Doctor Style, Research, and Other Weighty Matters

October 28, 2010

Today’s post starts with a summary of another study showing the importance of physician-patient communication, this time in the key and “massive” area of weight loss.  Then we veer into what may be the topic du jour in health policy: the very credibility of research results.  I think you’ll find the discussion interesting–and I’ll be interested in your reactions.

1906 print "Don't Be Fat" ad showing an overweight womanOne of our readers, Trish, noted a study report in the October issue of the  American Journal of Preventive Medicine that ties weight loss in overweight patients to the physician’s style of communication.  (Note, BTW, use of the word “preventive,” not the mouth-contorting “preventative.”)  Patients in the study tended to lose a significant amount of weight if their doctor used “motivational interviewing” that was tailored to the patient’s circumstances and readiness to change behavior.

But, patients tended not to lose weight if the doctor avoided the topic, or if the doctor spoke only in a general, prescriptive, or confrontational way about the importance of losing weight.  It seems we don’t respond well to robotic advice or to nannying.  Surprise.

Nicholas Bakalar reported on the study in the New York Times on October 25.  Bakalar emphasized that “cajoling and coaxing, scolding and reproach are all ineffective.”  What works is “collaborative discussion.”  The latter is exactly the type of conversation promoted in this blog and in our book.

The study, by Kathryn I. Pollak of Duke University and colleagues, involved 40 primary care physicians and 461 patients.

But, here’s the question:  Can we trust the results of studies like this? New findings show that shockingly large numbers of medical studies reflect the researchers’ biases and self-interests and produce inaccurate results.

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