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Physicians who tout well-being may scare off patients, Stanford researcher finds

Physicians have to walk a tough line when encouraging healthy behavior. Take Dr. J. She bikes to work, swims over lunch, jogs on the weekend and eats primarily veggies grown in her garden, supplemented by fish and poultry purchased at the local farmer's market. Will she relate well with Ms. E, who favors fast food and sodas and eschews exercise in favor of television dramas?

It's fairly obvious that their lifestyle differences could impair their relationship. But how can that gap be bridged? Stanford social psychology graduate student Lauren Howe and colleagues examined how doctors can frame their passion for personal health to help, rather than repel, their patients.

Working with Stanford experimental social psychologist Benoît Monin, PhD, Howe examined how patients at Kaiser Permanente select doctors. They rely only on brief bios, that may or may not mention a doctor's interest in fitness.

She describes their findings in a recent essay in The New York Times:

We found that participants who were overweight believed that the fit doctors would disapprove of patients with unhealthy habits, and as a result overweight participants preferred physicians who did not advertise their fitness. Interestingly, in our studies, doctors who emphasized their healthy habits were no more appealing to patients who were not overweight. So health care practitioners showing off a healthy lifestyle didn’t seem to draw in patients as might have been expected, and even drove away some.

This research documents that promoting that you practice what you preach can backfire. Doctors who advertise their commitment to fitness in their own lives can seem critical of patients with less-than-perfect health, and inadvertently threaten patients who are struggling. Well-meaning doctors who are proud to be leading by example could be repelling exactly the people they may hope to inspire. As a result, many individuals may be avoiding doctor visits and not getting the care they need.

Howe and Monin then tweaked some of the doctors' bios, adding blurbs like "I believe everyone has their own definition of a healthy life." Indeed, this change decreased the number of overweight patients who were put off by fit doctors.

Overall, it appears that physicians may be best served by modeling healthy behavior, but remaining humble and compassionate toward others who are less fit. Howe concludes:

By understanding the complex ways in which patients form impressions of health care providers, we can ensure that the greatest number of people, from the most diverse backgrounds, find their way to the care they need.

Previously: "This is my story, my body, my journey": A Stanford physician's quest for better health and Using arts and communication to help physicians improve health, avoid suicide
Image by mohamed1982eg

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