Why some people engage in ‘doctor shopping’

It would seem that a visit to the doctor’s office for a routine physical would be just that—routine. But for some overweight patients the appointment can be an extremely uncomfortable experience causing them to “shop” for a physician who is more sensitive to their needs.

Researchers at Johns Hopkins University School of Medicine found that overweight and obese patients are far more likely to repeatedly change primary care doctors more frequently than normal weight patients.

Known as “doctor shopping” the pattern may come from bad experiences in the doctor’s offices, that include, “off-putting comments by office staff, unsolicited weight loss advice by providers, or improperly sized medical equipment and office furniture,” researchers said.

Study leaders said patients who see three or more different primary care physicians in a two-year period are considered to be doctor shopping.

The study didn’t pinpoint precisely why people shop for doctors but said that focus groups have shed light on possible reasons.

“If they feel judged or hear offhanded comments about their weight, if the blood pressure cuff won’t fit properly or they are afraid the examination table will not support their weight, it reinforces negative stereotypes obese patients encounter elsewhere,” said lead researcher Kimberly A. Gudzune, MD in a news release.  We need to strive to create a safe, judgment-free environment where all patients can receive satisfying medical care.”

Dr. Tony Hampton, a family medicine physician with Advocate Medical Group in Chicago, says in principle, it’s smart to be discriminating when trying to find a doctor, but to a point.

“Although doctor shopping should be avoided in excess, deciding who will be your doctor should be taken just as seriously as buying your first car, home or even where you plan to attend college,” Dr. Hampton said. “It should be a good fit since you will likely have a long lasting relationship with the doctor and that relationship could have a substantial impact on your life.”

Using health insurance data, researchers looked at nearly 21,000 patients and found that 23 percent fell into the doctor shopping pattern. Of those, 19 percent were overweight and 37 percent were obese. Some of these patients saw five or more primary care doctors in the two year period.

Dr. Hampton says the research can be a wake-up call for physicians to be more sensitive to the special needs of their patients. He said it’s important to give patients ownership of their health care plan.

“I simply allow my patients to answer a simple question. ‘What are the overall goals you want to reach to be the healthiest you can be?’” Dr. Hampton explained. “In most cases, the patient will eventually talk about weight, diet or exercise which I then use to help them set goals.”

Dr. Jennifer DeBruler, an internal medicine physician also with Advocate Medical Group, echoes the point. She says she helps her patients realize it’s a journey.

“I am there for them each step, if they gain back some weight, I encourage them not be feel frustrated and remind them this is part of the process,” Dr. DeBruler said. “I just try to provide as much reassurance as possible and give them skills to help them reach their goals.”