How do physicians talk with their patients about risks?

To describe the communication about risk between community-based physicians and their patients, the authors audiotaped 160 physician-patient encounters in the private practices of 19 physicians. Coding was done using a structured scheme to identify the presence of talk about risk of future illness, and to describe its characteristics. Patient understanding and satisfaction were assessed through an interview. Risk discussion occurred in 26% (95% CI 19%–33%) of the visits, quantitatively in two cases and specifically with respect to outcome in 48% (95% CI 40%–56%) of the visits. The patients initiated only 16% of this discussion but were, in general, satisfied with their care and the information they had received, but they had poor recall of the specifics of the discussion. This work was carried out while Drs. Kalet and Roberts were fellows in the Robert Wood Johnson Clinical Scholars Program at the University of North Carolina at Chapel Hill. Presented at the annual meeting of the Society of General Internal Medicine, Seattle, Washington, May 1–3, 1991.