Health UK (Commonwealth Union) – A recent study conducted by the University of Oxford, published recently in the Annals of Internal Medicine, underscores the profound influence that doctors’ communication with patients who have obesity can exert on their success in achieving weight loss. This groundbreaking research delves into uncharted territory by not only acknowledging the significance of words but also examining how they impact patient outcomes in both the short and long term within a medical context.
The investigation involved an analysis of 246 recordings capturing doctor-patient interactions. The findings revealed that subtle elements of communication, including word choice and tone of voice, played a pivotal role in shaping patient outcomes. This implies that training healthcare providers in compassionate communication could prove instrumental in supporting weight loss efforts. The study assumes particular relevance in light of current obesity treatment guidelines, which encourage doctors to discuss weight loss with patients and offer referrals to weight loss services where appropriate. However, in practice, this recommendation is followed for only about 5% of affected individuals each year. This discrepancy between policy and practice underscores the pressing need to gain a deeper understanding of the most effective communication strategies for doctors.
Researchers of the study indicate that doctors often express reservations about broaching personally and socially sensitive topics, fearing they may cause offense or discomfort. On the other side of the consultation table, patients corroborate that the tone and choice of words used by doctors can inadvertently strain the doctor-patient relationship.
The research, conducted by the University’s Nuffield Department of Primary Care Health Sciences and supported by the National Institute for Health and Care Research School for Primary Care Research and the Foundation for the Sociology of Health and Illness, analyzed 246 audio recordings from a larger clinical trial in which doctors offered patients a referral to a 12-week weight loss program known as the BWel trial. Employing ‘conversation analysis,’ the researchers investigated how doctors’ word choices and tone of voice, known as ‘paralinguistic’ features, impacted obesity care.
The study identified three primary approaches that doctors took in delivering the referral offer: framing it as “good news,” “bad news,” or neutrally. Subsequent statistical analysis revealed that the approach used in the conversation significantly correlated with patients’ decisions to enroll in the program, attend sessions, achieve weight loss, and experience satisfaction. Notably, when the referral was presented as “good news,” 83% of patients attended, whereas only 50% attended when it was delivered neutrally. Furthermore, individuals who received the “good news” approach lost an additional half a stone in weight (equivalent to 3.6 kilograms).
Dr. Charlotte Albury, the lead author and a researcher in the Nuffield Department of Primary Care Health Sciences, indicated that with what they found was that when doctors framed the conversation as ‘good news’—emphasizing the benefits and opportunities of weight loss in a positive way —patients had a greater chance of enrolling in a weight loss program, attend more sessions, and, importantly, lose more weight compared to a neutral or negative framing.
“From the perspective of patient outcomes, we found that 83% of patients attended the weight loss programme when the conversation and referral were framed as ‘good news’. These patients lost approximately half a stone more (or 3.6kg, or 7lbs 15oz) compared to those who received ‘neutral’ or ‘bad’ news. For the latter groups, only half of the people accepted the referral, and there was no significant difference in weight loss between them.”
“We know words matter, and this research shows they really do -in the short and long term. Overall, our research shows that subtle changes in communication can significantly influence patient outcomes one year later. The elements that constituted ‘good news’ were subtle but had a clear and positive impact.”
