1989 to 0.19 percent in 2003. As the population grew more obese, imaging problems grew, too. And obesity is certainly an even bigger factor now than it was in 2003.

New research is being done on how to improve quality imaging for obese patients, including this study about forgoing contrast agents in appendix CT scans of patients with abdominal girth of  105 cm or more.

While research and evelopment continues, radiology practices are left making hard decisions about risk and investments.

Does your practice limit obese patients? And where do you set the limit?