Why is the BMI equation needlessly complex?

[InkJ]

I thought 'they' [scientist some time ago] magically decided we all fell into one of three body types [endomorph, etc]

I would have though any BMI system should take that into consideration [to find your natural / correct body weight]

Though I am fairly certain the three body type science is somewhat derided nowadays... still BMI came from back in the day - so i wondered why it was never part of the equation.

[AdamWW]

I thought 'they' [scientist some time ago] magically decided we all fell into one of three body types [endomorph, etc]

I would have though any BMI system should take that into consideration [to find your natural / correct body weight]

Though I am fairly certain the three body type science is somewhat derided nowadays... still BMI came from back in the day - so i wondered why it was never part of the equation.

'bodytypes' don't matter/aren't relevant... I think you're in need of some upgrades in your knowledge-base

[desslok]

'bodytypes' don't matter/aren't relevant... I think you're in need of some upgrades in your knowledge-base

Well he does have a point though that they were both made long long ago under different circumstances and are both outdated

[air2fakie]

Well he does have a point though that they were both made long long ago under different circumstances and are both outdated

Not really because how would that have worked, people would self-diagnose which ****type they were and then determine their BMI based on an adjusted formula specifically for their bodytype? Would add an extra layer for error/inaccuracy into the BMI equation.

[desslok]

Not really because how would that have worked, people would self-diagnose which ****type they were and then determine their BMI based on an adjusted formula specifically for their bodytype? Would add an extra layer for error/inaccuracy into the BMI equation.

I meant that he has a point in that they are both severely flawed and outdated.

[joewattie]

Slightly off topic but ...

I had my annual physical today. "Somebody" (clerk, technician, maybe a nurse) weighed me then asked me a series of questions. Depression? Have you fallen? Been threatened? And so on. I purposefully hesitated on a couple questions (to see if it generated further discussion) and even admitted that yes, I had fallen a few times. No response, no discussion.

The visit with the Doctor went fine, no complaints there.

So I later went to the online tool that summarized my visit.

It said my BMI was 26 and proudly went on about how I was counseled on being overweight and the importance of diet and weight management. 1 - There was NO such discussion. 2 - I only have a 29 inch waist.

(Further all the rout yes/no questions I answered were summarized as an "in depth consultation". Love my Dr. but all this bean counter crap they submit to the powers that be is BS ... including BMI.)

[desslok]

Slightly off topic but ...

I had my annual physical today. "Somebody" (clerk, technician, maybe a nurse) weighed me then asked me a series of questions. Depression? Have you fallen? Been threatened? And so on. I purposefully hesitated on a couple questions (to see if it generated further discussion) and even admitted that yes, I had fallen a few times. No response, no discussion.

The visit with the Doctor went fine, no complaints there.

So I later went to the online tool that summarized my visit.

It said my BMI was 26 and proudly went on about how I was counseled on being overweight and the importance of diet and weight management. 1 - There was NO such discussion. 2 - I only have a 29 inch waist.

(Further all the rout yes/no questions I answered were summarized as an "in depth consultation". Love my Dr. but all this bean counter crap they submit to the powers that be is BS ... including BMI.)

Sounds like Kaiser?

[joewattie]

Sounds like Kaiser?

Unfamiliar with the reference. Kaiser Permanente Healthcare?

[TolerantLactose]

It said my BMI was 26 and proudly went on about how I was counseled on being overweight and the importance of diet and weight management. 1 - There was NO such discussion.

It's a little fib so they can bill for it.

[air2fakie]

Slightly off topic but ...

I had my annual physical today. "Somebody" (clerk, technician, maybe a nurse) weighed me then asked me a series of questions. Depression? Have you fallen? Been threatened? And so on. I purposefully hesitated on a couple questions (to see if it generated further discussion) and even admitted that yes, I had fallen a few times. No response, no discussion.

The visit with the Doctor went fine, no complaints there.

So I later went to the online tool that summarized my visit.

It said my BMI was 26 and proudly went on about how I was counseled on being overweight and the importance of diet and weight management. 1 - There was NO such discussion. 2 - I only have a 29 inch waist.

(Further all the rout yes/no questions I answered were summarized as an "in depth consultation". Love my Dr. but all this bean counter crap they submit to the powers that be is BS ... including BMI.)

I once went for a routine fully covered dental cleaning and when my dental insurance sent me the claim summary the dentist had claimed thousands of dollars for four separate visits of dental procedures.

[EliKoehn]

This is all great to hear before my upcoming checkup this week... It's been years since I've been to the doctor and my former primary care physician retired. Going to have to be hypervigilant against this sort of thing looks like.

[RapidFail]

Slightly off topic but ...

I had my annual physical today. "Somebody" (clerk, technician, maybe a nurse) weighed me then asked me a series of questions. Depression? Have you fallen? Been threatened? And so on. I purposefully hesitated on a couple questions (to see if it generated further discussion) and even admitted that yes, I had fallen a few times. No response, no discussion.

The visit with the Doctor went fine, no complaints there.

So I later went to the online tool that summarized my visit.

It said my BMI was 26 and proudly went on about how I was counseled on being overweight and the importance of diet and weight management. 1 - There was NO such discussion. 2 - I only have a 29 inch waist.

(Further all the rout yes/no questions I answered were summarized as an "in depth consultation". Love my Dr. but all this bean counter crap they submit to the powers that be is BS ... including BMI.)

That's an impressive BMI and waist measurement - I would need to gain a lot of muscle and lose a little fat to get close to that. Is your listed age of 74 correct, if so that is even more impressive. When I last checked I had a 31" waist and a BMI of 22 - that's an estimated 13-14% body fat.

[Heisman2]

For many doctors much of the paperwork is autopopulated to save physicians a lot of time when charting. Many are not going to take the time to alter everything for each patient when it does not really impact the patient. So I would not get too bent out of shape when you see that it says something was discussed when it actually was not. You could easily argue we should be charting as precisely as possible but many doctors are already overworked and spending more time on paperwork/answering phone calls/talking with insurance/etc than we would like. The burnout is real from all the non-payment care aspects.

The exception would be if you get charged for said conversations that did not happen. Usually a physical is charged a certain amount regardless of what is discussed. So for anyone concerned I would try to figure out if the bill is just for a yearly physical or if it includes additional charges. If you actually get charged extra then I would argue.

I am not saying this is all ethically correct but I guarantee if physicians had to start being more accurate with all of the documentation for things that are inconsequential then many more would leave the profession when we already have a growing shortage of healthcare providers.

[joewattie]

For many doctors much of the paperwork is auto-populated to save physicians a lot of time when charting.

I totally agree with you. The important part, the actual visit with the doctor, was fine.

I posted because of the BMI part. I found humor in being called "overweight" by a professional medical office and its tie in with this thread.

Slightly disturbing, however, was when I admitted to multiple falls. I'm a senior (74) and it should have been a flag to at least a little further conversation. Falling seniors is often the beginning of the end. At a minimum they are sent to physical therapy to help reduce the risk of falling. (I took corrective action on my own sometime ago but they wouldn't know that.)

[joewattie]

That's an impressive BMI and waist measurement - I would need to gain a lot of muscle and lose a little fat to get close to that. Is your listed age of 74 correct, if so that is even more impressive. When I last checked I had a 31" waist and a BMI of 22 - that's an estimated 13-14% body fat.

Thank you for the compliment kind Sir! And, yes, I will be 75 next month.

Your pic suggests that you are doing just fine!!! (My "pic" is of my celebrity look alike - Danny DeVito. Yes, he's a little better looking but I'm a little taller :-)

But, back to the thread, BMI is not the end all be all. Take it with a grain of salt.

[Heisman2]

I totally agree with you. The important part, the actual visit with the doctor, was fine.

I posted because of the BMI part. I found humor in being called "overweight" by a professional medical office and its tie in with this thread.

Slightly disturbing, however, was when I admitted to multiple falls. I'm a senior (74) and it should have been a flag to at least a little further conversation. Falling seniors is often the beginning of the end. At a minimum they are sent to physical therapy to help reduce the risk of falling. (I took corrective action on my own sometime ago but they wouldn't know that.)

Yes, they should have followed up on the falling. Usually the nurse does screening questions and the answers are supposed to be seen by the provider so I have no idea why they let that slide.

[joewattie]

Yes, they should have followed up on the falling. Usually the nurse does screening questions and the answers are supposed to be seen by the provider so I have no idea why they let that slide.

I guess it's like you suggested earlier. Doctors are overworked and they report to business managers (bean counters) and insurance companies. I noticed my doctor spent more time on the computer than he did with me (again, he is a good doctor) so I teased him and asked how he liked his new career as a Computer Operator? I hit pay dirt. He laughed and went on a short rant about the crap he has to deal with now.

[Heisman2]

I guess it's like you suggested earlier. Doctors are overworked and they report to business managers (bean counters) and insurance companies. I noticed my doctor spent more time on the computer than he did with me (again, he is a good doctor) so I teased him and asked how he liked his new career as a Computer Operator? I hit pay dirt. He laughed and went on a short rant about the crap he has to deal with now.

Yeah, I spend almost all my time in patient rooms on the computer except when I'm physically examining the patient. That makes it much quicker for me, it also makes it quicker for the patient/family as I can type out the discharge instructions while I'm talking to them, and it increases the accuracy of my charting as it can be a bit difficult to remember everything later on. I get why some people would prefer more personal interaction but that's not the way the system is set up and I'm not willing to sacrifice my own time by putting off charting to later in the day.

[joewattie]

Yeah, I spend almost all my time in patient rooms on the computer except when I'm physically examining the patient. That makes it much quicker for me, it also makes it quicker for the patient/family as I can type out the discharge instructions while I'm talking to them, and it increases the accuracy of my charting as it can be a bit difficult to remember everything later on. I get why some people would prefer more personal interaction but that's not the way the system is set up and I'm not willing to sacrifice my own time by putting off charting to later in the day.

I do not disagree with a single thing you say Dr. However, my Doctor is an older gentleman and using a computer is very challenging for him. His frustration is palpable.

[Heisman2]

I do not disagree with a single thing you say Dr. However, my Doctor is an older gentleman and using a computer is very challenging for him. His frustration is palpable.

Completely understandable, one of my colleagues is older and types with 1 finger on each hand. It's so much easier for those of us who grew up using computers.

It would be more ideal if we only had to chart the atypical things instead of also charting everything that is normal. If I only had to chart the abnormal things it would likely take <60 seconds per patient on average. But for billing we need to show all the work we do for normal things as well so it just adds a bunch of unnecessary documentation. Thus everyone uses autopopulated notes that have everything normal and then we can either take time to delete the irrelevant stuff we did not discuss or do or we can just leave it in and hope nobody will care.

[EliKoehn]

EDIT: Comment removed and PMd to person addressed