Weighing the care: patients' perceptions of physician care as a function of gender and weight

OBJECTIVE: To examine patients' reports of the level of care that they receive from their physicians, and determine the influence of weight and gender in these reports.
DESIGN: In a four-cell design, male and female, overweight and nonoverweight patients reported on the medical care that they received immediately following their appointment.
SUBJECTS: A total of 125 patients affiliated to one of four large clinics in the Texas Medical Center of Houston completed this study.
MEASUREMENTS: Patients reported the positivity of the care that they received, the time that physicians spent with them, and the extent to which physicians discussed weight-related topics with them.
RESULTS: Overweight patients, as a whole, did not report poorer levels of care than did their thinner counterparts. Rather, the weight and gender of the patient significantly interacted across each of the measures to reveal some divergence between male and female patients' weight-based experiences. When significant differences in reported perceptions emerged, overweight men reported deficits in care relative to average weight men (eg, physicians spent less time), whereas overweight women reported enhanced care relative to average weight women (eg, better levels of care, more topics discussed).
CONCLUSION: Based on patients' reports, this study reveals that physician care may not be as influenced by patient weight as previously thought. Yet, there is a discernible impact of patients' weight on physician behavior. Overweight men, who may comprise the most at-risk population, indicate that less time is spent with them than that indicated by average weight men. While this may be alarming, overweight women do not report reductions in care. We propose that not only might physicians respond to them differently, but overweight female patients may also be engaging in denial strategies or compensatory behaviors that assure them of quality care.