Obese patients overestimate physicians' attitudes of respect

Objective: To evaluate whether obese patients overestimate or underestimate the level of respect that their physicians hold toward them. Methods: We performed a cross-sectional analysis of data from questionnaires and audio-recordings of visits between primary care physicians and their patients. Using multilevel logistic regression, we evaluated the association between patient BMI and accurate estimation of physician respect. Physician respectfulness was also rated independently by assessing the visit audiotapes. Results: Thirty-nine primary care physicians and 199 of their patients were included in the analysis. The mean patient BMI was 32.8kg/m² (SD 8.2). For each 5kg/m² increase in BMI, the odds of overestimating physician respect significantly increased [OR 1.32, 95%CI 1.04-1.68, p=0.02]. Few patients underestimated physician respect. There were no differences in ratings of physician respectfulness by independent evaluators of the audiotapes. Conclusion: We consider our results preliminary. Patients were significantly more likely to overestimate physician respect as BMI increased, which was not accounted for by increased respectful treatment by the physician. Practice implications: Among patients who overestimate physician respect, the authenticity of the patient-physician relationship should be questioned.