Changes in functional status related to health maintenance visits to family physicians

BACKGROUND Physicians do not provide preventive care at the level recommend ed by national organizations. This may be because of physicians' lack of tr aining or lon level of confidence or because of patients' fears, beliefs, a nd lack of health knowledge. METHODS We used an observational prospective cohort study in an academic fa mily practice office to investigate changes in patients' Functional status associated with receiving recommendations to change behavior from family ph ysicians, Patients 18 years and older presenting for health maintenance vis its to family physicians completed a functional status instrument and a bri ef intake questionnaire by telephone before their visit. After the visit pa tients were randomized to a debriefing interview or an observation-only gro up. The interview included the Patient/Doctor Interaction Scale and an asse ssment of whether patients received a recommendation to change behavior. RESULTS One hundred thirty-two patients were randomized to the debriefing g roup, and of those, 92% completed assessments at 3 months. Patients reporti ng recommendations to change behavior had lower scores at 1 and 3 months fo r mental health, social health, and self-esteem and higher anxiety and depr ession 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 v isits during which recommendations for behavioral change were made. Such de clines may inhibit physicians from making recommendations for behavioral ch ange or patients from accepting them.