• Why is patient-provider communication about sexual health important?
• Physicians
• 1) Play an important sex ed. role
• 2) Have a direct impact on the patient’s quality of life
• 3) Can influence patient health outcomes
• 4) Can influence positive behavior changes
• What are some reasons that patients don’t bring sex up?
• 1) Doctor knows best
• 2) Traditional gender roles
• 3) Worry/anxiety
• 4) Underestimating the risk
• 5) Uncomfortable bringing it up
• 6) Coming out (LGBT)
• 7) Empathy (“My doctor just won’t understand)
• What are some reasons that providers don’t bring sex up?
• 1) Embarrassment for self/patient
• 2) Not trained well enough in those communication skills
• 3) Not relevant to chief complaint
• 4) Underestimate patients’ risk/behaviors
• 5) Gynecologist should take care of it
• 6) Age barriers
• 7) Underlying assumptions
• What are three useful models of provider-patient communication?
• 1) Paternalistic Model: Provider>Patient
• Provider is in control
• Patient listens
• Little interaction
• Provider gives directions
• Most common today, also time efficient
• 2) Consumeristic: Provider<Patient
• Focus on what patient wants
• Patient as a consumer = therefore in control
• Internet self diagnosis (web-MD)
• Not as time efficient
• 3) Mutualism: ProviderPatient
• Parties engage in interaction
• Equal levels of input and questions
• This occurs rarely in health situations
• How are providers trained now?
• Focus on clinic skills
• Lack of clinical opportunities to interact with patients who have sex-related concerns
• About how much training do med students get? 3 hours the 3rd year of medical school
• Sexual satisfaction is a low priority in training
• Often taught “specialized” shortcut medicine

• Why should they be taught differently?
• Managing sexual health is a life-long risk
• Physicians are currently inadequately prepared to provide these services
• Don’t know how to deal with discomfort
• Lack of opportunity to practice counseling