While disability takes many forms, the doctors had much to say about people who use wheelchairs. Some doctors said their office scales could not accommodate wheelchairs, so they had told patients to go to a supermarket, a grain elevator, a cattle processing plant or a zoo to be weighed, or they would tell a new patient the practice was closed.
One said he didn’t think he could legally just refuse to see a patient who has a disability — he had to give the patient an appointment. But, he added, “You have to come up with a solution that this is a small facility, we are not doing justice to you, it is better you would be taken care of in a special facility.”
The doctors also explained why they could be so eager to get rid of these patients, focusing on the shrinking amount of time doctors are allotted to spend with individual patients.
“Seeing patients at a 15-minute clip is absolutely ridiculous,” one doctor said. “To have someone say, ‘Well we’re still going to see those patients with mild to moderate disability in those time frames’ — it’s just unreasonable and it’s unacceptable to me.”

results of a national survey of physicians: only 56% reported that they welcome patients with disabilities to their practice; 36% said that they know “little or nothing” about the ADA; and only 41% were confident that they could provide similar quality of care to patients with disabilities as they could to those without disability.

The other manipulation of significant is a misuse of the concept of “statistical significance.” When a study looks at an intervention’s outcomes and find that those outcomes are “statistically significant” it simply means that it is more likely that the outcomes are a result of the intervention than that they were the result of chance. So if a study had a statistically significant finding that people using some weight loss method lost 3% of their body weight, that would mean that it was more likely that the small amount of weight loss was due to the weight loss method than that it was by chance. However, if the study conclusion were to say that people lost a “significant amount of weight” when what they meant was that the weight loss was statistically significant, they might mislead people into thinking that “significant” in this case meant “a lot of” weight.

Weight stigma impacts negatively healthcare quality and hinders public health goals. The aim of this review was to identify strategies for minimizing weight bias among healthcare professionals and explore future research directions. An electronic search was performed in PubMed, PsycINFO and Scopus (until June 2020). Studies on weight stigma reduction in healthcare students, trainees and professionals were assessed based on specific inclusion and exclusion criteria. A narrative synthesis was undertaken to analyze emerging themes. We identified five stigma reduction strategies in healthcare: (i) increased education, (ii) causal information and controllability, (iii) empathy evoking, (iv) weight-inclusive approach, and (v) mixed methodology. Weight stigma needs to be addressed early on and continuously throughout healthcare education and practice, by teaching the genetic and socioenvironmental determinants of weight, and explicitly discussing the sources, impact and implications of stigma. There is a need to move away from a solely weight-centric approach to healthcare to a health-focused weight-inclusive one. Assessing the effects of weight stigma in epidemiological research is equally important. The ethical argument and evidence base for the need to reduce weight stigma in healthcare and beyond is strong. Although evidence on long-term stigma reduction is emerging, precautionary action is needed.

Patients have a federal right to “request to amend” their medical record. This right is conferred by the Standards for Privacy of Individually Identifiable Health Information, otherwise known as the HIPAA Privacy Rule of 2001 (45 C.F.R. § 164.526).

The provider may deny a patient’s request to amend. In denying the amendment, the provider must provide an explanation to the patient for the denial in plain language and in a timely manner. In this notification, the patient must be given the option to submit a statement of disagreement. The patient must also be given options to further complain, such as the name and telephone number of the health system’s compliance officer and relevant government agencies. If the patient submits a statement of disagreement, then the provider may issue a rebuttal statement.
Recordkeeping is crucial because ignoring a patient’s request to amend the record is a HIPAA violation. The Office for Civil Rights (OCR) has an online complaint portal and a toll-free number to trigger investigations. The OCR is empowered to assign civil money penalties and, with the Department of Justice, to enforce criminal prosecutions to medical providers.
If the record is amended, be sure to note the amendment in the medical record. Providers should never delete any portion of the medical record. Penalties skyrocket if there is evidence of retaliation against the patient. Retaliation could be evident if something derogatory is written about the patient in the chart because of the request to amend the medical record.
The Privacy Rule does not allow the provider to charge a fee to the patient for any work performed to receive, deny, or approve a patient’s request to amend the health record.

Providers have 60 days to respond but may extend another 30 days if needed.

primary aldosteronism, in which one or both adrenal glands, small structures that sit atop the kidneys, overproduce a hormone called aldosterone. Aldosterone increases blood pressure by sending sodium and water into the bloodstream, increasing blood volume. It also lowers potassium

So what we typically see with dieting is that people make behavior changes. After those changes are made, those folks often see health improvements, and sometimes see a small amount of weight loss (at least in the short-term.) Even though the weight loss is small, and often largely simultaneous with the health improvements, the weight loss gets credited with the health changes, rather than seeing both the health changes and the (at least short-term) small amount of weight loss as resulting from the behavior changes.

Giving the credit to weight loss, rather than the initial behavior change, drives a lot of profit to the weight loss industry, but drives a lot of harm to fat patients.

A large body of research going back decades indicates that stress of the type Bascom experienced can affect the fetus, causing physical and psychological harm that lingers throughout the child’s lifespan. With its chaotic response to the Covid-19 pandemic, the United States has unwittingly subjected more than a year’s worth of newborns to conditions resembling an enormous experiment on the long-term effects of stress during pregnancy.

cw: article contains a lot of anti-fat bias