May 2nd, 2013 by Dr. Val Jones in Health Tips, Opinion, Research
No Comments »
A recent, 358-person survey conducted by researchers at Yale University (and published in the International Journal of Obesity)Â suggested that patients may be less likely to follow the medical advice of overweight and obese physicians. Survey respondents were 57% female, 70% Caucasian, 51% had BMIs in the normal or underweight category (31% overweight and 17% obese), and were an average age of 37 years old.
Respondents rated overweight and obese physicians as less credible than normal weight doctors, and stated that they would be less likely to follow advice (including guidance about diet, exercise, smoking cessation, preventive health screenings, and medication compliance) from such physicians. Although credibility and trust scores differed between the hypothetical overweight and obese providers and normal weight colleagues, the respondents predicted less of a difference between them in terms of empathy and bedside manner. Respondents said they’d be more likely to switch physicians based on their weight alone. There was no less bias against overweight and obese physicians found in respondents who were themselves overweight or obese.
The study authors note that this survey is the first of its kind – assessing potential weight bias against physicians by patients of different weights. Previous studies (by Puhl, Heuer, and others) have documented weight bias against patients by physicians.
While the study has some significant limitations (such as the respondents being disproportionately Caucasian, thin, and female), I think it raises some interesting questions about weight bias and physicians’ ability to influence patients to adopt healthier lifestyles.
Considering the expansion of pay-for-performance measures (where physicians receive higher compensation from Medicare/Medicaid when their patients achieve certain health goals -such as improved blood sugar levels), being overweight or obese could reduce practice profit margins. If patients are less likely to follow advice from overweight or obese doctors, then it stands to reason that patients’ health outcomes could suffer along with the doctors’ income.
I’m certainly not suggesting that CMS monitor physician waist circumferences in an attempt to improve patient compliance with healthy lifestyle choices (Oh no, did I just give the bureaucrats a new regulatory idea?), but rather that physicians redouble their efforts to practice what they preach as part of a commitment to being good clinicians.
Some will say that the problem here is not expanding provider waistlines, but bias against the overweight and obese. While I agree that weight has little to do with intellectual competence, it does have to do with disease risk. Normalizing and destigmatizing unhealthiness is not the way to solve the weight bias problem. We know instinctively that carrying around a lot of extra pounds is damaging to our health. It’s important to show grace and kindness to one another as we join together on the same health journey – a struggle to make good lifestyle choices in a challenging environment that tempts us to eat poorly and cease exercising.
To doctors I say, let’s fight the good fight and model healthy behaviors to our patients. To patients I say, show grace to your doctors who carry extra pounds – don’t assume that they are less competent or knowledgeable because of a weight problem. And to thin, female, 30-something, Caucasian survey respondents I say – Wait till you hit menopause before you judge people who are overweight! đ
December 18th, 2011 by Dinah Miller, M.D. in Opinion, Research
No Comments »
For a while now we’ve been talking about issues related to psychiatry and electronic medical records. Roy is very interested in the evolution of EHR’s.
I don’t like them. I think they have too many problems still, both in terms of issues of efficiency and time, and how they divert the physician’s attention away from the patient, and they focus medical appointments on the collection of data– data that is used in a checkbox form: patient is not suicidal and I asked, whether it was clinically relevant or not– and will therefore serve as protection in a lawsuit, or demographic information used by insurers, the government, who knows.
From a privacy standpoint, I think they are appalling.  If you are a patient in the hospital where I work, you get Read more »
*This blog post was originally published at Shrink Rap*
October 17th, 2011 by Dinah Miller, M.D. in News
No Comments »
U N I T E D Â N A T I O N S
THE SECRETARY-GENERAL—MESSAGE ON WORLD MENTAL HEALTH DAY: 10 October 2011
There is no health without mental health. Mental disorders are major contributors to illness and premature death, and are responsible for 13 percent of the global disease burden. With the global economic downturn â and associated austerity measures â the risks for mental ill-health are rising around the globe.
Poverty, unemployment, conflict and war all adversely affect mental health. In addition, the chronic, disabling nature of mental disorders often places a debilitating financial burden on individuals and households. Furthermore, individuals with mental health problems â and their families â endure stigma, discrimination and victimization, depriving them of their political and civil rights and constraining their ability to participate in the public life of their societies.
Resources allocated for mental health by governments and civil society are Read more »
*This blog post was originally published at Shrink Rap*
June 2nd, 2011 by Dinah Miller, M.D. in Opinion
No Comments »
Here at Shrink Rap, we often talk about the stigma of having a psychiatric disorder. It’s funny, but society has it almost ranked, so that certain illnesses are very stigmatized–schizophrenia and schizoaffective disorder, and borderline personality disorder, to name a few, and others are pretty much socially acceptable: Attention Deficit Disorder, for example, especially among the high school/college crowd where the patient often gets identified (or self-identifies) as the source for those late-night stimulants that so many kids cop.
It’s not just the patients. Psychiatrists are also stigmatized, and that doesn’t help much when our society talks about the shrink shortage.
Exalya writes:
I’m a first (almost second) year medical student with a strong passion for psychiatry. I love listening to your podcasts; you give me hope for my future when the drudgery of first year classes is getting me down, and I feel like I always learn something useful.
That aside, I am writing to you seeking some advice. Read more »
*This blog post was originally published at Shrink Rap*
April 23rd, 2011 by Glenn Laffel, M.D., Ph.D. in Research
1 Comment »
Based on their experience during countless schleps to the market, moms know that kids pick cereals whose boxes have cartoon characters on them. Previous research by Yale scientists explained the phenomenon: kids say that the stuff poured from such boxes tastes better than the same stuff when poured from a cartoon-less box. The same thing happens when kids pick graham crackers, carrots and gummy fruit snacks.
Pictures of Shrek, Dora the Explorer, Scooby Doo and their kin make just about anything taste yummier, it seems.
Can this observation be leveraged to encourage kids to select healthier foods? Yes, it turns out. But the story isnât as straightforward as youâd think.
To study the impact of licensed media spokescharacters and other nutrition cues on kidsâ taste assessment of food products, scientists at the University of Pennsylvania fed cereal from a box that had been labeled either âSugar Bitsâ or âHealthy Bitsâ to 80 kids. Half the boxes in each âbrand categoryâ were adorned with cute cartoon penguins, while the other half were not. The kids were between 4 and 6 years old. Read more »
*This blog post was originally published at Pizaazz*
