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The doctor-patient relationship suffers when I call my patient fat

I have orchestra rehearsals on a Wednesday evening and I sit next to the French horn player, Jim. He is no shrinking violet and delights in referring to me as a medical student because ‘you still haven’t qualified yet’ – the vagaries of GP training are purposefully lost on him.

Jim was a little perturbed when he arrived at rehearsal last week. He demanded to know why his GP keeps bullying him about his weight – ‘she obviously thinks I’m a fat bastard’. Jim will no doubt be delighted to read the recent report from the Academy of Medical Royal Colleges (AOMRC) entitled: Measuring Up - the medical profession’s prescription for the obesity crisis. The title on its own takes them over their pun limit.

The authors suggest that, not only should a GP be addressing patients’ weight at every opportunity but that it is incumbent on the doctor to set an example. This seems to suggest - in fact, it does suggest - that overweight doctors are a bad example to their patients.

The authors acknowledge how difficult it is for obese patients to seek and make change, but that logic does not seem to be extended to doctors.

I was struggling to get ‘ideas, concerns and expectations’ into 20-minute appointments, during my ST2, so I don’ t think I can cope with people adding more components to my consultation. I agree (and who wouldn’t?) that it is important to deal with obesity, but I can’t help but feel that the doctor-patient relationship might suffer if, every time an overweight patient visits the surgery, the problem is brought up.

As for setting an example, I am hoping that myopia, pes planus and early male pattern baldness aren’t contagious - otherwise I really am a bad doctor.

What does this all mean for Jim? Well, I guess he’d better get used to his doctors telling him that he’s a fat bastard. In 18 months’ time when I eventually ‘qualify’, it sounds like the AOMRC wants me tell my own Jims the same.

Chocolate, anyone?

(Some names have been changed to protect the guilty).

Dr Michael Kilshaw is an ST2, living and working in Cheltenham. He can be found on Twitter @docmike79.

Edited, 19 March, to note the fact it is the Academy of Medical Royal Colleges and not the Association.