In dealing with patients, if you command them or browbeat them, you are going to lose the patient. They aren’t going to come back. They need a careful explanation. The better approach is behavior modification—diet and exercise. To get real buy-in and acceptance from the patients requires a better understanding of what the goals are than most doctors have time to explain. It is rather discouraging. On the other hand, when you see patients who are motivated to stop smoking or lose weight and they achieve goals, that is very gratifying, even when you realize you’re only reaching a fraction of the people who could benefit a lot more.
From my experience, it’s more about trying to not so much sell as convince by the use of motivational interviewing technique to get patients to see the light, to see the buy-in, about what they are going to gain from treating their high blood pressure, and weight loss, and smoking cessation, and exercise programs—all the things that we know work and are relatively safe and simple to do.
Having patients agree to have a colonoscopy as a preventive procedure is one thing. I can explain it to them and most people will go ahead and do that. But to change these lifetime behaviors is much more difficult.