Background: There is limited research on how patients prefer physicians to communicate about the topic of obesity, and there is even less understanding of which terms physicians most commonly use.Methods: In this cross-sectional, nonrandom sampling study, patients who were seeking treatment for weight loss rated the desirability of 12 terms to describe excess weight, and physicians rated the likelihood with which they would use those terms during clinical encounters. Participants rated terms on a 5-point scale, with ؊2 representing "very undesirable" or "definitely would not use" and ؉2 representing "very desirable" or "definitely would use."Results: Patients (n ‫؍‬ 143; mean age, 46.8 years; mean body mass index, 36.9 kg/m 2 ) rated "weight" (mean ؎ SD) as the most desirable term (1.13 ؎ 1.10), although it did not significantly differ from 5 other terms provided. They rated "fatness" (؊1.30 ؎ 1.22) as the most undesirable term, although this rating did not differ significantly from 4 other terms. Physicians affiliated with a community-based medical school (n ‫؍‬ 108; mean age, 48.8 years; 79.6% primary care specialty) were most likely to use "weight" (1.42 ؎ 0.89), which was significantly different from ratings for all other terms. They were least likely to use "fatness" (؊1.74 ؎ 0.59), although this rating did not differ significantly from 3 other terms.Conclusion: Physicians generally reported that they use terminology that patients had rated more favorably, and they tend to avoid terms that patients may find undesirable. Understanding the preferences and terminology used by patients and physicians is an important initial step to ensure that communications related to obesity and weight loss are efficient and effective. The provision of weight loss counseling by physicians in primary care settings offers a potentially effective approach to combating the problem of overweight and obesity.1-4 However, physicians often neglect broaching the topics of obesity and weight loss during primary care encounters. 3,[5][6][7][8] Barriers that may hinder physicians' provision of weight-loss counseling include time constraints, lack of reimbursement, and perceptions that treatment will be ineffective. In addition, physicians may feel ill-equipped to address these issues. 5,9 -12 Despite these barriers, overweight and obese patients may desire greater involvement of their primary care physician in weight-loss counseling and treatment efforts. 6,7 Until recently, however, few studies have examined how patients would prefer their physicians to discuss the topic of obesity. In one study, obese patients rated the term "weight" as significantly more desirable than a variety of terms physicians could use to describe excess weight; they rated "obesity," "excess fat," and "fatness" as the most undesirable terms physicians could use. 13 The parents of pediatric patients overwhelmingly preferred that physicians use the phrase "gaining too much weight" as compared with other options, including "overweight," when discussing their chi...

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To describe the challenges faced by rural caregivers in providing assistance to older family members with Alzheimer's disease and closely related conditions. Procedure: Preliminary focus group findings from a new grant initiative, Alzheimer's Rural Care Healthline, that assesses the efficacy of telephone-based cognitive-behavioral intervention for rural dementia caregivers. Groups identified specific caregiver educational and skills-training requirements and best methods for soliciting referrals from rural health providers, community elder care agencies, and churches. Results: Trust emerged as an overarching theme, along with family and community privacy issues and the stigma associated with dementia. Conclusions: Future studies should consider the educational priorities, technological requirements, and sociocultural context of rural caregivers in designing telehealth-based interventions, including issues of privacy, stigma, and trust. Recognition of these factors may lead to increased acceptability, frequency of use, and sustainability of rural telehealth programs.

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The purpose of the study was to extend the scope of earlier research on minority physicians attending to the needs of the poor and their own ethnicity by contrasting practice characteristics of Hispanic doctors in Colorado with those of their white, non-Hispanic counterparts. It was found that Hispanic physicians spent more hours per week in direct patient care, were more likely to have a primary care specialty, and were less often specialty board certified than white, non-Hispanic doctors. Hispanic generalists established practices in areas in which the percentages of the population that were (1) below poverty level, (2) Hispanic, (3) Hispanic and below poverty level, and (4) white, non-Hispanic, and below poverty level were greater than in areas in which white, non-Hispanic primary care physicians practiced. These findings argue for special provision to admit ethnic minorities to undergraduate and graduate medical education programs.