pull down to refresh
33 sats \ 3 replies \ @gmd OP 13h \ parent \ on: KETO-CTA trial - LMHR phenotypes showed rapid plaque accumulation on Keto diet HealthAndFitness
Curious do you have any fat friends or family? The reality is that it is very hard to get people to change their lifestyles, and most people don't want to hear it. Furthermore you don't need to see a doctor to get this advice. Any half-decent gym-bro can tell you the 80% you need to succeed. Most people already know what to do- it is very simple but very hard.
Many people can lose weight for a short period of time, the difficulty is keeping the weight off over a prolonged period of time. What we hear on social media is the echo of young influencers and virtue signalers, but the reality for most is they are older, have jobs, kids and all kinds of life stressors. When you have 15 minutes to see a patient and they want to talk about W, X, Y, Z it's very hard to insert a lecture about lifestyle stuff they don't want to hear about and probably won't follow anyway.
Curious do you have any fat friends or family?
Pretty much all of my extended family. Some of whom died from it, while refusing to follow doctors' advice.
This is a much bigger topic, and I'm sure you've heard it all before, but I think it's a mistake to let patients believe that the medications they're being prescribed are substitutes for lifestyle changes. I know that's not how almost any doctor explicitly communicates it. However, we all know that patients act that way.
Saying that it's hard to get this across to patients just sounds like a cop out. It's undoubtedly true, but it's also your jobs and failing to do it on a society wide scale should be taken as a huge point of shame for the entire profession, rather than just being brushed aside.
I also have several relatives who are medical professionals and they only reinforce my sense that there's way more emphasis on getting pharmaceuticals into people than addressing underlying issues.
reply
It's just not practical or possible. When you are expected to see 30-40 patients a day, older patients come in with a list of 10 things they want to talk about, you have to negotiate them down to the top 2-3 items, reconcile meds and refills, redirect and listen to them ramble about irrelevant nonsense and suddenly you're all out of time and you have a waiting room of patients who are upset you are running late (and then demand more of your time in return).
PCPs are just fighting to stay afloat in clinic. There's a reason my PCP always bugs me to schedule an appointment every year- she knows I'm younger, fit an healthy and it's an easy booking for her.
The loudest voices on social media are young people <50 who want to talk about how amazing their secret sauce is for staying healthy, but the reality is you generally don't need a doctor when you're young (outside of women's health issues). Don't get fat is all most of what you need to hear, which is advice that can be given by anyone. They don't see the 90% of other health issues that physicians actually deal with as patients get older.
reply
Don't get fat is all most of what you need to hear, which is advice that can be given by anyone.
- That's clearly not all that people need to hear. Do you think patients usually leave their appointments understanding the consequences of treating symptoms with medication vs fixing the underlying problem with a lifestyle change (when that distinction makes sense)?
- The source matters. Having this impressed upon you by your trusted doctor, who knows what he/she's talking about and knows what the various options are, is different than hearing it from another place.
I have been told by doctors I know that they don't want to alienate patients by telling them harsh truths. That is what upsets me and what I see as a professional failing. If you know patients are heading towards horrible illness and don't make the effort to communicate it in a way that sinks in, that's a failure.
I was a teacher for several years and it would have been a failing to not communicate to a student that they were on track to fail out, and those stakes are so much lower. Teachers also have lots of students to see and not as much time as they'd like for each.
I hope I'm not coming across as overly antagonistic here. I see the professions I'm part of (education and economics) as also largely failing at their core missions too and I find the blasé attitudes frustrating. My personal experience with the health care industry gives me that same impression.
reply