Dr. Toby Cosgrove
CLEVELAND, Ohio — Cleveland Clinic CEO Toby Cosgrove apologized to employees for any “hurtful” comments connected to a recent national discussion he’s led about obesity, personal responsibility and health care.
“During the past weeks, I participated in several forums where the focus has shifted from healthcare reform to the subject of obesity,” Cosgrove stated in a memo sent this week to staff. “My objective was to spark discussion about premature causes of death, but some of my comments were hurtful to our community. That was certainly not my intent, and for that I apologize.”
Cosgrove has used the costs and health problems related to obesity to try and push the concept of personal responsibility and greater wellness incentives further into the national debate on health care reform. He started provocatively in a New York Times article last month, saying that he would stop hiring the obese if he could.
He later backed off, saying that he meant to say he was concerned more about the problem of obesity and not about obese people themselves. However, critics confronted him at the Clinic’s own Obesity Summit last week and accused him of creating a “bias mentality” against fat people, and the debate over the topic of weight — and Cosgrove’s comments — raged online and in Cleveland-area print media.
In his message to staff this week, he framed his battle as one not against the obese but against a broad array of “lifestyle choices” — some of which also lead to obesity.
“Lifestyle choices that include smoking, poor nutrition and lack of physical activity are key contributors to the development of chronic diseases such as heart disease, diabetes and cancer,” he stated. “I feel strongly that we can lower this by working together and helping our communities through education and programs that enable people to lead healthier lives.
“As one of the nation’s largest medical centers, Cleveland Clinic has evolved into a leader advocating for healthcare reform that emphasizes wellness and prevention — a shift from ‘sick care’ to ‘health care’. For too long, our healthcare system across the nation has focused on treating diseases rather than preventing them.
“Those of us who care for patients are deeply motivated to heal, but medicine and surgery can only go so far,” he added. “There is much more we could do to prevent chronic diseases if we take measures to eat healthier, exercise and quit smoking.”
What’s left unanswered is whether Cosgrove will continue to seize the spotlight to insert personal responsibility and wellness promotion further into the national debate on health care. It’s likely that most people are in agreement with him over lifestyle issues, but the apology is a clear signal that his provocative tone has sent the debate careening in another direction.
![Reblog this post [with Zemanta]](http://img.zemanta.com/reblog_e.png?x-id=630e0155-ba0f-40f1-b54e-7a5831b47e82)
By Chris Seper MedCity News
Chris Seper is the CEO at MedCity Media, which publishes MedCityNews.com. He is also a senior writer at MedCity News. Reach him at chris@medcitynews.com.More posts by Author
I am dismayed to read so many comments from readers which make no attempt to address the issue just pillar the messenger. We can go on with denying the personal responsibility associated with obesity or we can face up to it. I applaud the good Doctor and thanks him for his courage to foster discussion on this taboo subject.
"Personal responsibility"? Right, you can look at a person and tell exactly how they live their life and everything they've ever done that has led up to the condition their body is in right at that moment? You have no idea why any individual is fat, what type of foods they eat in what amounts, what kinds of exercise they do/don't do for how long and when, if and when they see their doctor for what reasons, what illnesses they have, what genetic predispositions they have for those illnesses, or anything else about that individual at all. Making judgments about a person solely on the size of their body is as bad as judging them for the color of their skin, their gender, their sexuality, their height, or their hair color - all things over which they have little to no control.
Weight is not as easy to change as you think, but health improvements can come from eating better foods and exercising in ways that people enjoy and will continue to do - IF they can afford to do them and have safe spaces in which to do them. Whether or not their weight changes shouldn't be of concern if their health improves, because this is supposed to be about HEALTH, right? Or is it really about the fact that most people just think that fat people are disgusting to look at and use "health" as an excuse to browbeat and bully/shame them into trying to become "acceptable"?
Healthcare "professionals" should practice what they preach. There is nothing wrong with wanting your staff to be good role models to patients. Business is business. Hooters isn't required to hire fat women, because they would lose business. The military has weight requirements as well. This country is becoming so obese, and along with smoking, is the cause of a good majority of our health problems.
If this guy wants to exclude 67% of the population as potential employees, I say let him. See how well his hospital runs then. If you are overweight and work for the Cleveland clinic, Give your 2 weeks notice. What's more important to you, a paycheck, or being treated like a human being?
I really Surprised when I saw that article on the impact on obesity.In that article you had said all the causes of obesity and the helpful steps of prevention. Childhood obesity is certainly a recognized issue in today's society. Parents are get confused what would they were do when there child were suffering from obesity.<a href=Obesity In Children is an prospious health site which helps parents towards the awareness of obesity. We were started an Programs to educate parents about nutrition which are essential for the childrens. We provide an Health Chart For The daily diet of childrens. For more details please visit our site or you can also exchange your links with us.
Preventative health care can be a good thing if it is done with the proper perspective. Vaccinations, early detection tests, knowledge of genetic dispositions, awareness of specific allergies, keeping poisons away from children, wearing safety helmets, shoes and clothing, providing clean air and water, washing hands frequently and so forth are all good health care practices that prevent disease, injury or the spread of disease. But none of these things are fullproof and because we are human beings, illness and disability happens despite our best efforts. But for some reason we have come to equate "prevention" with "lifestyle" and with it have set up a vicious cycle of blame, shame and fear that leads to less prevention. Stigmatizing people on the basis of how they look or how they behave leads to those same people seeking less care. The doctor's comments regarding fat people is typical of the attitudes of many who claim to tout "preventative medicine," but are actually placing the blame of illness on individuals by equating "lifestyle" with prevention. Lifestyle discourse is just a new way to justify discrimination and those non-smokers who are considered "overweight" should pay attention because refusing to hire persons on the basis of their sex life or their sporting activities or their genetic dispositions is next. Risk factors are not causes of disease and avoiding risk factors are not an absolute guarantee that one will never be sick. But blaming people who are sick for their illnesses is an absolute guarantee that they will not seek out medical attention in early stages of disease or go to a doctor for vaccinations or preventative tests. In addition, stigma ensures a daily stress that is never good for health. Stigma ensures a public environment that feels and often is dangerous, reducing opportunities for exercise and activity. Stigma ensures isolation and fear that can lead to avoiding medical contact along with avoiding the creation of a strong social network that supports well-being. In short, stigma is unhealthy. So is poverty. Refusing to hire someone on the basis of how they look is ensuring poverty and since we continue in the US to want to connect having health care with having a job, it is a double condemnation. The doctor's comments encourages both and if he really cared about the health of "the obese" he would go out of his way to hire them and make sure they had health coverage. However, his apology is inadequate because his main point regarding "prevention" is misleading. To suggest that changing lifestyle is a legitimate alternative to providing universal access to services is a smoke screen designed by those who make substantial amounts of money off the current system to continue their greedy practices. Access to health care IS preventative medicine. Stigmatizing fat people (and others who "fail" the "lifestyle" test) will drive up the costs of health care even if we obtain universal coverage because it will make people afraid to seek attention or preventative measures. The later one seeks care, the more expensive that care will be. Bottom Line: The doctor and his lifestyle police buddies have a lot more to apologize for than threatening to refuse to hire fat people. The lifestyle rhetoric that is the basis for his argument is inaccurate and stigmatizing and unhealthy for us all.
The reporter stated that Cosgrove was "unapologetic" for saying he would not hire obese people, and now he apologizes? You know what, men die earlier than women on average. They should declare Cosgrove diseased with for his XY chromosome and then fire him. Doctors and clinics like him are what keep fat people afraid to even go to the doctors. Maybe us fat people would be more likely to take better care of our health knowing that medical staff care for us just like we are right now. Perhaps anxiety over discrimination and not weight is the real issue.
The doctor's apology to his staff does nothing to reverse the damage he has done. He owes an apology to all fat people everywhere. Careless words by a person in a place of authority do far reaching damage. This man has now encouraged employers everywhere to think twice before hiring a fat person. This hatred and bigotry does no good for anyone. Fat people are already discriminated against on their jobs and by their healthcare providers. Apparently this doctor did not read the study from Yale/Rudd Center last year? I find it difficult to believe that an educated man thinks it's okay to marginalize more than 60% of our country's population. He says he's fighting obesity, not obese people? Really? Saying that he wouldn't hire fat people if he could get away with it isn't directed at people? This is a prime example of what fat people face when they go to see their doctors....blame and shame. And one wonders why we are reluctant to see a doctor until it is absolutely necessary? Since many of us don't see doctors very often, I find it hard to understand how we are driving up the cost of a service we rarely use! Incorrect assumption: “There is much more we could do to prevent chronic diseases if we take measures to eat healthier, exercise and quit smoking.†You cannot tell by looking at a person's physical appearance whether or not they eat healthy foods and exercise. Eating healthy foods and exercising do not equal "thin". Fat does not equal "unhealthy". There is a fast growing body of scientific evidence to support this. Maybe the doctor should start reading and thinking before he speaks!
Call a spade a spade. It's disgusting behavior and we all know he meant it. Grow up.
He was innapropriate, but he's right. Until we shift from an allopathic health care system back to a holistic and homeopathic, preventive one, our overall health will be abysmal. Our mainstream "healthcare" system really is a "disease-management" system which provides a steady stream of income to the "healthcare" industry.
Dr. Cosgove's anti-fat bigotry is not unusual among medical doctors. I am a proud fat person. He is not someone I would work for, and certainly not someone I would trust to provide me with any form of medical care!!! His apology does not acknowledge the very real and pervasive weight-based workplace discrimination that he was perfectly happy to foment.
In the discussion of obesity, everybody ignores the fact that Agribusiness,the FDA and our Food industry are making foods that have hidden items in them that do nothing to help a healthy life style. The US food supply and production is the 500 lb gorilla in the living room relative to health care reform.
Apparently Dr. Cosgrove has had some time to rethink his approach to "helping" fat people. One hopes that not too many companies will take his original advice seriously to not hire the obese. It was never clear to me how refusing to hire an entire group of people without any regard to their job skills would help anyone. If he had said that if he had his way, he would not hire black people, or Jewish people, or Asian-Americans, or gays, or those over the age of 50, you can bet that his remarks would not have gone unchallenged. -Bill Fabrey, BSEE Biomedical Engineer (retired) Council on Size & Weight Discrimination Mt Marion, NY