Risk Management Tip: Safely Caring for Patients of Size in the Office Practice

MLMIC Risk Management Tip #7 addresses medical professional liability risks related to “Safely Caring for Patients of Size in the Office Practice.”

The Risk

Obesity continues to be a serious health issue in the United States. Physicians’ offices may not be well equipped to accommodate patients of size. Injuries can occur if appropriate equipment is not available to accommodate them. Further, bias or ambivalence by healthcare professionals in treating obese patients can negatively affect patient care and lead to poor outcomes. Providing a safe environment, while optimizing sensitivity to the needs of this patient population, will enhance patient care and minimize your exposure to claims of negligence.

Recommendations

1. Examination rooms and waiting areas should include appropriate and safe furnishings, such as large sturdy chairs, high sofas, benches, or loveseats that can accommodate patients of size and visitors.
2. Diagnostic and interventional equipment that can accommodate morbidly obese patients should be available. This may include, but is not limited to:
   • Appropriate scales for patients who weigh more than 350 lbs.
   • Extra large adult-sized blood pressure cuffs
   • Gowns to accommodate patients weighing more than 350 lbs.
   • Extra-long phlebotomy needles and tourniquets
   • Large examination tables
   • Floor-mounted toilets
   • Sturdy grab bars in bathrooms
   • Sturdy step stools in examination rooms
3. The office staff should be knowledgeable about the weight limits of their office equipment. Color coded labels can be used to discreetly identify weight limits.
4. The office staff should be educated and trained in techniques for safely assisting and transferring patients of size.
5. Although patients of size may face many additional medical issues, they are less likely to obtain preventative care and more likely to postpone or cancel appointments because of embarrassment and/or a feeling of bias on the part of healthcare providers. Patient support and follow-up are important.
6. Healthcare providers should assess their own potential for weight bias. Recognize any pre-conceived ideas and attitudes regarding weight. Give appropriate feedback to patients to encourage healthful changes in behavior. Encourage patients to set goals and actively participate in their plan of care.
7. Educate the staff about treating obese patients and the needs of this patient population to enhance their ability to demonstrate understanding, respect, and sensitivity.

This MLMIC Risk Management Tip is available here as a PDF: “Safely Caring for Patients of Size in the Office Practice.”