Motivating patients to change is hard. We're not good at it, and they're not good at it. Hard problems with simple solutions are rare, but it is human nature to seek simple solutions in the face of hard problems. Testing for subclinical disease is one such attractive maneuver to the hard problem of motivating patients to change unhealthy behaviors. The rationale is simple—a picture is worth a thousand words. Seeing ultrasonographic images of plaque may induce a transformative emotive learning experience that would motivate lifestyle change. This testing for subclinical disease for the purpose of motivating behavioral change has become a common practice, despite scant supporting evidence. There is much less effort on cultivating the communication and relationship skills necessary for motivating patients (where there is substantially more evidence), probably because this strategy is harder and more labor intensive.
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