People who struggle with weight are more likely to repeatedly switch primary care doctors, a practice known as “doctor shopping” that disrupts continuity of care and leads to more emergency room visits, new Johns Hopkins research shows.
The trend may be a result of negative experiences obese and overweight individuals have with the healthcare system — including off-putting comments by office staff, unsolicited weight loss advice by providers, or improperly sized medical equipment and office furniture, said Kimberly A. Gudzune, M.D., an assistant professor of internal medicine at the Johns Hopkins University School of Medicine.
"There's something going wrong in these doctor-patient relationships that make these switches so frequent for this group of people," said Dr. Gudzune, who led the research published online in the journal Obesity. "The real problem here is that the health of overweight and obese patients who doctor shop is being compromised. 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."
Dr. Gudzune and her colleagues define doctor shopping as seeing three or more different primary care physicians in 24 months. In tracking more than 20,700 patients in a BlueCross BlueShield claims database, the researchers found that 23 percent met the definition. The odds of doctor shopping increased by 19 percent for overweight patients and 37 percent for obese patients, compared with normal-weight patients in the database.
Dr. Gudzune noted not all doctor shopping is bad. "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 said. The concern is that some patients may not find a provider that can help them maintain their health.
The researchers also found that overweight and obese doctor shoppers are 85 percent more likely than their normal-weight peers to visit the ER.
"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," Dr. Gudzune said.
"We need to strive to create a safe, judgment-free environment where all patients can receive satisfying medical care."
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