Physicians build less rapport with obese patients
Open accessAbstract
Objective: Physicians' negative attitudes toward patients with obesity are well documented. Whether or how these beliefs may affect patient–physician communication is unknown. To describe the relationship between patient body mass index (BMI) and physician communication behaviors (biomedical, psychosocial/lifestyle, and rapport building) during typical outpatient primary care visits was aimed. Design and Methods: Using audio‐recorded outpatient encounters from 39 urban primary care physicians (PCPs) and 208 of their patients, the frequency of communication behaviors using the Roter Interaction Analysis System was examined. The independent variable was measured; patient BMI and dependent variables were communication behaviors by the PCP within the biomedical, psychosocial/lifestyle, and rapport building domains. A cross‐sectional analysis using multilevel Poisson regression models to evaluate the association between BMI and physician communication was performed. Results: PCPs demonstrated less emotional rapport with overweight and obese patients (incidence rate ratio, IRR, 0.65, 95%CI 0.48‐0.88, P = 0.01; IRR 0.69, 95%CI 0.58‐0.82, P < 0.01, respectively) than for normal weight patients. No differences in PCPs' biomedical or psychosocial/lifestyle communication by patient BMI were found. Conclusions: Our findings raise the concern that low levels of emotional rapport in primary care visits with overweight and obese patients may weaken the patient–physician relationship, diminish patients' adherence to recommendations, and decrease the effectiveness of behavior change counseling.
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- Authors
- Gudzune, K. A., Beach, M. C., Roter, D. L., & Cooper, L. A.
- Affiliations
- Johns Hopkins University (US)
- Corresponding author
- Gudzune, Kimberly A.
- Venue
- Obesity
- Publisher
- Wiley
- Published
- 2013-06-06
- Volume
- 21
- Issue
- 10
- Pages
- 2146-2152
- ISSN
- 1930-7381 (ISSN-L)
- 1930-739X
- PMC
- PMC3694993
- OpenAlex
- W1939621591
- Semantic Scholar
- 508be2ba4d790c46bd8dc718435df57b38e19518
- Cited by
- 171
- References
- 32
- Citations by year
- 2026: 3 · 2025: 16 · 2024: 16 · 2023: 13 · 2022: 11 · 2021: 15 · 2020: 16 · 2019: 14 · 2018: 21 · 2017: 10 · 2016: 9 · 2015: 11 · 2014: 8 · 2013: 8
- FWCI
- 22.68
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Obesity (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- Johns Hopkins University
- Health Resources and Services Administration
- U.S. Public Health Service (T32 HP10025-16-00)
- National Heart, Lung, and Blood Institute (P50HL105187, P50-HL0105187, R01HL088511, R01HL069403, K24HL083113)
- National Institute of Diabetes and Digestive and Kidney Diseases (P30DK079637)
- Topics
- Health Sciences › Health Professions › Pharmacy › Obesity and Health Practices
- Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
- Health Sciences › Medicine › Psychiatry and Mental health › Empathy and Medical Education
- Keywords
- patient-physician communication, physician-patient rapport, body mass index, primary care, biomedical communication, Roter Interaction Analysis System
- MeSH terms
- Attitude of Health Personnel, Body Weight, Cross-Sectional Studies, Humans, Life Style, Obesity, Physician-Patient Relations, Physicians, Body Mass Index
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