Patients want doctors to talk to them about more than just physical symptoms, medications

Today’s patients have a broader view of what good health means, according to a new survey, and they have greater expectations of what their doctors should be talking about during office visits.

The survey of 2,027 U.S. adults conducted by the Harris Poll on behalf of Samueli Integrative Health Programs, found a disconnect in doctor-patient conversations. Half of patients said their doctors do not have conversations beyond their medical needs. They want their doctors to talk to them about more than physical health, test results and medications.

For instance, most Americans who have a primary care physician (74%) say their doctor typically discusses their physical health, but far fewer talk about behavioral factors that can strongly influence health, such as exercise (51%), diet (44%) and sleep (40%).

And while doctors focus on physical health, some of the most common health problems that patients face are mental health issues. The four most common health issues were: depression (19%), anxiety (18%), chronic pain (11%) and diabetes (10%).

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Yet, among patients with a PCP, doctors discuss factors that influence the mind-body connection, such as mental health and spiritual health only 36% and 10% of the time.

The survey showed that doctors aren’t talking to their patients about important factors that influence their health, said Wayne Jonas, M.D., executive director of Samueli Integrative Health Programs, and a practicing family physician, during a media briefing to discuss the survey findings.

Doctors need to take a whole-person, integrative approach to health, Jonas said.

“We need to restructure how we do primary care,” he said, so that instead of waiting for problems, such as diabetes, to show up, doctors are focusing on patients’ lifestyle choices that can help prevent or reverse problems. That will save money in the long-run.

Jonas admits that doctors’ addressing all of a patient’s needs in a 15- or 20-minute office visit is not easy. “This is a major problem. I hear it all the time and I struggle with it myself,” he said. Doctors may need to schedule more visits to address a patient’s more complex needs, such as patients who suffer from chronic pain.

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Jonas said doctors can introduce nonpharmacologic treatments such as meditation, yoga, massage therapy and acupuncture to patients.

An interesting result of the survey is that younger people (18-44) are more likely than their older counterparts to say that they and their doctor don’t really talk about much more than medical needs such as physical symptoms, tests, medications and surgeries. They wish their doctor talked more about why they want to be healthy (55%) and about nondrug treatments (63%).

Jonas thinks younger people are much more aware of the influences of behavior and lifestyle choices on their health. “They realize these conversations need to take place. They are more empowered to take action,” he said. They are more likely to say to their doctor that they heard or read about something and want to have a conversation.

Jonas, the former director of the NIH Office of Alternative Medicine, said doctors can find resources to talk to patients about various issues on his website.

The Harris Poll backs up another survey earlier this year that found primary care doctors are neglecting to talk to patients about the things that are most likely to kill them.

The survey of 3,000 Americans by ImagineMD, a direct primary care medical practice in Chicago, found few doctors are talking to patients about issues such as drug overdose, suicide and traffic accidents—some of the leading causes of death in America.