Two barriers that cause patients to forgo necessary screening are shame due to body image and getting weighed in the office. Many pap smears, skin checks, colonoscopies, and mammograms for cancer screening don’t occur for these reasons.
Years ago, I knew a gynecologist who sent letters to her patients who had been no-shows or canceled their appointments in the past 12 to 18 months. She wrote in her letter that she would like them to make an appointment for their gynecologic pelvic exam, and emphasized that she would NOT be weighing them or discussing their weight during the visit. Suddenly her phone started ringing, and she even had to extend her office hours to accommodate everyone within a reasonable time frame.
Anecdotally, I will share with you that my dad drove 2 hours for his annual physical exam to see his primary care physician and then called his physician from his cell phone once he arrived in the parking lot. He told the doctor that he was in the parking lot and wanted to get his physical exam done while seated in his car. When asked why, my dad said that he didn’t want to get weighed and hear a bunch of advice about losing weight. He knew he was overweight and didn’t need to get on the doctor’s scale to confirm it. The doctor actually did come out to his car and took his blood pressure, listened to his chest, looked at his swollen feet, and even gave him a flu shot and pneumonia vaccine.
We have also seen patients too embarrassed about their body appearance that they avoid getting mammograms, colonoscopies, and other needed tests and screenings.
So consider folding this information into a discussion with your patients. Ask them when they last saw their gynecologist, primary care physician, dermatologist, and other providers. Ask what the barriers are to keeping these needed appointments. If you suspect that it is their physical appearance without clothes and/or their weight, contact their provider and see if an agreement can be made to not step on the scales this time or embark on a discussion about their body’s appearance.
