Of course, she's not real, either.
She's the video doctor, a computer-based multimedia program to help real doctors reduce smoking and alcohol use among their patients.
"The most promising advantage of video doctor technology is that there is no human fallibility, time pressure, or inconsistency in delivery or style," says Barbara J. Gerbert, Ph.D., professor at the Center for Health Improvement and Prevention Studies at the University of California San Francisco.
In a study published in the July issue of the journal Health Promotion Practice, Gerbert and several colleagues reported on patient response to the video doctor.
The video doctor (prerecorded by an actor) asks the patients about their health histories, including smoking and alcohol use behaviors. The patient chooses a response on the screen, and the program then comments or asks another question based on the patient's previous responses. The video doctor's side of the conversation is personalized, depending on the number of cigarettes smoked or drinks consumed by the patient.
Brief interventions by doctors have been found to be helpful in advising or motivating patients about improving their health. But because doctors are pressed for time and may not be reimbursed for delivering such messages, alternatives to physician interventions could benefit patients while alleviating the time crunch for the doctors, the researchers suggest.
The video doctor program compared three levels of intervention. During a pilot study of 52 patients at three San Francisco area clinics, 16 percent were offered a pamphlet describing risk factors that the program identified, 36 percent got a 90-second to three-minute advice message and another 36 percent also received a brief motivational message that lasted three to four minutes. Thirty-one percent of the patients were current smokers, 40 percent were drinking at risky or hazardous levels and 29 percent both smoked and drank.
In the advice segment, the video doctor told patients that smoking put their health in jeopardy and that "quitting smoking is the single most important thing that most people can do to live longer and healthier lives." The aim of the motivational message was increasing the patient's readiness to change, and it urged participants to take the steps needed
At each step, the video doctor asks permission before offering information or advice.
"We believe that the act of asking permission will enhance participants' perception of personal control and freedom and leave them more receptive to hearing the video doctor's advice and recommendations," Gerbert says. When a patient has had enough, the video doctor politely offers well-wishes.
Patients said they liked the program, found it easy to use, and were comfortable discussing personal health information with the video doctor. Many also said they were ready to quit smoking or change their drinking habits. Still, even with this positive response, 72 percent said they would still prefer consultation with a real doctor.
In the future, say Gerbert and colleagues, the video doctor may work best not as a stand-alone program, but as an integrated part of primary care practice.
By Aaron Levin, Staff Writer
Health Behavior News Service
For more information:
Health Behavior News Service: 202-387-2829 or http://www.hbns.org.
Interviews: Contact Barbara J. Gerbert at 415-502-7283 or gerbert@itsa.ucsf.edu.
Health Promotion Practice: Contact Elaine Auld at 202-408-9804.
Journal
Health Promotion Practice