Physicians' attitudes about obesity and their associations with competency and specialty: A cross-sectional study

Melanie Jay, Adina Kalet, Tavinder Ark, Michelle McMacken, Mary Jo Messito, Regina Richter, Sheira Schlair, Scott Sherman, Sondra Zabar, Colleen Gillespie

Research output: Contribution to journalArticle

Abstract

Background. Physicians frequently report negative attitudes about obesity which is thought to affect patient care. However, little is known about how attitudes toward treating obese patients are formed. We conducted a cross-sectional survey of physicians in order to better characterize their attitudes and explore the relationships among attitudes, perceived competency in obesity care, including report of weight loss in patients, and other key physician, training, and practice characteristics. Methods. We surveyed all 399 physicians from internal medicine, pediatrics, and psychiatry specialties at one institution regarding obesity care attitudes, competency, including physician report of percent of their patients who lose weight. We performed a factor analysis on the attitude items and used hierarchical regression analysis to explore the degree to which competency, reported weight loss, physician, training and practice characteristics explained the variance in each attitude factor. Results. The overall response rate was 63%. More than 40% of physicians had a negative reaction towards obese patients, 56% felt qualified to treat obesity, and 46% felt successful in this realm. The factor analysis revealed 4 factorsPhysician Discomfort/Bias, Physician Success/Self Efficacy, Positive Outcome Expectancy, and Negative Outcome Expectancy. Competency and reported percent of patients who lose weight were most strongly associated with the Physician Success/Self Efficacy attitude factor. Greater skill in patient assessment was associated with less Physician Discomfort/Bias. Training characteristics were associated with outcome expectancies with newer physicians reporting more positive treatment expectancies. Pediatric faculty was more positive and psychiatry faculty less negative in their treatment expectancies than internal medicine faculty. Conclusion. Physician attitudes towards obesity are associated with competency, specialty, and years since postgraduate training. Further study is necessary to determine the direction of influence and to explore the impact of these attitudes on patient care.

Original languageEnglish (US)
Article number106
JournalBMC Health Services Research
Volume9
DOIs
StatePublished - Jul 29 2009

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Obesity
Cross-Sectional Studies
Physicians
Self Efficacy
Internal Medicine
Statistical Factor Analysis
Psychiatry
Weight Loss
Patient Care
Pediatrics
Weights and Measures
Regression Analysis
Therapeutics

ASJC Scopus subject areas

  • Health Policy

Cite this

Physicians' attitudes about obesity and their associations with competency and specialty : A cross-sectional study. / Jay, Melanie; Kalet, Adina; Ark, Tavinder; McMacken, Michelle; Messito, Mary Jo; Richter, Regina; Schlair, Sheira; Sherman, Scott; Zabar, Sondra; Gillespie, Colleen.

In: BMC Health Services Research, Vol. 9, 106, 29.07.2009.

Research output: Contribution to journalArticle

Jay, Melanie ; Kalet, Adina ; Ark, Tavinder ; McMacken, Michelle ; Messito, Mary Jo ; Richter, Regina ; Schlair, Sheira ; Sherman, Scott ; Zabar, Sondra ; Gillespie, Colleen. / Physicians' attitudes about obesity and their associations with competency and specialty : A cross-sectional study. In: BMC Health Services Research. 2009 ; Vol. 9.
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abstract = "Background. Physicians frequently report negative attitudes about obesity which is thought to affect patient care. However, little is known about how attitudes toward treating obese patients are formed. We conducted a cross-sectional survey of physicians in order to better characterize their attitudes and explore the relationships among attitudes, perceived competency in obesity care, including report of weight loss in patients, and other key physician, training, and practice characteristics. Methods. We surveyed all 399 physicians from internal medicine, pediatrics, and psychiatry specialties at one institution regarding obesity care attitudes, competency, including physician report of percent of their patients who lose weight. We performed a factor analysis on the attitude items and used hierarchical regression analysis to explore the degree to which competency, reported weight loss, physician, training and practice characteristics explained the variance in each attitude factor. Results. The overall response rate was 63{\%}. More than 40{\%} of physicians had a negative reaction towards obese patients, 56{\%} felt qualified to treat obesity, and 46{\%} felt successful in this realm. The factor analysis revealed 4 factorsPhysician Discomfort/Bias, Physician Success/Self Efficacy, Positive Outcome Expectancy, and Negative Outcome Expectancy. Competency and reported percent of patients who lose weight were most strongly associated with the Physician Success/Self Efficacy attitude factor. Greater skill in patient assessment was associated with less Physician Discomfort/Bias. Training characteristics were associated with outcome expectancies with newer physicians reporting more positive treatment expectancies. Pediatric faculty was more positive and psychiatry faculty less negative in their treatment expectancies than internal medicine faculty. Conclusion. Physician attitudes towards obesity are associated with competency, specialty, and years since postgraduate training. Further study is necessary to determine the direction of influence and to explore the impact of these attitudes on patient care.",
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