# Article:  Hospital refuses to hire obese workers



## Pam Brooks (Apr 11, 2012)

I recently read this article, and wanted to post it on our board to see what everyone thought.....our hospital has recently initiated a 'wellness' program for all employees, since our health insurance costs are skyrocketing (apparently, we're the unhealthiest hospital employees in the area). Employees are rewarded with credits against their annual deductibles for participating in wellness activities, including exercise, smoking cessation, and food journaling. Is anyone else doing this? What do you think about this approach and knowing you might not be considered for a position if your BMI is over 35? Do we have an obligation to present ourselves as healthy-appearing hospital employees? Does it make us hypocritical if we don't practice what we preach? 

From a devil's advocate perspective, I would rather not have to pay higher deductibles to offset the healthcare costs of my unhealthy coworkers, particularly if their health conditions are related to poor lifestyle choices. Does that make me prejudiced? Or fiscally savvy? Does anyone work at any of the hospitals mentioned, or one that does limit employees to comply with certain health standards? 

Just for clarification, I'm not obese (BMI of 24), and I'm not a smoker (in case you were wondering)....but I do have family members who struggle with obesity, and would never consider them unemployable, although some hospitals obviously do. 

1. Hospital refuses to hire obese workers
While some providers are refusing to see patients who weigh more than a certain amount, Citizens Medical Center in Texas is turning down job applicants for being too overweight, reported _The_ _Texas Tribune_.
According to its hiring policy, potential hospital employees must have a body mass index of less than 35 and a physique that should "fit a representational image or specific mental projection of the job of a healthcare professional."
Citizens Medical does offer overweight applicants help with lowering their body mass index, CEO David Brown told the _Tribune_. He also noted it doesn't terminate current employees who become obese while working at the hospital.
The hospital's hiring policy is legal, as Texas law protects race, age and religion from discrimination in hiring but not weight, the article noted. Only Michigan and six U.S. cities prohibit employers from discriminating against the overweight.
However, the policy could still lead to lawsuits: Some courts have considered obesity a disability, making overweight applicants protected under the Americans with Disabilities Act, according to the newspaper.
Despite the potential liabilities, hospitals are enforcing stricter hiring practices. Hospitals in Florida, Georgia, Massachusetts, Missouri, Ohio, Pennsylvania and Tennessee all have turned away job applicants who smoke. The hospital employers attributed the move to enhanced worker productivity, reduced healthcare costs and improved personal well-being.
In addition to instituting no-smoking rules, hospitals are enrolling workers into exercise programs or offering healthy food options to keep their employees healthy, according to a _FierceHealthcare_ editorial.
"We should be the model, not only for our own employees ... but for reaching out to the community as a leader and a model for what it means to be healthy and to provide those opportunities for the folks in our community," Susan L. Johnson of the employee wellness program at Medical University of (Charleston) South Carolina previously told _FierceHealthcare__._
For more:
- read the _Texas Tribune_ article


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## LLovett (Apr 11, 2012)

*Wow, slippery slope*

I'm in Michigan so apparently this can't happen here but I will say in the past 2 years the hospital I worked at and the law firm I'm at now have both made wellness programs options. If you participate you get discounts on your insurance benefits. 

They also have different insurance policy rates for smokers vs non-smokers at the hospital I came from.

I think this is an absolutely unacceptable practice, not hiring someone due to BMI. I do personally have weight issues but that is not why I think this is unacceptable. There are many things that make people unproductive and unhealthy. Once you start on this path where does it end? Drama queens cause more issues than anyone else in any office I have ever been in. How do you single them out so they can be kept out of the office and therefore maintain some idealistic image?

I find it very interesting the more weight aware we become as a society the fatter we get. 

Keeping people out based on BMI alone will only make the problem worse. They will whine and fuss until they are covered by antidiscriminatory regulations as well. Then you will have to hire people with non-ideal BMI or face lawsuits.

I wouldn't want to deal with a healthcare provider that would condone this, as an employee or as a patient.

I am actually kind of thrown by the fact that they can get away with this at all. You can't ask someone how old they are, if they are married, if they have kids, etc.. during an interview but you can get a height and weight from them? Or are they making them get a pre-employment physical and stating they failed it based on BMI?


Sorry this seems to have fired me up a bit today! Getting off my soap box now.

Thanks for posting this, it was an eye opener.

Laura, CPC, CPMA, CEMC


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## Bready (Apr 11, 2012)

I read this too. It will be interesting to see how it plays out.  The hospital I am affiliated with has just recently announced that it will no longer hire smokers.  Already, the campus is off limits to smokers and citations are issued if caught.  I have seen patients in gowns and attached to IV poles receive citations.  "morbid obesity" does have its own health issues of diabetes, hypertension, exacerbated arthritis and weight loss is a life time committment which is different from breaking the habit of smoking. As you state, extreme obesity, with its health complications, is considered a disability.  Addiction to tobacco is not although insurance premiums are higher for smokers too(lung cancer, head & neck cancer, athersclerosis, etc)


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## jmcpolin (Apr 11, 2012)

I would love it if my employer offered exercise classes and healthy food options, I myself am a bit fluffy and would greatly appreciate any encouragement I could get!


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## tpontillo (Apr 11, 2012)

I wouldnt mind incentives to help the employees to lose weight but I dont think that BMI should determine if you can get a job or not.  I am considered obese on the BMI scale.  I have Hashimotoes disease.  I had gained 80lbs because of it.  I was thin before Hashimotoes.  My weight gain was because of the disease not because I overate or am eating the wrong things.  I eat less now and healthier but have a hard time losing this weight.  I am also going to the gym.  I have been working at the job I have now for over a year.  I have not called in sick one time.  I do not have any other medical conditions associated with obesity.  My Thin coworkers are always calling in sick, they have high blood pressure, cholesterol problems etc etc.  So now you are going to say I cant have a job because my BMI is high.  I will probably be healthier than any of the skinny people that they would hire over me.  I dont think that would be fair to discriminate for BMI.  I dont have a problem with incentives.  I wish my job would have incentives to help me to lose weight but to discriminate because someone is overweight is not fair.


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## Pam Brooks (Apr 16, 2012)

I definitely agree...it's not fair to discriminate based on BMI (in this case >35, which is obese, not overweight). Unfortunately, obesity in and of itself is not considered a disability, so doesn't fall under those disability protection laws. 

I think that hospitals are looking at this for two reasons. First, many preventable diseases are exacerbated by obesity....diabetes, hypertension, hyperlipidemia....and cause healthcare organizations to have to pay out millions of dollars each year in medical expenses to treat their employees who they feel should be making wiser choices. That is exactly why our hospital has begun a series of health-related initiatives, to reward employees for healthy behaviors. I see their point, but it can be humiliating for employees who might have 100 or more pounds to lose. 
Secondly, as healthcare workers, it's difficult to justify the patient education and encouragement of a healthy life style if the physician, nurse or office staff doesn't practice what they preach. The hospital wants to maintain some credibility with employees that walk the walk.We have a smoking area for employees, but I'm pretty sure it won't be long before we're a smoke-free campus. 

The issue that I see is that not all obesity is preventible, as indicated above, and I'd be willing to bet that an employee with an underlying medical condition would be protected against such a mandate. Unfortunately, they'd be expected to share their condition with their employer in order to be hired....not something everyone wants to do. As for smoking....I am a former smoker who really understands how difficult it can be to quit, and although I have sympathy, I code for a thoracic surgeon, and the vast majority of our lung cancer patients are smokers. Can't deny the connection. 

I am sure we've not heard the last of this, as an initative being taken by hospitals and practices to cut employee healthcare costs.


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