Rodney Dangerfield
Update. 1/22/2010. I have received a few strong comments to my messages on obesity. A few pharmacists have accused me of being insensitive and mean. One woman RPh called me a dick. Linda Bacon, who I quoted, sent a long letter denying the statistics I used. My source is impeccable, by the way. What I wrote was threatening and that is good. A woman who is five foot two and 300 pounds is in a dismal situation no matter how much propaganda is out there. They may smile at the pharmacy counter, but there are gallons of tears on pillows every night.
My most recent JP at Large column in Drug Topics was on the growing menace that obesity presents to our country. The CEO of The Cleveland Clinic will not hire smokers and would not hire obese people if he could get away with it. 67% of Americans are overweight or obese. Women are 20 pounds heavier than they were in 1978. Diseases associated with obesity drain $150,000,000,000.00 a year. That is $50 billion more than cancer.
Of course, I had fun. You wouldn’t read it if it was just statistics. I referred to Fried Twinkies. I accused fat pride promoters of revisionist propaganda. I said that obesity could be a death sentence.
I also suggested the idea that some pharmacists might see an increase in Rx business once the coming health care changes insure everyone, including fat people who are uninsurable right now.
A good friend, from my childhood, is a school psychologist. I shared this column with him. He suggested that I was insensitive and that I should not be dealing with such subjects. He said that I should not be treading where I did not belong.
I had a huge problem with that. I wrote back and told him that I have been a well-educated, qualified and competent health professional for over four decades. I told him that this is exactly what I should be doing with my bully pulpit.
I told him that I was insulted that he apparently saw my lifelong professional job as one of a pill pusher. He was showing enormous ignorance. The pharmacist, I argued, is in the best spot to deal with this national problem. We are at the bottom of the funnel. We often have friendly relationships with patients. We can casually break the ice. Talk about it. Most pharmacists know exactly what an obese person needs to do to save her life.
The doctor will give the rote message, “You could lose weight, Brenda.” At the same time that he is writing 8 prescriptions to treat the symptoms of the comorbidities of obesity. That’s it. Brenda is left twisting in the wind.
Back to my friend. I told him that I would never, ever presume to even comment on his professional choices when he tested a child and found the kid to be ADHD.
That is not my job. Not in my bailiwick. I am a casual observer of what he does and would never criticize his choices. I expected that same courtesy from him even though it was very clear to me that he had marginal respect for me, what I do and the profession of pharmacy. I have heard from him many times since, but not one word on this.
Now, whose fault is it that my friend, and probably the majority, look at us as modern Mister Gowers? It is not my fault. I tell anyone who will listen what pharmacy is really about. When medical care is 90% Rxs written at the end of the office visit, why do we have such a back seat position?
I say that it is the APhA’s fault. They have the name, grandfathered from when they really did work for us. I say that it is the APhA that needs to get its ass in gear before all of us lose ours.
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The simple fact is that OBESITY, FAT is the greatest CAUSE of health problems that this country faces. That FAT LADY riding that electric cart up to the pharmacy window inside Wal-mart to ger her 15 prescriptions filled is not suffering from HBP, diabetes, heart failure, back problems, knee problems, and clogged arteries. Her problem is being too FAT. This means she is EATING TOO MUCH and probably TOO MUCH OF THE WRONG foods. For the life of me, I cannot see how this country is going to be able to afford medicare and medicaid. The FAT people are going to break the system.
You may have noticed that I said FAT instead of OBESE. I am making a point. I am being politically INCORRECT. Your psychologist friend probably thinks it is politcally incorrect to tell his depressed obese patients that the cause of their depression is eating too much and being too FAT. Maybe pharmacies should be the bully pulpit promoting a better lifestyle for the overweight customer. Yes, throw out the tobacco. Throw out the liquor. Throw out all that diet crap which does not work. Put up some signs about obesity. Put out some literature on how to lose weight. You are right Jim…we can be at the forefront. However, for a lot of us there is one BIG problem. We work for those big, bad chains. First, we are going to have to get our message to those chains. In fact, this might be an opening for us pharmacists to begin a dialogue with our employers.
I am with you Jim. Where do I sign?
JP, if by menace you mean the biggest drain on the American health care system then yes, obesity is a menace. It must be priority one for this country to reverse the obesity trend if we as a nation have any hope to get healthier.
As for the APhA, they seem to be more worried about MTMs than anything else. But it’s good to know we will be able to bill for all those consults with patients twice the weight they should be right? Forgive me for not being excited.
People talk about being Carbon neutral. How about working on calorie neutral first? Maybe that snickers bar would not be so interesting if it meant an extra 15 minutes on the elliptical bike.
It’s all about self discipline and personal accountability. Things that we lack in our culture and many parents fail to teach their children. I applaud all health professionals that take an active role in telling people the truth.
Two years ago my doctor chose to tell me I needed to “breath hard and sweat 30 minutes a day - every day” rather than telling me to take drugs for cholesterol and blood sugar. 6 months later my blood tests were normal, blood pressure was down and lost 15 pounds. I am healthier than I have been in a long time. That is what healthcare is all about. (sorry that the pharmacy lost the business… I still buy vitamins though).
Why do you assume he was saying that because you think he doesn’t respect you as a professional pharmacist? you can be a pharmacist and still be an insensitive a-hole towards fat people.
If presenting the statistics and suggesting that people who are now uninsured because of obesity can break the health care bank
when universal health care come saround.. I am an insensitive a-hole. Doctor Delos Cosgrove, the CEO of The Cleveland Clinic had to
apologize for his insensitivity.
However, he made it very clear that he was taking nothing back.
Obese people are going to have to “get it”. Obesity leads to all sorts of health problems. Obesity kills! Sensitive or insensitive…don’t we have to get across to our patients that there number one goal should be to lose weight? At the rate things are going, the obese people will bankrupt the whole healthcare system. Why should you or I pay for insurance for someone that eats like a pig?
Honestly, without treating type 2 diabetes (obesity), where would we be? I bet I would fill 50% of the prescriptions that I do now. It’s too bad that it’s a health condition that is good for our profession.
Self-control is a behavior that can’t be prescribed. My favorite is the patient that comes through the drive-through with a biggie size meal (eating it while talking of course) and picking up her Lantus 100 units BID. It’s working great for her though! Denial and laziness are powerful emotions, but your friend knows all about that…right JP?