Thursday, December 15, 2011

New post in The Empowered Patient on Informed Decision Making

See the latest "The Empowered Patient" column in the January issue of MPN Forum, an online magazine that features stories and news about myeloproliferative neoplasms. In my column, I share personal experiences with shared decision making and offer some background information about the process of informed medical decision making. The column can be found at: You can find a link to MPN Forum in my favorites on the right side of this page. I have added a link to the Foundation for Informed Medical Decision Making in my favorites as well. Check it out for excellent information and news.

Sunday, December 11, 2011

Empathy and Reflective Statements in Primary Care Discussions About Weight

A recent study of discussions of weight concerns in primary care, published in the Journal of the American Board of Family Medicine (, found that physician empathy (assessed by trained raters who coded audiotapes of primary care visits) was linked to improved patient satisfaction, while physician use of reflective statements was associated with patients'  perception that the physician suppported their autonomy. The study included 40 physicians and 320 of their overweight or obese patients. Of note, physician empathy was only rarely expressed in these encounters; only 18 of the 320 encounters were rated as demonstrating a physician empathy score of greater than 1 on a scale of 1-5! Of those encounters with empathy scores greater than 1, 27% of the patients rated their satisfaction as excellent, compared to 11% of the visits with empathy scores equal to 1. Reflections were rated as present in only 38% of the encounters. When reflections were present, 47% of patients reported high levels of autonomy support, a measure dervied from Self-Determination Theory (SDT). Previous studies suggest that increased autonomy support is associated with increased intrinsic motivation as well as improved patient follow-through. The authors conclude that strategies that increase physician empathy and number of reflective statements could improve patients’ adherence to recommendations. Limitations of this study include the small sample of physicians, high patient refusal rate and a rather well-educated patient population.