Role of behavioral medicine in primary care

Abstract

Behavioral medicine is a vast field with an ever-increasing knowledge base. We review important findings over the last 18 months. We organized advances in behavioral medicine into four main topic areas: the doctor and patient, health-related behavior, integration of behavioral medicine in primary care, and teaching and assessing behavioral medicine competencies in primary care. Section I reviews research on difficult encounters, delivering bad and sad news, and physician well being. Section II examines improvements in the treatment of obesity and tobacco abuse, as well as interventions which boost adherence. Section III discusses advancements in care management and collaborative care in the USA and resource-constrained settings. Finally, section IV deals with teaching and assessing communication skills, behavior change, and professionalism. Physician skills such as communication, professionalism, behavior change, and self-care are not innate abilities, but teachable and learnable skills. Collaborative care and the integration of behavioral medicine with care for other conditions can benefit patients, and can be done effectively with case management and telemonitoring strategies. Future behavioral medicine research should include evaluation of implementation strategies so that we may incorporate principles of behavioral medicine more widely into clinical practice.