Laura Robitschek, DO

Approach to care

• What does it look like for you to provide care to patients in larger bodies? How is, or isn’t, your approach different from how you care for patients in smaller bodies? If you work with children, how is or isn’t your approach different when working with children?

  I discuss with patients that individuals living in larger bodies tend to receive substandard healthcare due to fat bias in medicine/healthcare. I inform them of my goals to make sure they are keeping up to date on healthcare maintenance items in an environment where they feel heard and respected.

• What is your perspective on how weight is or is not related to health?

  I tend to follow the HAES approach in relation to weight/healthcare. Overall, I am weight-neutral -- regardless if a patient desires weight loss or not, I am supportive in their healthcare journey.

• Finish this sentence: "Fat people are..."

  deserve equal access to healthcare without judgement or stigma.

• How do you, your clinic, and the healthcare system you work in use BMI (i.e BMI cutoffs for accessing certain services, BMI on charts and printouts, etc)? Is this flexible?

  BMI is included on our charts/printouts as a healthcare metric, we can remove this info from the after visit summary if the patient desires. If BMI is a concern for a particular referral or test, we will make sure to communicate with the provider/service to help accommodate our patients.

• If a patient declines to be weighed, how do you and/or your staff proceed?

  I will ask if there are any barriers I can assist with, such as weighing facing away, not verbalizing what the current weight is, or not including that information on patient after visit summary. The patient is allowed to decline weight at any visit.

• If a patient declines to discuss weight loss, nutrition, and/or exercise, how do you proceed?

  I will ask if they have any questions/concerns that I can help with, and if not, then we will proceed with the visit.

• What does the physical accessibility of your office space look like? What kinds of accommodations are present for people in larger bodies? Are there things you wish were in place that are currently not?

  We have a scale with handles for easier use, allows for weights >600lbs. Exam room has a bench rather than a chair (approximately 2x width of typical chair) to allow for more comfortable seating. Clinic is also equipped with bariatric wheelchair and thigh blood pressure cuff to accommodate larger arms.

• What do you do to allow fat people to feel comfortable and welcome in your office?

  Our exam rooms are very accommodating and accessible to those living in larger bodies. I demand that all staff are respectful to every patient that we see, regardless of body size.

• If you’d like to use this space to talk about any identities (gender, race, size, sexuality, etc.) you hold and how this relates to your care, please do so.