Many patients remain ignorant of just how the state or federal government controls the lives of our patients and subsequently the practice of medicine. Let me take the privilege of enlightening with another true-life senerio.

I saw Duane recently for probable sleep apnea. He didn’t come for an appointment because he thought he had sleep apnea or even because he thought he had some of the symptoms often associated with it such as daytime sleepiness, high blood pressure, or excessive snoring–often reported by the sleeping partner, by the way.

Duane came to the office because the state mandated that he do so. Duane is a bus driver with one of the local public schools. The state noticed that he had a BMI (Body Mass Index) over the recommended level (that means he’s over-weight) and now has required that these disgusting fat people are probably not qualified to drive school buses any longer.

Even after I verified that he was not suffering from apnea (low oxygen) through an oximetry study, he returned a second time because they demanded an official over-night sleep study be completed–at his expense, of course. You’re not going to be driving our kids around if you’re one of those fat people Mrs. Obama thinks needs her special culinary help.

Now think about where you may soon fit into this picture. Are you overweight? Most of us are. Would you qualify for employment as a state or federal employee? Will the BMI soon be a part of your employment evaluation?