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Negotiating behavior changes with patients who have diabetes: negotiation or coercion?

Robert M Anderson & Martha M Funnell

Negotiation as a strategy for getting patients to make lifestyle changes has been used in diabetes as well as other chronic diseases for over 20 years. It is thought of as a patient-centered technique because it requires healthcare professionals to be flexible with regards to their recommendations. However, when the process of negotiating with patients is examined closely, it is apparent that it lacks one of the major elements required for equitable negotiation. Negotiation as it is applied in counseling patients with diabetes is actually a form of coercion, such as a way pressuring patients’ to change their behavior. Because of the discrepancy between what negotiation appears to be and what it actually is, we question whether it has a place in truly patient-centered care.