A recent study examined the effect of a physician’s weight on multiple aspects of the patient-physician relationship, eventually concluding that patients of an overweight or obese physician were less trusting of their doctors, less likely to take the physicians’ lifestyle advice, and more likely to switch to a different doctor.
The researchers identify that the widely identified weight bias or stigma extends into the exam room. Key factors suggested as contributors to a physician being overweight or obese included a lack of work-life balance and poor sleep habits.
It is ironic that in the health profession, many of our professional demands make it more difficult to be healthy rather than enhance our ability to model good lifestyle choices for our patients. While work duty hour reform for resident physicians continues to winnow away many of the unreasonable demands generations of physicians experienced, there are no work duty rules for attending physicians and we tend to manage our professional responsibilities like we were taught to do in medical school and residency.
I remember when I started my clinical rotations during my third year of medical school. My boyfriend at the time (now my husband) was a fellow medical student but was just starting his PhD work and wasn’t yet in clinical rotations. I found it hard to understand his frustration with my work schedule. He was frustrated that I had no free weekends for months on end, couldn’t commit to dinner plans, and was exhausted during the few hours I wasn’t in the hospital. I thought there was something wrong with him! It was medical school, after all. What did he expect? What actually was going on was that he was still in the real world where work didn’t need to consume every moment of your time, energy and passion. I was already indoctrinated into the medical system which placed the work we did above everything else.
When I graduated to residency training, I was proud of myself for prioritizing two things — sleep and food. Unless a patient was having an urgent issue, I always made sure I had dinner before my night on call. When I got off call, I made myself sleep first before doing anything else. I thought that my commitment to these two priorities demonstrated exceptional work-life balance. How skewed it is that in our profession, basic physiologic necessities such as nutrition and sleep become luxuries.
So, I’m not surprised that our patients see our own battles with weight and health as character flaws. The “do what I say, not what I do” model doesn’t work well in the clinic or in parenting. However, what those of us in the medical community know very well is that the character flaw we’re really guilty of is becoming doctors in the first place — committing to practice medicine in an environment that is the very antithesis of health.