Achieving superior clinical outcomes often depends less on physicians making the right diagnosis and recommending the correct treatment and more on their patients’ willingness to take the necessary steps to maintain or improve their health.

Heart disease, cancer, stroke and diabetes together kill more than 1 million Americans each year, according to the Centers for Disease Control and Prevention. And it is patient choices — to give up smoking, shed pounds, exercise and faithfully take prescribed medications — that are essential to making a meaningful dent in that deadly toll.

But despite their best attempts to educate, inform, cajole or bargain with patients, physicians often find themselves tossing up their hands in despair at patients’ failure to change their harmful health habits. “It’s a source of great frustration,” says Yul Ejnes, MD, a general internist in private practice in Cranston, R.I.

Doctors have long hoped that developing a rapport with patients would help their messages finally sink in and prompt change. Now a growing body of evidence suggests that alternative ways of communicating with patients — ones that involve fewer instructions and more questions — can help physicians motivate at-risk patients to make smarter choices regarding their health.

My latest feature article. Read the whole shebang.