Hospital in Texas won't hire people w/BMI over 35?

[SunsFun]

Age is a protected class in the workforce, so that argument is negated by law. I won't touch your landmine re: sexual orientation.

Sure, it is the applicant's "choice" to smoke/maintain a healthy weight/limit drinking/etc just as it is an employer's choice not to hire them for specific reasons. Just because someone doesn't like the rules laid out for a particular job doesn't mean that said rules must be changed provided they are within the framework of the law. Welcome to the real world.

Sorry those were not the best examples. I probably should have thought of some kind of behavior that is not illegal yet could be tied to higher healthcare costs. Racing maybe?

Anyway, I know the real world is not a fair place. But, that doesn't mean we should accept everything as is and not call it out when we see a problem. It really bugs me when an employer tries to run someone's life for their financial benefit. Being surrounded by obese people might suck but it would suck much less for me than being randomly tested for cholesterol, glucose, nicotine, and having my employment contingent on it.

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Members don't see this ad.

 

[Ashley1989]

Age is a protected class in the workforce, so that argument is negated by law. I won't touch your landmine re: sexual orientation.

Sure, it is the applicant's "choice" to smoke/maintain a healthy weight/consume alcohol/do drugs/etc just as it is an employer's choice not to hire them for specific reasons. Just because someone doesn't like the rules laid out for a particular job doesn't mean that said rules must be changed provided they are within the framework of the law. Welcome to the real world.

We can't combine ethics with law. History has proven that just because something is within the framework of the law does not mean it is right, which is how we can trace the changes in laws through the years as people see its wrong and needs to be changed.

 

[SpecterGT260]

This strikes me as something that could quickly devolve into a race issue given that African-Americans and Mexican-Americans are much heavier on average than other groups.

some people are trying to make it that. But luckily (so far) we have been smart enough to know that given enough variables we had to come up with a coincidental correlation at some point. It cannot be a race issue because there will be white individuals and individuals of other races that will be equally effected. And according to the stats you elude to, these whites/other races would be a minority in said cohort We cannot discriminate against them, now can we?

 

[235788]

I don't follow. Could you explain why you considered that a poor example, and what point you were making with this one? I didn't pick up on it.

nfl lineman are great examples of obese/chronic obese individuals. Have you ever seen one in real life?

 

[Marge]

Do you know what a BMI of 35 looks like?

5'3" and 197 pounds
5'8" and 230 pounds
6'0" and 258 pounds

That's big; that's not a muscle-bound weight lifter.

This is a pic I took of me. I'm 5'11" and 300. My BMI is 42. This is such a terrible law, because it unfairly discriminates against the key professional bodybuilder / physican subpopulation.

 

[deleted103644]

BMI is an awful metric. Body fat or waist size would be more appropriate (although body fat would obviously need to be tailored to males and females separately).

 

[SpecterGT260]

no way in hell guys like that would pass mandatory drug testing anyways /thread

 

[SpecterGT260]

BMI is an awful metric. Body fat or waist size would be more appropriate (although body fat would obviously need to be tailored to males and females separately).

psh.... no. 1 number gives more beer-gut wiggle room for the guys and dictates an alternative population that is easier on the eyes. Stop trying to be "fair"

 

[evanbaines]

BMI is an awful metric. Body fat or waist size would be more appropriate (although body fat would obviously need to be tailored to males and females separately).

The military has done pretty well for years with a simple height/weight/age/gender table (essentially BMI), with the option of "tape testing" those who fall outside the normal limits. A series of measurements with a $0.50 tape measure can separate the jacked from the jelly.

 

[deleted103644]

psh.... no. 1 number gives more beer-gut wiggle room for the guys and dictates an alternative population that is easier on the eyes. Stop trying to be "fair"

What are you talking about? Are you saying BMI is more relevant to health than body fat % or waist circumference?

Those are both more closely tied to disease than BMI, but are harder to measure.

 

[SpecterGT260]

What are you talking about? Are you saying BMI is more relevant to health than body fat % or waist circumference?

Those are both more closely tied to disease than BMI, but are harder to measure.

no, im just saying that using 2 bodyfat %s for men and women puts us at a disadvantage... not for getting hired, but for how fat we can be. Mostly because this thread has already run its course... twice....

 

[Marge]

no way in hell guys like that would pass mandatory drug testing anyways /thread

u miring brah?



Just kidding. I think BMI is close enough. Exceptions can be made for freakishly muscular people. Healthy doctors are better doctors.

 

[SpecterGT260]

u miring brah?



Just kidding. I think BMI is close enough. Exceptions can be made for freakishly muscular people. Healthy doctors are better doctors.

I cant help but read your posts in the voice of marge simpson... @@@@@@@
sorry

 

[Marge]

I cant help but read your posts in the voice of marge simpson... @@@@@@@
sorry

The name wasn't taken yet! Lol.

 

[TheMightySmiter]

I don't think this policy really intends to target physicians. More like nurses and other ancillary staff. There are a LOT of overweight and obese nurses, and much of that is the result of shift work. Working an odd or irregular schedule is not good for your weight. I think a better option is to include more incentive programs to live a healthy lifestyle.

 

[deleted103644]

The military has done pretty well for years with a simple height/weight/age/gender table (essentially BMI), with the option of "tape testing" those who fall outside the normal limits. A series of measurements with a $0.50 tape measure can separate the jacked from the jelly.

That's just it. BMI is an easy metric, not a good one.

 

[deleted103644]

no, im just saying that using 2 bodyfat %s for men and women puts us at a disadvantage... not for getting hired, but for how fat we can be. Mostly because this thread has already run its course... twice....

Can't be avoided. Certain aspects of female anatomy give them a higher minimum body fat %.

Guys can get down to 4% or lower without being unhealthy. Female minimum is a lot higher.

 

[Marge]

I don't think this policy really intends to target physicians. More like nurses and other ancillary staff. There are a LOT of overweight and obese nurses, and much of that is the result of shift work. Working an odd or irregular schedule is not good for your weight. I think a better option is to include more incentive programs to live a healthy lifestyle.

Like this one?

 

[SpecterGT260]

Can't be avoided. Certain aspects of female anatomy give them a higher minimum body fat %.

Guys can get down to 4% or lower without being unhealthy. Female minimum is a lot higher.

johnny... I dont think you are picking up what I am putting down....

 

[evanbaines]

That's just it. BMI is an easy metric, not a good one.

Perfection is the enemy of good enough. I don't disagree that there are limitations to BMI, but the combination of BMI and some workarounds is the most practical solution, at least until resistance-measured body fat analysis becomes accurate enough to be clinically relevant.

I don't see an alternative that meets all of the following criteria:
-Does not require lots of expensive/complicated equipment
-Fairly easy to standardize procedure
-Easy to train evaluators who have limited skill sets (IE caliper measure varies majorly depending on the training and technique of the evaluator).
-Adequate to establish baseline health standards, even if not adequate to parcel out the finer points of people at the margins (IE standards must probably be set either a little loose or a little tight, depending on your organizational goals).

The standardization and training issues are crucial from an organizational standpoint, especially when such measurements impact people's careers. These sorts of issues may in fact be MORE important to the organization than the ability to differentiate folks at the margins with a high degree of precision. As I said, the real outliers are covered by the addition of a tape test.

 

[deleted103644]

Perfection is the enemy of good enough. I don't disagree that there are limitations to BMI, but the combination of BMI and some workarounds is the most practical solution, at least until resistance-measured body fat analysis becomes accurate enough to be clinically relevant.

I don't see an alternative that meets all of the following criteria:
-Does not require lots of expensive/complicated equipment
-Fairly easy to standardize procedure
-Easy to train evaluators who have limited skill sets (IE caliper measure varies majorly depending on the training and technique of the evaluator).
-Adequate to establish baseline health standards, even if not adequate to parcel out the finer points of people at the margins (IE standards must probably be set either a little loose or a little tight, depending on your organizational goals).

The standardization and training issues are crucial from an organizational standpoint, especially when such measurements impact people's careers. These sorts of issues may in fact be MORE important to the organization than the ability to differentiate folks at the margins with a high degree of precision. As I said, the real outliers are covered by the addition of a tape test.

I agree that for screening BMI is cheaper. We just really need a better measure, particularly for medical studies where the additional cost is warranted for better results.

 

[circulus vitios]

As a former fatty with a peak BMI of 36.6, I will say that fat people, whose fatness is not a result of a legitimate medical condition, deserve to be discriminated against. Stop being fat. It's disgusting.

And stop bringing up the "BMI is a poor metric" argument. For the .01% of the population that is jacked to the moon, BMI is a poor metric. For everyone else, it is a fine metric, especially when we're talking about BMIs >35.

 

[235788]

Like this one?

no hawt chix allowed! this isnt a pron site.

 

[SpecterGT260]

As a former fatty with a peak BMI of 36.6, I will say that fat people, whose fatness is not a result of a legitimate medical condition, deserve to be discriminated against. Stop being fat. It's disgusting.

And stop bringing up the "BMI is a poor metric" argument. For the .01% of the population that is jacked to the moon, BMI is a poor metric. For everyone else, it is a fine metric, especially when we're talking about BMIs >35.

you sir, are awesome.

 

[evanbaines]

I agree that for screening BMI is cheaper. We just really need a better measure, particularly for medical studies where the additional cost is warranted for better results.

Oh, totally agree there. As I said, I'd love to see if electric resistance body composition analysis could be improved to the point where it would be clinically relevant... but the problem there is standardizing things like body surface moisture and hydration levels.

From what I understand, hydrodensitrometry is the best option that doesn't involve radiation.

 

[drizzt3117]

1) Saying 35 BMI is an obstacle for jacked people is idiotic. An example would be a former Badger FB who is currently on the Bengals. He's 6' and 256, I.e. Exactly the weight limit for this hosp. He also squatted 605x10 raw and deadlifted > 700. How many bodybuilders is this really going to rule out?

2) looking at the population of med students/residents I've seen, I'd be hardpressed to name one person who wouldn't be hired because of excess BMI.

 

[deleted103644]

Oh, totally agree there. As I said, I'd love to see if electric resistance body composition analysis could be improved to the point where it would be clinically relevant... but the problem there is standardizing things like body surface moisture and hydration levels.

From what I understand, hydrodensitrometry is the best option that doesn't involve radiation.

You could probably create an absolute measurement from MRI, but that's not exactly cheap.

And really obese people wouldn't, um, fit.

Maybe ultrasound, depth of abdominal fat? That shouldn't be too hard to standardize, but is a bit expensive and operator dependent.

 

[Marge]

1) Saying 35 BMI is an obstacle for jacked people is idiotic. An example would be a former Badger FB who is currently on the Bengals. He's 6' and 256, I.e. Exactly the weight limit for this hosp. He also squatted 605x10 raw and deadlifted > 700. How many bodybuilders is this really going to rule out?

2) looking at the population of med students/residents I've seen, I'd be hardpressed to name one person who wouldn't be hired because of excess BMI.

Oh so you're going to just ignore the bodybuilder physicians? I thought diversity mattered in medicine. We want our noble profession to reflect the general population. Bodybuilders are people, too.

 

[tantacles]

As doctor I plan to respect my patient's life choices even if I don't think they will be the most beneficial. I would give my advice about the diet and exercise when I see a need. But, there is no way I would try to force a rational adult that can make his or her own informed decisions to follow my diet plan. This seems very unethical to me. Hospitals trying to monitor smoking, exercise, and dieting of their employees for profit reasons (not even because they actually care) feels like a bigger invasion of personal space and privacy. Look, I can agree that fat people should try to lose weight, but they shouldn't be forced by anyone to do so, especially by their employer. It is their personal choice and showing zero respect for it is just messed up.

Also, homosexual males are more likely to contract certain venereal diseases. Should hospitals stop hiring homosexual men to control their healthcare costs? How about seniors who are more sick than younger people? Should they be let go as well to control insurance costs?

To be fair, no, they aren't. Not uniformly. Being homosexual in and of itself does not predispose you to venereal disease, but being obese does predispose you to congestive heart failure, atherosclerosis, and a whole bunch of nasty other things that will lead to health issues.

 

[SpecterGT260]

To be fair, no, they aren't. Not uniformly. Being homosexual in and of itself does not predispose you to venereal disease, but being obese does predispose you to congestive heart failure, atherosclerosis, and a whole bunch of nasty other things that will lead to health issues.

however it is associated with particular sex acts more of the time and therefore pre-disposing factors. Things tend to tear when you use an exit as an entrance
had to ask a prof about this one time because I felt the "statistics" were simple stereotypes from the 70s. Turns out there is an etiological reason

 

[deleted103644]

however it is associated with particular sex acts more of the time and therefore pre-disposing factors. Things tend to tear when you use an exit as an entrance
had to ask a prof about this one time because I felt the "statistics" were simple stereotypes from the 70s. Turns out there is an etiological reason

That's not really the reason.

MSM are more likely to have multiple partners and there's also a bit of an epidemic of risky behavior in some MSM communities (unprotected sex, IV drug use, etc).

 

[SpecterGT260]

MSM?
either way, soft-science correlates arent really a good policy-maker... however torn mucosa is less subjective and verifiable.

 

[deleted103644]

MSM?
either way, soft-science correlates arent really a good policy-maker... however torn mucosa is less subjective and verifiable.

Mainstream media obviously.

It's an epidemiology term for homosexual/bisexual men - men who have sex with men.

 

[Marge]

Mainstream media obviously.

It's an epidemiology term for homosexual/bisexual men - men who have sex with men.

And some straight dudes, for a variety of reasons. Don't ask.

 

[Sephiroth]

And some straight dudes, for a variety of reasons. Don't ask.

They really needed the money?

 

[tantacles]

however it is associated with particular sex acts more of the time and therefore pre-disposing factors. Things tend to tear when you use an exit as an entrance
had to ask a prof about this one time because I felt the "statistics" were simple stereotypes from the 70s. Turns out there is an etiological reason

Yes, but it doesn't uniformly affect all people who are gay in the same way, which makes it distinctly different from obesity. Obese people don't have to have anal sex or share needles or have multiple sex partners to cause higher health costs - it's part and parcel of being obese.

 

[tantacles]

And some straight dudes, for a variety of reasons. Don't ask.

A hole's a hole.

 

[SpecterGT260]

Yes, but it doesn't uniformly affect all people who are gay in the same way, which makes it distinctly different from obesity. Obese people don't have to have anal sex or share needles or have multiple sex partners to cause higher health costs - it's part and parcel of being obese.

have you taken genetics?
I only ask because I think calculating risk is a good example here. There is a 1/25 carrier chance for cystic fibrosis. So if you are giving genetic counseling to someone whose cousin had a son with CF, we know that your cousin is a carrier and that either aunt or uncle are a carrier and therefore potentially grand-dad (or mom) had the CF gene in your family. you would calculate it out as 1/2(chance that your cousin got it from your side of the family, no need to repeat for both aunt and grandad)*1/2(chance grand-dad gave it to your dad)*1/2(chance it was passed to you). So you have a .5*.5*.5 chance of having the allele. Now we want to know about your kid. So that number *1/25 = chance of your kid getting CF without testing being done to your spouse (or surrogate egg donor... keepin' it PC...)

If there is a positive non-zero prevalence of a disease in a population and a specific activity increases susceptibility, then it can be assumed on a population level that individuals who engage in that activity have an increased risk. This will be shown epidemiologically when more individuals who engaged in that activity show up sick. A counfounder (and to stick with homosexuality) like rigorous testing by the individual of partners ahead of time stands as another "risk factor" but this time in the opposite direction, but does not change the individual contribution of the first risk factor - just offsets it.

so I am definitely splitting hairs now and I see your point, but my point was that we cannot discount an association ONLY because it is not directly causative. There will be plenty of times where illness or findings are secondary to another issue and yet still highly correlated. With a large sample size (like a whole population) such risk factors which are not intrinsically illness-causing in and of themselves will still prove to be a cost down the road.

 

[Marge]

And some straight dudes, for a variety of reasons. Don't ask.

Curious, gay porn for $$, weekend at the cabin with the bros, etc. We've all been there.

[YOUTUBE]http://www.youtube.com/watch?v=PQensCD7xcE[/YOUTUBE]

 

[Koosalagoosagoo]

Also, this is discriminatory. Certain races weigh more on average, thus this can effectively be a barrier for them to enter.

This is the day I leave SDN....

 

[tantacles]

Curious, gay porn for $$, weekend at the cabin with the bros, etc. We've all been there.

Tyra, you go girl.

 

[Marge]

This is the day I leave SDN....

Don't DOs usually weigh more than MDs?

 

[StoicJosher]

As a former fatty with a peak BMI of 36.6, I will say that fat people, whose fatness is not a result of a legitimate medical condition, deserve to be discriminated against. Stop being fat. It's disgusting.

And stop bringing up the "BMI is a poor metric" argument. For the .01% of the population that is jacked to the moon, BMI is a poor metric. For everyone else, it is a fine metric, especially when we're talking about BMIs >35.

/thread.

 

[tantacles]

have you taken genetics?
I only ask because I think calculating risk is a good example here. There is a 1/25 carrier chance for cystic fibrosis. So if you are giving genetic counseling to someone whose cousin had a son with CF, we know that your cousin is a carrier and that either aunt or uncle are a carrier and therefore potentially grand-dad (or mom) had the CF gene in your family. you would calculate it out as 1/2(chance that your cousin got it from your side of the family, no need to repeat for both aunt and grandad)*1/2(chance grand-dad gave it to your dad)*1/2(chance it was passed to you). So you have a .5*.5*.5 chance of having the allele. Now we want to know about your kid. So that number *1/25 = chance of your kid getting CF without testing being done to your spouse (or surrogate egg donor... keepin' it PC...)

If there is a positive non-zero prevalence of a disease in a population and a specific activity increases susceptibility, then it can be assumed on a population level that individuals who engage in that activity have an increased risk. This will be shown epidemiologically when more individuals who engaged in that activity show up sick. A counfounder (and to stick with homosexuality) like rigorous testing by the individual of partners ahead of time stands as another "risk factor" but this time in the opposite direction, but does not change the individual contribution of the first risk factor - just offsets it.

so I am definitely splitting hairs now and I see your point, but my point was that we cannot discount an association ONLY because it is not directly causative. There will be plenty of times where illness or findings are secondary to another issue and yet still highly correlated. With a large sample size (like a whole population) such risk factors which are not intrinsically illness-causing in and of themselves will still prove to be a cost down the road.

I know nothing about CF. Please educate me.

Note, though, that my argument wasn't about discounting the association or not. Rather, it was in response to this article, in which obese people are uniformly not hired because of obesity's direct effect on health.

And because there are significant mitigating factors (notwithstanding the fact that there are plenty of heterosexual people who participate in anal sex AND one of the most prevalent HIV positive groups is black people, whom it would be extremely unreasonable to discriminate against), it can be quite easy to separate out those who have less likelyhood of falling victim to such a condition provided full disclosure. HOWEVER, the fact is that many MSMs don't even publicly disclose that they ARE MSMs and display the aforementioned behaviors.

BMI, however, is a lot easier to measure, and it's a lot easier to differentiate a body builder from your average fat dude - you lift up his shirt.

 

[Marge]

We need more of this:

This dude's an actual DO, btw.

 

[deleted393595]

But those guys are cut like diamonds. You could have one guy with 25% bodyfat and no muscle get accepted, but a muscular guy with 25% bodyfat get rejected. I don't know about you, but that seems flawed to me.

Sliceofbread... Everyone knows body builders have trouble with BMI. But whens the last time you met a physician (or any clinical staff) who was jacked [and tan]? Maybe as residents, but not as attendings (exceptions always exists -- but rarely!)

It would be hard to believe that they'd reject fit looking, highly muscular people with a BMI of 35. It's more likely that it's used to screen out your low muscle, high fat obese employee - although it's not completely their fault for their condition.

Weight has a genetic component too. The most obese people in the world right now are the ones who live on the Islands. Their bodies are more adapted to eating fruit and fish and very little red meat. Due to dietary changes they gain weight much easier and retain it more when subjected to the exact same diet as white people for example.

Wait, WHAT? The most obese people live on islands? Just....what? Wouldn't people eating fruit and fish and very little red meat be thinner?

I agree with Wile here because of what she's hinted at (in bold). It's not your genetic makeup, but your environment that plays a big role: Your average Pacific Islander in the Pacific is not going to have a higher chance of being obese than your average American here in 'Merica.

It's because of how different those environments are in terms of physical activity and food delivery. I don't know much about the Pacific Islander diet, but I'd argue that an extremely high chunk of it is much lower in calories than what we eat. Whataburger and McDonalds isn't exactly the best thing to feed yourself or your kids. Add to this the problem of the socioeconomic worse off having much higher obesity and mortality rates in part to environmental situations such as food deserts and having a lack of time or knowledge to cook healthy meals for their kids (Hard to do that when you're working 2 to 3 jobs a day to provide for your family).

That being said, calories are calories. With a lack of substantive physical activity, eating a large amount of fish (@Wile) and red meat (@SunsFuns) are both likely to result in a large caloric intake since our bodies can convert protein, along with anything and everything, into calories and extra fat padding. There might also be cultural aspects to this in that if those differences really do exist, it's because of the differences in food preparation. Pacific Islanders may rely more on traditional methods of cooking their fish (that result in less caloric garbage being added) while relying on our "unhealthy" methods for preparing their red meat - and vice versa for Americans.

So the answer is that both Pacific Islanders and Caucasians are likely to have the same genetic factors, on average, for obesity. It's just that differential environmental and lifestyle conditions result in vastly different outcomes, if there are any.

A hospital we rotate through in Louisiana has similar policies. They blood test everyone for nicotine on hiring, and if you pop positive you aren't hired. They don't refuse to higher the obese, but they have cut all of the desserts and sodas from the cafeterias and part of your pay comes in the form of a bonus for meeting certain health goals. For example they make everyone wear a pedometer, and you get a bonus if you hit your target number of steps.n

I spoke to one of the physicians that implemented the policy and he said it was 100% about controlling costs. People don't realize what a huge chunk of labor costs healthcare is, they estimated it at about 15% of the gross. They found another hospital that implemented a similar program and cut their health insurance costs in half.

FWIW the program seems to work. It was kind of cool to watch the entire nursing staff slim down over the course of the year.

It's good both for the people and the hospital. You're ensuring a higher quality of life for staff, and lower unnecessary costs for the hospital.

however it is associated with particular sex acts more of the time and therefore pre-disposing factors. Things tend to tear when you use an exit as an entrance

That's not really the reason.

MSM are more likely to have multiple partners and there's also a bit of an epidemic of risky behavior in some MSM communities (unprotected sex, IV drug use, etc).

QFT.

Add to that the stigmatization of homosexuals and the lack of public health services administered to them. No wonder the AIDS epidemic swept through the gay community that quick: it's because no one gave a **** about them, besides stereotyping and stigmatizing them (I'm hetero btw).

either way, soft-science correlates arent really a good policy-maker...

The entire fields of public health, sociology, and anthropology would laugh themselves to death over the inanity of that comment and over your so called "medical expertise".

 

[SpecterGT260]

I know nothing about CF. Please educate me.

Note, though, that my argument wasn't about discounting the association or not. Rather, it was in response to this article, in which obese people are uniformly not hired because of obesity's direct effect on health.

And because there are significant mitigating factors (notwithstanding the fact that there are plenty of heterosexual people who participate in anal sex AND one of the most prevalent HIV positive groups is black people, whom it would be extremely unreasonable to discriminate against), it can be quite easy to separate out those who have less likelyhood of falling victim to such a condition provided full disclosure. HOWEVER, the fact is that many MSMs don't even publicly disclose that they ARE MSMs and display the aforementioned behaviors.

BMI, however, is a lot easier to measure, and it's a lot easier to differentiate a body builder from your average fat dude - you lift up his shirt.

i actually wasnt being sarcastic in my post I just used CF because 1/25 (1/16-1/28ish) is a pretty well known number for average carrier status in Caucasians.

the point being that the "spouse" in the example above - other than via demographics has no reason to be suspected of CF, and that seemingly inconsequential qualities WILL have a tangible effect when applied to a whole population. Yes, heterosexuals can engage in the same "risky" behaviors as homosexuals. However a larger % of homosexuals always will. It is all just a numbers game.

althought I am not entirely sure where you are going with the rest of this... it doesnt matter if a "MSM" is "out" or not. The correlation to sexuality is secondary. The primary correlation is between the sex act and chance of exposure leading to infection. If exposure is assumed to be constant across all peoples, the sex act alone will pre-dispose to infection. Also MSM's are more likely to engage in that act. ergo MSMs are predisposed as a group.

you are right, that determination of the "predisposing factor" is easier with BMI vs sexuality. I dont think that really matters though. It is all about "how do you want to slice the pie". Even including the athletes, as a group people with high BMI suffer from more health effects. The athletes may skew this towards a healthier number, but the end result is that BMI is positively correlated. Just like "MSM" is positively correlated.

obviously there are different ways for this texas hospital to get what they want. I think applying the term "better ways" is a bit narrow sighted.... This may be the way that suits them best for a number of reasons and if you are the unlucky few who practice medicine as a hobby between Mr Olympia contests... well... sucks bro, but that isnt protected against. Or maybe they just didnt think about it nearly as deeply as we are here

 

[SpecterGT260]

It would be hard to believe that they'd reject fit looking, highly muscular people with a BMI of 35. It's more likely that it's used to screen out your low muscle, high fat obese employee - although it's not completely their fault for their condition.





I agree with Wile here because of what she's hinted at (in bold). It's not your genetic makeup, but your environment that plays a big role: Your average Pacific Islander in the Pacific is not going to have a higher chance of being obese than your average American here in 'Merica.

It's because of how different those environments are in terms of physical activity and food delivery. I don't know much about the Pacific Islander diet, but I'd argue that an extremely high chunk of it is much lower in calories than what we eat. Whataburger and McDonalds isn't exactly the best thing to feed yourself or your kids. Add to this the problem of the socioeconomic worse off having much higher obesity and mortality rates in part to environmental situations such as food deserts and having a lack of time or knowledge to cook healthy meals for their kids (Hard to do that when you're working 2 to 3 jobs a day to provide for your family).

That being said, calories are calories. With a lack of substantive physical activity, eating a large amount of fish (@Wile) and red meat (@SunsFuns) are both likely to result in a large caloric intake since our bodies can convert protein, along with anything and everything, into calories and extra fat padding. There might also be cultural aspects to this in that if those differences really do exist, it's because of the differences in food preparation. Pacific Islanders may rely more on traditional methods of cooking their fish (that result in less caloric garbage being added) while relying on our "unhealthy" methods for preparing their red meat - and vice versa for Americans.

So the answer is that both Pacific Islanders and Caucasians are likely to have the same genetic factors, on average, for obesity. It's just that differential environmental and lifestyle conditions result in vastly different outcomes, if there are any.




It's good both for the people and the hospital. You're ensuring a higher quality of life for staff, and lower unnecessary costs for the hospital.





QFT.

Add to that the stigmatization of homosexuals and the lack of public health services administered to them. No wonder the AIDS epidemic swept through the gay community that quick: it's because no one gave a **** about them, besides stereotyping and stigmatizing them (I'm hetero btw).



The entire fields of public health, sociology, and anthropology would laugh themselves to death over the inanity of that comment and over your so called "medical expertise".

you missed the point. A legitimate epidemiological mechanism for increased susceptibility is no more "stereotyping" than suspecting sickle cell disease in an african american is racist. Get over your idealism and understand that you will only hurt your patients if you blindly adhere to a "people are people are people" sort of mentality.

and there is a very good chance you simply didnt understand the last comment you quoted

 

[deleted393595]

you missed the point. A legitimate epidemiological mechanism for increased susceptibility is no more "stereotyping" than suspecting sickle cell disease in an african american is racist. Get over your idealism and understand that you will only hurt your patients if you blindly adhere to a "people are people are people" sort of mentality.

You also missed my point. I'm saying that our construct of epidemiological mechanisms is more than often shaped by social and cultural forces. You blame homosexuals for having a higher rate of veneral diseases due to anal sex rather than focusing on other much important factors. This is nothing more than a continuation of the homo anal sex stigma that has viewed their sexual behavior as filty - disgusting - and unclean. I'm not calling you out for saying that homosexuals have a higher incidence of veneral disease, but rather that you put down an entire community by focusing on a BS reason that plays only a minor role in those outcomes.

Idealism and standing for what's right hurts patients? If so, I guess we'd better go out and arrest this dude before he ends up screwing up any more of his patients: Paul Farmer.

And that's a crappy argument from you anyways. How would my conclusions in any way result in damaging my patients health? That's just a stupid thing that you threw out there to put me down because you don't have any better retorts. You're just saying that to boost your ego. After all, you're only a med student with no experience as a doctor and lack knowledge of any significant public health principles. Try coming back to me about that after you get through residency and become a real doctor. Maybe then that argument might hold some water.

 

[SpecterGT260]

You also missed my point. I'm saying that our construct of epidemiological mechanisms is more than often shaped by social and cultural forces. You blame homosexuals for having a higher rate of veneral diseases due to anal sex rather than focusing on other much important factors. This is nothing more than a continuation of the homo anal sex stigma that has viewed their sexual behavior as filty - disgusting - and unclean. I'm not calling you out for saying that homosexuals have a higher incidence of veneral disease, but rather than you put down an entire community by focusing on a BS reason that plays only a minor role in those outcomes.

Idealism and standing for what's right hurts patients? If so, I guess we'd better go out and arrest this dude before he ends up screwing up any more of his patients: Paul Farmer.

And that's a crappy argument from you anyways. How would my conclusions in any way result in damaging my patients health? That's just a stupid thing that you threw out there to put me down because you don't have any better retorts. You're just saying that to boost your ego. After all, you're only a med student with no experience as a doctor and lack knowledge of any significant public health principles. Try coming back to me about that after you get through residency and become a real doctor. Maybe then that argument might hold some water.

Nobody is putting down a community. If you noticed where this started - the issue of "risk" among homosexuals came up for me in a small group discussion and we asked our physician facilitator about it - the reason being that I originally felt the stats were given just as a throwback to more discriminatory times. However, as explained by our facilitator, it is due to the reasons listed above. If he is wrong, and I was wrong by extension, please provide data.

As for the part in bold - Do you have any idea how backwards and asinine that comment is? You want me to come back to you when you are potentially still in medschool (or, if we play the odds, still trying to get in ). Yes... amazing how you feel you can speak with the air of a doctor as a pre-med but according to you it vanishes as a medical student

your stated point of view can hurt patients because you deny legitimate physiological and epidemiological differences between groups of people for the sake of being PC. you said it yourself (underlined). nobody said anything qualitative about these sexual practices, nor was "filthy" even so much as implied. you just lack the ability to separate objective rationale from subjective PC reactionism. If you get into medical school you will likely see a good many things in terms of stats that trip your PC trigger, but you will have to learn to get over them because (especially with the ever growing diversity of medicine) these stats are not remnants of ignorance past, but useful data for treating people with specific histories.