Facilitating patient participation: the doctor-patient encounter

Our purpose in undertaking this review has been to extract from the literature behavioral prescriptions for physicians and strategies for prevention. We have demonstrated that the physician who wishes to be a successful counselor needs to ensure that the patient knows what to do, work toward patient commitment to behavior change, negotiate and tailor the specifics of the treatment, and be a warm, attentive interviewer who provides support to patients by attending to emotional responses as they arise. We have suggested ways that the encounter can be embedded in a functioning primary care organization where other members of the team are involved, and where follow-up mobilization of social support and the systematic application of behavioral techniques can achieve permanent behavior change.