Table 4.

Explanations of Five Notable “Talk Types” Derived from Patient-Clinician Conversations Recorded During Annual Wellness Visits

Annual Wellness Visit Talk TypeTalk Type DefinitionExamples from Annual Wellness Visit Recordings
Change talkVerbalization of the intent of or strategies for changing health behavior (by patient or clinician)Patient: “Do you think it would be healthier if I switched from cigarettes to vaping?”
Clinician: “Well, vaping still carries health risks, but it may be a step for you in the right direction.”
Goal-setting talkDiscussion of specific (short or long-term) goals for changing behavior (by patient or clinician)Clinician: “So, what I am hearing is that you could increase your sleep time by about an hour, so you could sleep at least 6|n$ hours every night? Could you start maybe next week?”
Patient: “Yes, I think I could do that.”
Education talkProviding more in-depth patient education (eg, explaining mechanisms)Clinician: “Physical activity has been shown to improve steadiness and balance by strengthening our muscles and helping us better feel our movements as we walk. This can also help prevent falls.”
Advice talkProviding specific and focused suggestions or recommendations (without further explanation)Clinician: “I encourage you to do the things we have discussed and you said you would do, so we can get your blood sugar under control. I am afraid that if we can't get your sugar under control, you may have to go on insulin.”
Prescriptive talkClinicians simply tell patients what to do without much discussion or explanationClinician: “You really need to see the nutritionist! When we are finished, I am going to go ahead and put in a referral.”
Clinician: “Your pneumonia shot is due today; I will ask the nurse to give you the shot before you leave.”