title: A national probability survey of American Medical Association gynecologists and primary care physicians concerning menopause.
abstract: OBJECTIVE
  This survey intended to clarify physicians' understanding of the issues surrounding women, menopause, alternative medicine, and drug therapy for the treatment of menopause.
  
  
  METHODS
  This study was designed as a national probability sample survey of primary care physicians and gynecologists nationwide. Its focus was to identify major concerns and issues identified by patients about menopause and perceived communication with effectiveness how to communicate with their patients. Physicians were also asked to rate their comfort level in recommending the use of herbal remedies and which herbal remedy they felt comfortable recommending to interested patients.
  
  
  RESULTS
  Data indicated that a patient's complaint about menopausal symptoms was the most common factor leading to discussion of menopausal issues with physicians (91%) and that the primary concern to the patient was management of menopausal symptoms. Other factors were controversies about hormone replacement therapy, long-term health implications of menopause, and hormone replacement therapy. Eighty percent of the physician found confusing messages with regard to menopause to be the most challenging aspect in patient communication. The second most challenging issue is "inconclusive data about hormone replacement therapy" (56%). Seventy-six percent of the physicians found "showing sympathy" to be the most important factor for the physicians to communicate effectively with patients, whereas "being honest and open" was the most important patient attitude cited for the same purpose. When it comes to herbal therapy for menopause symptom control, only 4% of the physicians indicated that none of their patients take any remedies. Only 18% were not very comfortable in discussing or recommending herbal therapies, whereas the rest ranged from fairly comfortable to completely comfortable.
  
  
  CONCLUSIONS
  This study has provided data with regard to physician understanding of menopause treatment options and their primary interaction with patients on this issue. More in-depth studies concerning efficacy and/or side effects of each available treatment will be the relevant next step, given the controversies about both hormone replacement therapy and alternative therapies. The relative efficacy, safety, and cost-effectiveness of different treatments should also be put into the context of both clinical diagnosis and physicians' clinical judgment. Attention to comments by physicians and patients with regard to communication may produce better information exchange and trust between patient and physician.
authors.affiliation: Southern California University of Health Sciences, Whittier, Calif, USA. betssingh@scuhs.edu
authors.forename: Betsy
authors.initials: B
authors.lastname: Singh
authors.forename: Xiao-Dong
authors.initials: XD
authors.lastname: Liu
authors.forename: Claudia
authors.initials: C
authors.lastname: Der-Martirosian
authors.forename: Mary
authors.initials: M
authors.lastname: Hardy
authors.forename: Vijay
authors.initials: V
authors.lastname: Singh
authors.forename: Neil
authors.initials: N
authors.lastname: Shepard
authors.forename: Sonal
authors.initials: S
authors.lastname: Gandhi
authors.forename: Raheleh
authors.initials: R
authors.lastname: Khorsan
mesh_terms: D001291:Attitude of Health Personnel; D005194:Family Practice; D005260:Female; D006176:Gynecology; D006801:Humans; D007388:Internal Medicine; D008593:Menopause; D010817:Physician-Patient Relations; D008517:Phytotherapy; D011320:Primary Health Care