Although adherence to healthy lifestyle behaviors and treatment recommendations is complex and multidimensional, a common frustration expressed by physicians is the ability to provide optimal care when their patients are non-adherent with the treatment recommendations. Non-adherence is a common problem among patients, with some estimates suggesting that as many as 50% of patients are non-adherent to treatment. Although there are many known reasons for non-adherence (e.g. intolerable side effects, numerous psychological, disease-specific, social and financial factors), the foundation of most non-adherence is likely due to weaknesses in both cognition and cognitive flexibilities, aspects that are unique to each patient. This paper proposes that by adding and enhancing the traditional medical style interview with a conversational style interview, the physician will be better able to attend to the unique cognitive attributes of each patient and be in a better position to tailor the approach that best fits the patient, thereby promoting adherence and improving outcomes. In essence, it confirms the clinical approach of different rules for different patients. The foundation of the conversational approach is the physician-patient rapport, which allows exploring in more depth the patient's cognitive abilities. As with the adoption of any new useful and practical technique, the initial challenge will be to learn the value of incorporating this new brief practical approach in everyday clinical practice.
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