Obese Patients May Be More Prone to 'Doctor Shopping'
Stigma, judgments in office visits might prompt frequent switches, study authors say
Friday, May 31, 2013
Recurrent bad experiences with doctors -- being made to feel uncomfortable during office visits -- may be to blame for the trend, the researchers said.
"There's something going wrong in these doctor-patient relationships that make these switches so frequent for this group of people," study author Dr. Kimberly Gudzune, an assistant professor in the division of general internal medicine at the Johns Hopkins University School of Medicine, said in a university news release.
"If they feel judged or hear offhanded comments about their weight, if the blood pressure cuff won't fit properly or they are afraid the examination table will not support their weight, it reinforces negative stereotypes obese patients encounter elsewhere," Gudzune explained. "We need to strive to create a safe, judgment-free environment where all patients can receive satisfying medical care."
The study involved more than 20,700 patients in a BlueCross BlueShield claims database. The researchers found that 23 percent of patients engaged in "doctor shopping," seeing three or more primary care physicians within a two-year span. The research team noted that overweight patients were 19 percent more likely to repeatedly change doctors, while obese patients were 37 percent more likely to do so.
The study also found that 4 percent of patients saw at least five doctors over the course of two years. Those who were overweight or obese were more likely to be among this group.
Overall, overweight and obese people who shopped around for a doctor were also 85 percent more likely than normal-weight "doctor shoppers" to require a visit to the ER. The researchers believe, however, that many of the issues experienced by the patients could have been addressed or prevented in a doctor's office.
"The real problem here is that the health of overweight and obese patients who doctor shop is being compromised," Gudzune said. "Because they do not remain with their doctors for very long, they are ending up in the emergency room, likely for things that could have been taken care of in a primary care office."
Prior studies have shown that continuity in care is linked to fewer hospitalizations, trips to the ER, greater use of preventive services and reduced health care costs, Gudzune's team noted. The researchers believe more study is needed to determine the exact cause of doctor shopping among overweight and obese patients.
Finding a physician that does not make a patient feel stigmatized or uncomfortable is key to better health care, Gudzune said. "If you are dissatisfied with your care or feel judged because of your weight, then you may be better served by finding a provider who can meet your needs," she advised.
The findings were published online this month in Obesity.