their advice, follow their treatment plans, and feel comfortable disclosing information about themselves. Some forms of communication by the physician, such as self-disclosure and patient-centered communication, have been shown to decrease medical mistrust in patients. Medical mistrust has been shown to be greater for minority group patients, and is associated with decreased compliance, which can contribute to poorer health outcomes. Research of breast cancer patients showed that African American women who received concerning mammogram results were less likely to discuss this with their doctor if they had greater medical mistrust. Another study showed that women with higher physician mistrust waited longer to report symptoms to a doctor and receive a diagnosis of ovarian cancer. Two studies showed that African American patients had more medical mistrust than white patients, and were less likely to undergo a recommended surgery as a result. Benefiting or pleasing A dilemma may arise in situations where determining the most efficient treatment, or encountering avoidance of treatment, creates a disagreement between the physician and the patient, for any number of reasons. In such cases, the physician needs strategies for presenting unfavorable treatment options or unwelcome information in a way that minimizes strain on the doctor–patient relationship while benefiting the patient's overall physical health and best interests. When the patient either can not or will not do what the physician knows is the correct course of treatment, the patient becomes non-adherent. Adherence management coaching becomes necessary to provide positive reinforcement of unpleasant options. For example, according to a Scottish study, patients want to be addressed by their first name more often than is currently the case. In this study, most of the patients either liked (223) or did not mind (175) being called by their first names. Only 77 individuals disliked being called by their first name, most of whom were aged over 65. On the other hand, most patients do not want to call the doctor by his or her first name. Some familiarity with the doctor generally makes it easier for patients to talk about intimate issues such as sexual subjects, but for some patients, a very high degree of familiarity may make the patient reluctant to reveal such intimate issues. Transitional care Transitions of patients between health care practitioners may decrease the quality of care in the time it takes to reestablish proper doctor–patient relationships. Generally, the doctor–patient relationship is facilitated by continuity of care