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Background: Physicians do not provide preventive care at the level recommended by national organizations. This may be because of physicians' lack of training or low level of confidence or because of patients' fears, beliefs, and lack of health knowledge.Methods: We used an observational prospective cohort study in an academic family practice office to investigate changes in patients' functional status associated with receiving recommendations to change behavior from family physicians. Patients 18 years and older presenting for health maintenance visits to family physicians completed a functional status instrument and a brief intake questionnaire by telephone before their visit. After the visit patients were randomized to a debriefing interview or an observation-only group. The interview included the Patient/Doctor Interaction Scale and an assessment of whether patients received a recommendation to change behavior.Results: One hundred thirty-two patients were randomized to the debriefing group, and of those, 92% completed assessments at 3 months. Patients reporting recommendations to change behavior had lower scores at 1 and 3 months for mental health, social health, and self-esteem and higher anxiety and depression scores than patients not receiving these recommendations.Conclusions: There are declines in social and emotional functional status in patients presenting to family practice clinicians for health maintenance visits during which recommendations for behavioral change were made. Such declines may inhibit physicians from making recommendations for behavioral change or patients from accepting them. [ABSTRACT FROM AUTHOR]

With increasing scrutiny of the role of women in the medical profession, there has been speculation that women physicians provide more sensitivity and empathy to their patients. To compare the psychosocial awareness of female and male physicians, medical records were reviewed for 909 patient visits to six women and seven men who were first year family practice residents. Charts were audited for evidence of acknowledgement of 21 categories of psychosocial or sexual problems. Women physicians saw more patients than their male counterparts and had a higher percentage of visits from women patients (73 percent compared to 65 percent): Types of medical problems seen were similar for men and women physicians with 42 percent of patients noted to have at least one psychosocial or sexual problem. Recognition of problems did not differ significantly between men and women physicians. Women physicians found 44 percent of their female patients had at least one psychosocial problem compared to a 40 percent rate for men physicians seeing either male or female patients, but this small difference could have occurred by chance. When three family medicine faculty members were asked to rank the residents, their ratings were better predictors of psychosocial awareness than was the sex of the resident physician.