Why docs who say 'I'm fit!' may get fewer patients

Doctors may promote their own health and fitness on online profiles to appeal to patients, but the practice doesn't necessarily attract healthy patients—and it may alienate those who are concerned about their own weight, according to a study in the Journal of Personality and Social Psychology

Key insights on medical weight loss programs

Study details

For the study, researchers Lauren Howe and Benoît Monin from Stanford University scanned Kaiser Permanente's online physician profiles and grouped the profiles into two categories: profiles that emphasized fitness—in which the physician said he or she prioritized staying active and healthy or listed at least two active hobbies, such as hiking or cycling—and profiles that did not emphasize fitness.

The researchers then recruited 143 people who had a BMI over 25—the minimum to be considered overweight—and who had expressed concerns about their weight. The participants were asked to rate 10 of the physician profiles, five of which were fitness-focused and five of which were not.

Key findings

The researchers found that the study participants felt doctors who advertised their interest in fitness would judge patients who had unhealthy habits. As a result, the participants said they would be less likely to select the fitness-focused physicians as their doctor and would prefer a doctor who didn't mention fitness in his or her profile.

And when the researchers surveyed an additional batch of respondents who were not overweight, those respondents said the fitness-focused profiles were no more likely to make them select those physicians as their own—meaning fitness-focused providers were not only alienating some patients, but also failing to attract new, healthier patients, the researchers said.

Howe and Monin then tweaked the fitness-focused profiles, adding caveats such as, "I try to maintain a regular exercise routine (though it's hard to find the time and energy)." When asked to rate the new profiles, study participants with BMIs over 25 rated the profiles as less judgmental—but they still said they would be less likely to choose those physicians to be their doctor.

The researchers then went a step further, adding non-judgmental phrases such as "everyone has their own definition of a healthy life and what it means to be healthy for them" to the fitness-focused profiles. After that tweak, those physicians were the most preferred option among study participants with a BMI over 25.

Discussion

Writing in the New York Times' "Well," Howe says the research illuminates the counter-perspective to federal guidelines encouraging physicians to "model healthy behaviors." Not only does the research suggest that providers trying to lead by example might be alienating "exactly the people they may hope to inspire," but it also shows that this "pressure to lead by example could prompt less-than-perfect providers who understand firsthand the struggles patients face in maintaining healthy habits to keep their valuable insights to themselves."

According to Howe, the research suggests providers adopt a more "nuanced" approach. Rather than "blanket recommendations that providers need to practice and demonstrate healthy habits in their own lives to be effective," the medical profession should "realize that doctors who don't advertise healthy lifestyles may appear more approachable to some patients" and that "super-fit physicians may want to display compassion and understanding toward patients who do not find exercise appealing, or do not conform to stereotypical portraits of health."

Howe concludes, "By understanding the complex ways in which patients form impressions of health care providers, we can ensure that the greatest number of people, from the most diverse backgrounds, find their way to the care they need" (Howe, "Well," New York Times, 7/13; Fradera, British Psychological Society Research Digest, 4/18).

Key insights on medical weight loss programs

 Key insights on medical weight loss programs

As obesity and its related comorbidities remain top concerns nationwide, many hospitals are considering how to enhance their services to this patient group. Understanding that weight loss demands a comprehensive approach to care, many hospitals have launched non-surgical weight loss programs to support those patients who are not candidates for surgery.

These weight management programs vary greatly in their organization, program offerings, patient referral patterns, payment structure, and marketing strategies, though all aim to help patients lose excess weight. This brief profiles three non-surgical weight loss programs at community and teaching hospitals to identify the variety of services available.

Download the brief


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