Jerry Rodriguez hasn't seen a doctor in over two years, even though the Pasadena-based home care provider is grossly overweight, has pain and bloating in both his legs and suspects he has diabetes.
The problem isn't accessibility --- Rodriguez belongs to one of the most advanced and prolific health maintenance organizations in the country. Nor is the problem fear of medical treatment, since in the two decades before he moved to the Los Angeles area, Rodriguez was "one of the most diligent people you'd ever meet," when it came to keeping up with his periodic general check-ups twice a year and staying current with all of the added testing his previous doctor requested, and even voluntarily undergoing tests that weren't necessarily required.
"Even though I've always had a weight problem --- I should say, because I've always had a weight problem --- I was extremely aware and conscientious about medical care," he said.
In fact, "I'm still really concerned about my health," but "I just haven't found a doctor that was like the one I used to have."
Put another way, Rodriguez, who previously lived in Fresno, Calif., hasn't yet found a doctor that makes him feel as welcome as did his former physician.
"It might sound stupid, but, no, I haven't seen a doctor all this time because I haven't found anyone I really feel comfortable with."
Whereas his previous doctor "came across almost as a caring brother, always concerned about my physical conditions but respectful enough not to make me feel inferior because I am so fat," Rodriguez said "each one" of the handful of doctors he saw his first few months in the L.A. area "talked down to me...came across as cold and unable to truly understand me, where I'm coming from."
Most importantly, Rodriguez said, the doctors he most recently saw "spoke to me about my weight as if I were a stupid child, unable to understand basic concepts....I mean, I got a problem with my weight, not my ability to understand. So, I just figure, these thin, beautiful-looking doctors don't treat me like they really care about me, why should I put myself through that. I'll probably look for a better doctor again, but right now, I'm too busy to deal with those types of feelings."
As it turns out, Rodriguez is hardly the only overweight patient unable to connect with his doctor, according to research recently published in the medical journal Obesity
The new study, which looked at 39 primary care doctors and 208 of their patients and compared the patients' BMI with doctors' ability to show empathy, concern and understanding, regardless of the medical topic discussed, found physicians generally build less rapport with obese and overweight patients.
The researchers did not find a difference in the quantity of the physicians' medical questions, advice, counseling or treatment regimen discussions.
But, as explained by lead researcher Kimberly A. Gudzune, a medical doctor at John Hopkins University School of Medicine, a lack of emotional rapport with one's doctor can play a key role in a patient's likelihood to adhere to his or her doctor's advice.
"If patients see their primary care doctors as allies, I think they will be more successful in complying with our advice," Gudzune said. "I hear from patients all the time about how they resent feeling judged negatively because of their weight. Yes, doctors need to be medical advisers, but they also have the opportunity to be advocates to support their patients through changes in their lives."
Gudzune said the latest results didn't come as a surprise, as several other previous studies have also indicated physicians in general may hold negative attitudes toward obese patients.
Nonetheless, "patients want information and treatment, but they also need the emotional support and attention that can help them through the challenges that accompany weight loss and the establishment of a healthy lifestyle," Gudzune said.
Physicians, she asserted, should be mindful of any negative attitudes they have when treating the obese or overweight --- and then try to adjust those feelings.
Much more, physicians should take it up themselves to bond and then spend time with their overweight and obese patients, said Gudzune, especially when discussing psychosocial and lifestyle issues.
Then, maybe patients like Jerry Rodriguez will once again find the level of medical care and support they need.
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