Nicole D Agaronnik1, Tara Lagu2, Christene DeJong3, Aixa Perez-Caraballo3, Kimberly Reimold4, Julie Ressalam5, Lisa I Iezzoni6. 1. Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, United States. 2. Institute for Healthcare Delivery and Population Science and Department of Medicine, Baystate Health, Springfield, MA, United States; University of Massachusetts Medical School, United States. 3. Institute for Healthcare Delivery and Population Science and Department of Medicine, Baystate Health, Springfield, MA, United States. 4. University of Massachusetts Medical School, United States. 5. Center for Bioethics and Humanities, University of Colorado School of Medicine, United States. 6. Health Policy Research Center, Mongan Institute, Massachusetts General Hospital, United States; Department of Medicine, Harvard Medical School, United States. Electronic address: liezzoni@mgh.harvard.edu.
Abstract
BACKGROUND: Given the growing population of U.S. adults with obesity and mobility disability, physicians will need to accommodate these patients. OBJECTIVE: To explore attitudes and practices of US physicians related to caring for patients with obesity and mobility disability. METHODS: Three open-ended, semi-structured, web-based focus group interviews with practicing physicians in selected specialties, which reached data saturation. Interviews were video recorded and transcribed for qualitative, conventional content analysis. Measurements included commonly expressed themes around caring for patients with obesity. RESULTS: Physicians recognized obesity as a disability that poses challenges to high quality, safe, and efficient patient care. Observations coalesced around four themes: (1) difficulty routinely tracking weight; (2) reluctance to transfer obese patients to exam tables; (3) barriers to diagnostic testing; and (4) weight stigma. Physicians described difficulties accurately assessing weight, performing complete physical examinations, arranging diagnostic imaging, and providing prenatal care for obese patients. Lack of accessible medical diagnostic equipment impeded care for patients with obesity. Other participants did not contest comments of individual participants' that suggested weight stigma. CONCLUSIONS: Our findings suggest that important gaps may remain in providing equitable access to care for patients with obesity, requiring additional training and accessible medical diagnostic equipment to safely accommodate these patients.
BACKGROUND: Given the growing population of U.S. adults with obesity and mobility disability, physicians will need to accommodate these patients. OBJECTIVE: To explore attitudes and practices of US physicians related to caring for patients with obesity and mobility disability. METHODS: Three open-ended, semi-structured, web-based focus group interviews with practicing physicians in selected specialties, which reached data saturation. Interviews were video recorded and transcribed for qualitative, conventional content analysis. Measurements included commonly expressed themes around caring for patients with obesity. RESULTS: Physicians recognized obesity as a disability that poses challenges to high quality, safe, and efficient patient care. Observations coalesced around four themes: (1) difficulty routinely tracking weight; (2) reluctance to transfer obese patients to exam tables; (3) barriers to diagnostic testing; and (4) weight stigma. Physicians described difficulties accurately assessing weight, performing complete physical examinations, arranging diagnostic imaging, and providing prenatal care for obese patients. Lack of accessible medical diagnostic equipment impeded care for patients with obesity. Other participants did not contest comments of individual participants' that suggested weight stigma. CONCLUSIONS: Our findings suggest that important gaps may remain in providing equitable access to care for patients with obesity, requiring additional training and accessible medical diagnostic equipment to safely accommodate these patients.
Authors: Nicole D Agaronnik; Elizabeth Pendo; Eric G Campbell; Julie Ressalam; Lisa I Iezzoni Journal: Health Aff (Millwood) Date: 2019-04 Impact factor: 6.301
Authors: Monika Mitra; Ilhom Akobirshoev; Nechama Sammet Moring; Linda Long-Bellil; Suzanne C Smeltzer; Lauren D Smith; Lisa I Iezzoni Journal: J Womens Health (Larchmt) Date: 2017-08-23 Impact factor: 2.681
Authors: Adit A Ginde; Anthony Foianini; Daniel M Renner; Morgan Valley; Carlos A Camargo Journal: Obesity (Silver Spring) Date: 2008-09-11 Impact factor: 5.002
Authors: Lisa I Iezzoni; Sowmya R Rao; Julie Ressalam; Dragana Bolcic-Jankovic; Nicole D Agaronnik; Tara Lagu; Elizabeth Pendo; Eric G Campbell Journal: Health Aff (Millwood) Date: 2022-01 Impact factor: 6.301
Authors: Lisa I Iezzoni; Sowmya R Rao; Julie Ressalam; Dragana Bolcic-Jankovic; Nicole D Agaronnik; Karen Donelan; Tara Lagu; Eric G Campbell Journal: Health Aff (Millwood) Date: 2021-02 Impact factor: 6.301
Authors: Lisa I Iezzoni; Sowmya R Rao; Julie Ressalam; Dragana Bolcic-Jankovic; Karen Donelan; Nicole Agaronnik; Tara Lagu; Eric G Campbell Journal: Jt Comm J Qual Patient Saf Date: 2021-06-23