Lifestyle discussion in the provision of health care. An empirical study of patient-physician interaction

The main issue explored is how patients and physicians communicate about lifestyle in the clinical encounter and what role this talk plays in terms of the outcome of the consultation. The data, collected at two primary health care centers, consist of 42 audiorecorded consultations. The analyses are based on these transcribed dialogues. Our study shows that communication about lifestyle issues is used as a source for determining what health care measures are relevant. Physicians provided a variety of types of information and explicit connections were made between lifestyle and the medical problem by physicians as well as patients. Within the process of reaching decisions on advice or treatment, two forms of interaction appeared referred to here as "paternalism" and "mutuality". In general, the results show that the physicians are very cautious about making explicit medical inferences concerning specific issues of the individual's lifestyle. (C) 1998 Elsevier Science Ltd. All rights reserved.