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To Change or Not To Change: “Sounds Like You Have a Dilemma”

Wendy Levinson, MD; Marc S. Cohen, MD; Donald Brady, MD; and F. Daniel Duffy, MD
[+] Article, Author, and Disclosure Information

Dr. Levinson: University of Chicago; Chicago, IL 60637 Dr. Cohen: Medical College of Georgia; Augusta, GA 30912-4050 Dr. Brady: Emory University School of Medicine; Atlanta, GA 30303 Dr. Duffy: American Board of Internal Medicine; Philadelphia, PA 19106

Acknowledgments: The authors thank the American Academy on Physician and Patient and the Bayer Institute for Health Care Communication. Both organizations have helped the authors develop their skills in counseling patients and in teaching physicians these skills.

Requests for Single Reprints: Wendy Levinson, MD, University of Chicago Medical Center, 5841 South Maryland Avenue, MC 2007, Chicago, IL 60637; e-mail, wendy@medicine.bsd.uchicago.edu.

Current Author Addresses: Dr. Levinson: University of Chicago Medical Center, 5841 South Maryland Avenue, MC 2007, Chicago, IL 60637.

Dr. Cohen: Section of Urology, Medical College of Georgia, Room BA-8408, Augusta, GA 30912-4050.

Dr. Brady: Emory University, 69 Butler Street SE, Atlanta, GA 30303.

Dr. Duffy: American Board of Internal Medicine, 510 Walnut Street, Suite 1700, Philadelphia, PA 19106.

Ann Intern Med. 2001;135(5):386-391. doi:10.7326/0003-4819-135-5-200109040-00027
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One of a physician's most important tasks is to help patients change unhealthy behaviors, such as smoking, hazardous alcohol use, overeating, or physical inactivity. Such lifestyle changes often affect the outcome of care more than any other medical treatments that physicians have to offer. Physicians can play a pivotal role in helping patients make these changes, even during brief office visits (12). Yet, physicians seldom effectively counsel patients about behavior changes during routine office visits because of time limitations and a suspicion that urging patients to change long-standing habits can be fruitless. Since only 20% of patients seeking medical care are ready to change unhealthy behavior, it is not surprising that physicians feel frustrated (3).

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