Good morning! In today's issue, we look at practical steps medical offices can take to improve patient satisfaction.

Be sure to participate in today's SmartBrief Reader Poll, below, which examines patient communication on the topic of exercise. Do you often speak with your patients about the importance of physical activity for overall health?

Also, take a look at our results from last week's poll on the health effects of time changes.

Research presented at a meeting of the American College of Gastroenterology found that 35.3% of patients with celiac disease have bile acid malabsorption, contributing to persistent diarrhea despite adherence to a gluten-free diet. The study found that patients who had a cholecystectomy had a greater likelihood of bile acid malabsorption, and those with bile acid malabsorption had faster colonic transit.

A study in the Annals of Internal Medicine suggested that longer walks are more beneficial for heart health than shorter ones. Researchers found that walking 15 minutes or more, rather than doing multiple shorter walks, was associated with lower risks of heart disease and mortality over nearly a decade. The study involved 33,560 adults with a median age of 62.

An animal study in the journal Brain Medicine suggests that exercise can reduce depressive and anxiety-like symptoms linked to a high-fat, high-sugar diet. Researchers found that exercise helped normalize insulin and leptin levels and reduced the decline in gut microbiome metabolites that are important for brain health.

Data on more than 2.1 million births linked prenatal exposure to air pollutants such as sulfate and ammonium to a higher risk of autism spectrum disorder in children. The research, published in JAMA Network Open, found the second and third trimesters were vulnerable periods because they are associated with neuronal growth, myelination and synapse formation in the fetal brain.

A research letter published in the Journal of the American Medical Association found that stillbirths affect about 1 in 150 pregnancies in the US, higher than the CDC's reported rate of 1 in 175. Researchers used commercial insurance claims data, which they said is more reliable than fetal death certificates. They also found disparities in stillbirths, with rates rising to 1 in 112 births in low-income areas and 1 in 95 in Black families, compared with white families.

Maintaining a high level of satisfaction among patients means paying attention to their needs before, during and after their visits. A Q&A offers practical tips that offices and teams can implement to improve patient communication, access and experiences. Staff engagement, wait times, online reviews and satisfaction measures are examined.

A 12-week, web-based self-help program was as effective as a 20-week cognitive behavioral therapy program for treating binge-eating disorder, according to a study in JAMA Network Open. The usual care group reported a stronger therapeutic alliance, but BMI increased among participants in that program while remaining stable for those in the web-based program. "Based on the positive findings from this study, future work should examine the source of guidance in the guided self-help program," researchers wrote.

Compliant billing for Medicare and other federal health care programs can be achieved by understanding what government auditors focus on, developing clear policies and procedures and tailoring training, writes certified documentation integrity practitioner Cheryl Ericson. Compliance training should be tailored to cover the organization's specific needs and risks as well as general compliance risks identified by CMS contractors.