Physician Respect for Patients with Obesity
(1) Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, 2024 East Monument Street, Suite 1-500, Baltimore, MD 21205, USA
(2) Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
(3) Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Medical Institutions, Baltimore, MD, USA
(4) Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
Received: 16 March 2009 Revised: 28 July 2009 Accepted: 18 August 2009 Published online: 18 September 2009
ABSTRACT
INTRODUCTION Obesity stigma is common in our society, and a general stigma towards obesity has also been documented in physicians. We hypothesized that physician respect for patients would be lower in patients with higher body mass index (BMI).
METHODS We analyzed data from the baseline visit of 40 physicians and 238 patients enrolled in a randomized controlled trial of patient-physician communication. The independent variable was BMI, and the outcome was physician respect for the patient. We performed Poisson regression analyses with robust variance estimates, accounting for clustering of patients within physicians, to examine the association between BMI and physician ratings of respect for particular patients.
RESULTS The mean (SD) BMI of the patients was 32.9(8.1) kg/m2. Physicians had low respect for 39% of the participants. Higher BMI was significantly and negatively associated with respect [prevalence ratio (PrR) 0.83, 95% CI: 0.73–0.95; p?=?0.006; per 10 kg/m2 increase in BMI]. BMI remained significantly associated with respect after adjustment for patient age and gender (PrR 0.86, 95%CI: 0.74–1.00; p?=?0.049).
CONCLUSION We found that higher patient BMI was associated with lower physician respect. Further research is needed to understand if lower physician respect for patients with higher BMI adversely affects the quality of care.
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