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Survey finds significant gaps in doctor-patient conversations

Americans define health in broad terms; wish doctors would talk to them about more than just physical health


Last updated 10/25/2018 at 10:41pm

WASHINGTON – Many Americans experience a disconnect between how they personally define health and how they talk about their health with their doctors. Nearly half, or 45 percent, of U.S. adults who have a primary care physician said they wish they talked with their doctor more about why they want to be healthy, and a majority of younger people – 57 percent of those aged 18-44 – said they wish their doctor would talk to them about treatments that do not involve medication, according to a new survey released by Samueli Integrative Health Programs.

“Patients see their health as much more than just their physical symptoms, yet doctors aren’t talking to their patients about important factors that influence their health,” Dr. Wayne Jonas, executive director of Samueli Integrative Health Programs, said. “A whole-person, integrative approach to health and well-being allows patients to get to the root of their health conditions, but we haven’t yet made this approach a priority in treating patients.”

The survey, which involved more than 2,000 adults ages 18 and older and was conducted online by The Harris Poll on behalf of Samueli Integrative Health Programs in September 2018, also found that more than nine in 10 Americans, or 92 percent, said health is about far more than just not being sick, and when asked to define health, many selected factors such as being happy, 59 percent; being calm and relaxed, 56 percent, and being able to live independently, 53 percent. Yet, a majority of those who have a primary care physician, or 52 percent, said they and their doctor don’t talk about much more than their medical needs.

For example, most Americans who have a primary care physician, or 74 percent, said they typically discuss their physical health with their doctor, but far fewer talk about other behavioral factors that strongly influence health, such as exercise, 51 percent; diet, 44 percent and sleep, 40 percent. Furthermore, very few Americans who have a primary care physician discuss factors that influence the mind-body connection, such as mental health, 36 percent and spiritual health, 10 percent, with their doctor.

“We know from past research that some 80 percent of health and healing are influenced by behavioral and social determinants of health – factors that affect a patient outside of their medical treatment,” Jonas said. “Health starts with the person, not the disease. And we as physicians should be asking ‘What matters?’ instead of just ‘What’s the matter?’ This is essential for patient-centered care.”

The survey also found sharp differences between younger people 18-44 years and older age groups. Younger people who have a primary care physician were 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 – 57 percent versus 48 percent of those aged 45 and above. At the same time, however, younger people were more likely to say that they wish they and their doctor talked more about why they want to be healthy – 55 percent versus 38 percent of those aged 45 and above – and about non-drug treatments – 63 percent versus 46 percent of those aged 45 and above.

“The current model of medicine focuses on providing pills and procedures for addressing physical symptoms and prescribing quick fixes,” Jonas said. “But younger patients want more. They are looking for options that fit their lifestyle and personal needs. This generational shift proves that more and more patients will be seeking out ways to address the underlying causes of health.”

The findings also showed that almost half of Americans, 48 percent, have been diagnosed with a chronic health condition, including about one in five diagnosed with anxiety, 18 percent, or depression, 19 percent. Despite the prevalence of these psychological conditions, only 36 percent of Americans with a primary care physician report discussing their mental health with their doctor.

The survey also found noteworthy differences based on geographic region. People living in the Northeast are more likely to rate their health as excellent, 24 percent, compared to Southerners, 18 percent and Midwesterners, 17 percent. Northeasterners who have a primary care physician are most likely to discuss with their doctor why it is important for them to be healthy – 27 percent versus 20 percent South, 17 percent Midwest and 18 percent West.

Samueli Integrative Health Programs is dedicated to the promotion of personal health and well-being with the support of health teams dedicated to all proven approaches, including conventional, complementary and self-care. Jonas, the former director of the NIH Office of Alternative Medicine and the former director of a World Health Organization Center for Traditional Medicine, is clinical professor of Family Medicine at the Uniformed Services University and at Georgetown University School of Medicine.

Submitted by The Reis Group.


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