Weighing the care: physicians' reactions to the size of a patient

OBJECTIVE: To examine how the weight of a patient affects both the attitudes that physicians hold as well as the treatments that they intend to prescribe. DESIGN: In a six-cell randomized design, physicians evaluated a medical chart of a male or female patient, depicted as either average weight, overweight or obese, who presented with a migraine headache. SUBJECTS: A total of 122 physicians affiliated with one of three hospitals located in the Texas Medical Center of Houston completed the experiment. MEASUREMENTS: Using a standard medical procedure form, physicians indicated how long they would spend with the patient and which of 41 medical tests and procedures they would conduct. They also indicated their affective and behavioral reactions to the patient. RESULTS: The weight of a patient significantly affected how physicians viewed and treated them. Although physicians prescribed more tests for heavier patients, F(2, 107) = 3.65, P < 0.03, they simultaneously indicated that they would spend less time with them, F(2, 107)= 8.38, P < 0.001, and viewed them significantly more negatively on 12 of the 13 indices. CONCLUSION: This study reveals that physicians continue to play an influential role in lowering the quality of healthcare that overweight and obese patients receive. As the girth of America continues to increase, continued research and improvements in the quality of such healthcare deserve attention.