# Why Don't Doctors Get It??? **URL:** \ **Category:** In My Humble Opinion\ **Created:** [January 5, 2010, 11:42pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815 "2010-01-05T23:42:36Z")\ **Posts on this page:** 20\ **Page:** 4
**Author:** ![aruvqan](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/aruvqan/32/2891_2.png) [@aruvqan](https://boards.straightdope.com/u/aruvqan)\ **Post date:** [January 6, 2010, 9:11pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/61 "2010-01-06T21:11:52Z")
> [@Least\_Original\_User\_Name\_Ever](#): > > This isn’t going to come out nice, so I won’t sugar-coat it. With that being said, I’m not trying to be a dick. Apparently, it’s just natural for me. > > You reap what you sow. You’re in this because you’ve got a long history of doing it to yourself. Now you’re at the point where, because of your lack of previous activity, any little bit of activity helps, but now there are other problems/excuses getting in the way. You can’t lean on friends and neighbors because you didn’t cultivate those relationships. It takes a village to raise a child, but it also takes effort to maintain the village and the relationships within. You may very well have some pre-existing conditions or some defects, but that’s not the whole picture. TO address this … I could and did go for walks before the CPPD in my feet and my podiatrist stopped it. I have 44 acres of absolutely wonderful woods behind me that my dog and I have explored quite thoroghly. I was in the habit of walking Souage for between 30 and 60 minutes a day unless it was raining or snowing. My diet has not changed from a medically approved diet other than an occasional oddity like the gallon of milk challenge, or our annual lobster fest for our shared birthday. As to the neighbors - it may come as a shock to you, but many times the populace of an area that is beholden to the military for their continued financial influx, they can be quite nasty to actual members of the military that they are depending upon for that influx of money. Not that it matters, but oddly enough in the 19 years we have owned this property, it has been ‘reappraised’ 9 times and each time the tax raised … including the time it was reappraised because we _removed_ a building. In that time, the entire town has been reappraised twice. I have been told once on a message board and once to my face in the town grocery store that they hoped my husband died because he was a ‘warmonger’. With neighbors like that, who needs enemies. The friends I do have, from work are 50 miles away … where I USED TO WORK. There being no jobs I could do locally, I went to where there were jobs. Otherwise it is people I know from the internet. I suppose we should have gone without work rather than get jobs so far away? I suppose we should have let the bank foreclose on the house so we could move to Hartford instead of continuing to pay the mortgage on it? It certainly isn’t going to sell in this market, there are at least 10 other houses on just this rather long country road that have been on the market for much longer than the market crash and they arent selling … ---
**Author:** ![maladroit](https://avatars.discourse-cdn.com/v4/letter/m/f475e1/32.png) [@maladroit](https://boards.straightdope.com/u/maladroit)\ **Post date:** [January 6, 2010, 9:12pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/62 "2010-01-06T21:12:55Z")
I always guessed jicama would be like water chestnut but never got around to trying one. My problem is with condiments, I’m a dipper. Carrots are great but waaay better with a little ranch dressing. I also read somewhere that the nutrients are better absorbed from carrots when accompanied by some fats so I can justify it too 🙂 To address the op though, if your doctor is a dick find a new one. I have great doctors now, but have had bad ones in the past - but not for long! ---
**Author:** ![Pazu](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/pazu/32/15522_2.png) [@Pazu](https://boards.straightdope.com/u/Pazu)\ **Post date:** [January 6, 2010, 9:25pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/63 "2010-01-06T21:25:30Z")
> [@Really\_Not\_All\_That\_Bright](#): > > I think we only have 3-5 who are openly physician-y. **Quadgop the Mercotan** is one. I forget who the others are. Hmpf. 😉 ---
**Author:** ![Green\_Bean](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/green_bean/32/1760_2.png) [@Green\_Bean](https://boards.straightdope.com/u/Green_Bean)\ **Post date:** [January 6, 2010, 9:27pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/64 "2010-01-06T21:27:56Z")
> [@Sleeps\_With\_Butterflies](#): > > The PS was a nod to the bruhaha that erupted between Lynn and another member about midnight pie, not an actual suggestion… _sweetheart_. Laughing helps boost your metabolic rate according to a Vanderbilt University study, so you might try a sense of humor. Just an FYI. How would anybody be expected to know that that was an inside joke? We can only see what you write. And, an FYI for you–I think that may be the first time anybody’s ever accused me of not having a sense of humor. I’m sure you didn’t realize that you were being insulting. I gave you the benefit of the doubt. Now perhaps you could try doing the same for me. > [@](#): > > I actually have professional experience working with morbidly obese patients as a registered nurse so it’s a little more than “Let me halp u get thin!!!111one!” so your wild ranting about unsolicited advice doesn’t really work. I get _paid_ to help people lose weight. I was simply mentioning an observation that I’ve experienced that I’ve often had my advice dismissed simply because I’m thin. Again, how would anybody be expected to know that you’re an RN? And if you think that was wild ranting…well, come to think of it, it was pretty wild for me. Maybe I even burned some calories! You clearly did more than mention your observation. You did give advice as well. The problem wasn’t that it was unsolicited. The problem was that your tone was condescending. > [@](#): > > But hey, who knew you could get such an over-the-top reaction from a throw away question and a joke? Welcome to the SDMB! BTW, would you mind providing a link to the midnight pie brouhaha? I like a good brouhaha. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [January 6, 2010, 9:47pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/65 "2010-01-06T21:47:09Z")
> [@Sleeps\_With\_Butterflies](#): > > True. Maybe I should talk about tipping next? Or declawing white supremacist cats at the bottom of the Marianas Trench while seizing their guns. ---
**Author:** ![ToeJam](https://avatars.discourse-cdn.com/v4/letter/t/dfb087/32.png) [@ToeJam](https://boards.straightdope.com/u/ToeJam)\ **Post date:** [January 6, 2010, 9:47pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/66 "2010-01-06T21:47:30Z")
> [@shiftless](#): > > It seems a little dishonest to me for doctors to charge the amounts they do if they are only dispensing the same advise everybody else gives. Overeating and smoking - two huge killers - and the best the medical community can come up with is" “don’t do that - that will be $100, pay on your way out”? Well to be fair, with the rise of Evidence based medicine and all, the goal isn’t simply just to tell EVERYONE the same generic comments but to tailor it towards what a person needs. A doctor usually will have labs, charts, and patient histories to go on to try to specify his advice- everyone else may say “You should lose some weight, it’s good for you.” A doctor should hopefully also be able to pull up some data, show you your high cholesterol levels, your history of eating habits, your weight changes over the last few visits, and your BMI to try to say “hey, these are the starts of a not so good trend here, it’s a good idea to make some changes or else we’re going to have to look into more expensive and riskier options.” Same thing with the Alcohol- not everyone who comes in gets a generic “You should stop drinking cold turkey”, but instead right now we’re taught to try to take a history, and assess the drinking and see if we can get the patient to cut back to healthier levels. Smoking is the one pretty much where we just want you to stop smoking in the long run, but if we can get you to just consider the idea of quitting or consider cutting back well that’s a step in the right direction. And again, though your doctors may be giving you the “same advice” as everyone else, when the fat finally hits the fan and you’re in the danger zones of HTN, Diabetes, and Hyperlipidemia- the doctor will be there with the prescriptions and medications and the happy lil’ pills for you to try to better manage your condition. In the end, the Doctor is there for you- if you take the advice, or even if you don’t take the advice. Either outcome, they’ll modify the treatment plan for you based on what you’ve done. If everyone else did the same thing every step of the way, well then you’re right- there’s no need to really have the doctors around. ---
**Author:** ![zweisamkeit](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/zweisamkeit/32/4360_2.png) [@zweisamkeit](https://boards.straightdope.com/u/zweisamkeit)\ **Post date:** [January 6, 2010, 9:54pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/67 "2010-01-06T21:54:15Z")
> [@Sleeps\_With\_Butterflies](#): > > But you’re right, a lot of people see a thin person and assume they can eat whatever they want and won some kind of genetic lottery. There are plenty of people in my family who are obese and I have to work at it just like everyone else does. Honestly, I completely understand what you mean here, and I’ve noticed it for just about any attribute/talent/hobby. I knit and I can’t tell you how many people see a finished project and sigh whistfully, saying, “I wish I had some talent like that!” Do you really think I sprang out of the womb able to do this? I had to be taught what to do, practice, make a ton of mistakes, make things that looked like complete ass, and just keep on doing it. In high school I drew a lot. Always had a sketch pad. People would say, “I wish _I_ could draw like that!” You could _if you spent some time drawing_! And as someone who’s fat and working at being not-fat, applying those examples from my life to the “I wish I was as thin as _you_!” was one of the best lightbulb moments. _It’s the same thing I heard about my drawing or my knitting_, just with weight. With that being said, there _are_ psychological issues that I deal with wrt overeating. I’ll have an overwhelming desire to eat even when I’m not hungry (or even when I’m actually full). I have to work really hard at breaking these psychological issues before I can succeed with weightloss long term\*. And yes, that’s haaaaaaaaaaaaaaard. And it sucks. And I get bummed out with how freaking hard it is for me, mentally, to work to lose weight. But y’know what? Some of the people who are jealous of my knitting could learn the basic stitches and practice for years and probably still not be as good as I am at it\*\*. It’ll just be _harder_ for them. So it is with me and losing weight. That doesn’t mean that if I really want to lose weight (or they really want to knit), that I should just give up, though. - I remember a study done a couple of years ago that said that many bariatric weight loss patients who kept weight off then moved on to another addiction (gambling, alcoholism, drugs, shopping addiction, etc.) because they didn’t actually address the root cause of _why_ they overate. \*\* Not saying I’m some Master Knittress or anything. ---
**Author:** ![irishgirl](https://avatars.discourse-cdn.com/v4/letter/i/8edcca/32.png) [@irishgirl](https://boards.straightdope.com/u/irishgirl)\ **Post date:** [January 6, 2010, 10:16pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/68 "2010-01-06T22:16:03Z")
**Jinx** - I’m a doctor, and you know what, I like nothing better than to come home from work, cook a nice meal and curl up on the sofa with a glass of wine beside my husband. Some of my colleagues smoke, some drink to excess, some indulge in kinky sex, some pound the pavements, others have religion- they do all the same things to relax and blow off steam that the rest of the world does. But when they see patients it isn’t about saying “so, you smoke 20 a day- very bad for your health, I’d recommend som BDSM instead- it certainly relaxes me!”, because, quite frankly you’d probably never want to go to that doctor again. You say “So, would you like to quit smoking? Have you tried before? What did you find helpful? How do you feel about NRT/hypnosis/medications/self-help groups?” and go from there. Or… You can do what my old boss (a cardiologist) did upon meeting every heart attack patient… “So, do you smoke?” “Yes” “Not any more- you’re not leaving my ward for the next 3 days and as there’s no smoking here, I suggest you consider yourself an ex-smoker”. Not very helpful, admittedly, but surprisingly effective. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [January 7, 2010, 2:01am UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/69 "2010-01-07T02:01:24Z")
> [@irishgirl](#): > > But when they see patients it isn’t about saying “so, you smoke 20 a day- very bad for your health, I’d recommend som BDSM instead- it certainly relaxes me!”, because, quite frankly you’d probably never want to go to that doctor again. Well, that depends. Is she hot? 🆒 ---
**Author:** ![Dr\_Paprika](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/dr_paprika/32/3042_2.png) [@Dr\_Paprika](https://boards.straightdope.com/u/Dr_Paprika)\ **Post date:** [January 7, 2010, 2:44am UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/70 "2010-01-07T02:44:34Z")
I am very fond of sunshine and lollipops. Most doctors know living is stressful. Good ones try to advise you without lecturing or being too judgemental. The thing about smoking and weight loss is the patient already knows it is something they should address. You don’t need to lecture. I ask people how much they smoke, and if they would like some advice on cutting down. I weigh people, and ask if they would like advice on diet and exercise. As for booze, there is a big difference between a drink a day and ten drinks a day. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [January 7, 2010, 2:48am UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/71 "2010-01-07T02:48:23Z")
If you’d gone to engineering school instead you’d know that the exact difference is _nine_. 😉 ---
**Author:** ![Jinx](https://avatars.discourse-cdn.com/v4/letter/j/c6cbf5/32.png) [@Jinx](https://boards.straightdope.com/u/Jinx)\ **Post date:** [January 7, 2010, 3:29am UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/72 "2010-01-07T03:29:46Z")
> [@Tenar](#): > > I generally loathe it when knuckleheads quote the entire first post, and I apologize for doing so, but I ask you to take a step back and re-read it, **Jinx**. > > I really do apologize for sounding snarky, but what do you _expect_ doctors to do? a) My, but you are snarky, ain’t ya? 🆒 b) I don’t need some doctor to tell me to switch jobs, etc. Don’t they think I’ve tried? Perhaps it is my destiny. They have the nerve to act like we can control everything. c) I blame the lawyers for making the doctors having to cover their butts in this fahsion by hounding us to morph our lives into some utopia. ---
**Author:** ![Eyebrows\_0f\_Doom](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/eyebrows_0f_doom/32/3119_2.png) [@Eyebrows\_0f\_Doom](https://boards.straightdope.com/u/Eyebrows_0f_Doom)\ **Post date:** [January 7, 2010, 6:07am UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/73 "2010-01-07T06:07:12Z")
> [@Jinx](#): > > They have the nerve to act like we can control everything. Yeah. Smoking, drinking to excess & overeating are not things people can control. ---
**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\ **Post date:** [January 7, 2010, 1:56pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/74 "2010-01-07T13:56:06Z")
[QUOTE=Jinx] I blame the lawyers for making the doctors having to cover their butts in this fahsion by hounding us to morph our lives into some utopia. [/QUOTE] Physicians don’t advise patients to stop or limit bad habits to satisfy lawyers. And there clearly are obese or even smoking docs out there. It’s just that prevention works out so much more nicely than trying to fix severe problems after they happen. I sometimes try reverse psychology on this board, by telling smokers how they’re financing a piece of **Jackmannii** ’s retirement by ensuring a steady flow of malignant pathology his way. As in yesterday, when I made two new cancer diagnoses in smokers, one of whom has a date with the radiation oncologist and the other got a wedge of lung resected. A third smoker got a piece of lung taken out for what was thought to be a tumor but instead turned out to be benign granulomatous disease. You’d think the scare would get him to stop smoking, but I kind of doubt it. Stress, you know. :dubious: ---
**Author:** ![audiobottle](https://avatars.discourse-cdn.com/v4/letter/a/bc8723/32.png) [@audiobottle](https://boards.straightdope.com/u/audiobottle)\ **Post date:** [January 7, 2010, 2:19pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/75 "2010-01-07T14:19:50Z")
I’m still hung up on the apparently presumption that a doctor’s life is NOT stressful. I’m just a lowly med student, but it’s already quite apparent that my world is not sunshine and lollipops. Regarding the actual question, it’s been shown that some people do listen to doctors. We have actual lectures devoted just to smoking cessation advice because tobacco smoking is such a huge health issue in the US. There will always be people who will continue their 3 pack a day habit until the day they die (whether it be at age 90 or age 50), but some people might say, “Hey, my doctor is telling me to stop, it’s getting to be more and more expensive to keep going, the continuing trend to non-smoking buildings is going on… maybe this is a good time to try stopping.” I’m sure it’s annoying to hear it every time you see your doctor, but your doctor isn’t just saying it because (s)he wants to keep the lawyers at bay. Your doctor actually WANTS you to quit. All of this applies to excessive drinking and eating, albeit to a lesser degree. Having said that, there are certainly better ways to approach it, and if your doctor is giving you the same spiel every time with a look of boredom on his/her face, let your doc know that you want to try something different. Or go to somebody else. In the end, it’s your life, your call, but blithely ignoring good advice is probably not in your best interest. ---
**Author:** ![Silverstreak\_Wonder](https://avatars.discourse-cdn.com/v4/letter/s/a88e57/32.png) [@Silverstreak\_Wonder](https://boards.straightdope.com/u/Silverstreak_Wonder)\ **Post date:** [January 7, 2010, 2:37pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/76 "2010-01-07T14:37:17Z")
The real answer is that the doctor would not lecture, but instead have drugs or actions that would simply stop the desire to do the harmful things. In other words make a drug that takes hunger away from a fat man, he can stop the drug once his weight is normal. Something that makes a drunkard sick on the first drink so he can’t get drunk, and things like that. For cases where actions are needed, like these people who can’t sleep, go to one of those 24 hour fitness places and work out till you are tired then, at some point you WILL be tired, I guarantee it, unless Superman is among us. Not only will you sleep you will help the rest of your body too and even look better. ---
**Author:** ![Machine\_Elf](https://avatars.discourse-cdn.com/v4/letter/m/82dd89/32.png) [@Machine\_Elf](https://boards.straightdope.com/u/Machine_Elf)\ **Post date:** [January 7, 2010, 3:45pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/77 "2010-01-07T15:45:37Z")
> [@Silverstreak\_Wonder](#): > > The real answer is that the doctor would not lecture, but instead have drugs or actions that would simply stop the desire to do the harmful things. > > In other words make a drug that takes hunger away from a fat man, he can stop the drug once his weight is normal. Something that makes a drunkard sick on the first drink so he can’t get drunk, and things like that. There are indeed [drugs that control appetite,](http://en.wikipedia.org/wiki/Appetite_suppressant) and there are other [drugs to combat alcoholism,](http://en.wikipedia.org/wiki/Alcoholic#Medications) just as there are drugs to help overcome addiction to [tobacco](http://en.wikipedia.org/wiki/Smoking_cessation#Methods_of_quitting_the_habit_of_tobacco_use) and [heroin.](http://en.wikipedia.org/wiki/Methadone) There are also surgeries to combat obesity. But drugs and procedures cost money, and inevitably come with side effects/risks. If you’re overweight, it stands to reason that the doc isn’t going to recommend bariatric surgery the very first time he sees you, especially if you’re only modestly overweight; he’ll suggest less invasive/expensive approaches first, like less food and more exercise. He will eventually help you pursue drugs and surgeries if you’re really interested, but you first need to demonstrate that your health is in immediate danger AND that you have an utter lack of ability to fight your addiction(s) on your own. ---
**Author:** ![Ludy](https://avatars.discourse-cdn.com/v4/letter/l/d6d6ee/32.png) [@Ludy](https://boards.straightdope.com/u/Ludy)\ **Post date:** [January 7, 2010, 4:15pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/78 "2010-01-07T16:15:59Z")
> [@irishgirl](#): > > Or… > You can do what my old boss (a cardiologist) did upon meeting every heart attack patient… > “So, do you smoke?” > “Yes” > “Not any more- you’re not leaving my ward for the next 3 days and as there’s no smoking here, I suggest you consider yourself an ex-smoker”. > > Not very helpful, admittedly, but surprisingly effective. My Grandmother smoked like a chiminy and could not quit, no matter what she tried. Then she got in a pretty bad car accident. She was in a coma for a while and in the hospital for months. After that she lived with my Mom while she recovered in a no smoking house. It may not be the best way to quit smoking, but it sure did work! ---
**Author:** ![ToeJam](https://avatars.discourse-cdn.com/v4/letter/t/dfb087/32.png) [@ToeJam](https://boards.straightdope.com/u/ToeJam)\ **Post date:** [January 7, 2010, 5:58pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/79 "2010-01-07T17:58:54Z")
> [@Silverstreak\_Wonder](#): > > For cases where actions are needed, like these people who can’t sleep, go to one of those 24 hour fitness places and work out till you are tired then, at some point you WILL be tired, I guarantee it, unless Superman is among us. Not only will you sleep you will help the rest of your body too and even look better. Actually there are medical conditions where there simply is no treatment for sleeplessness, and it’s a fatal genetic condition. No matter HOW MUCH they work out they would not be able to go to sleep. It’s a traumatic and deadly condition known as[Fatal Familial Insomnia.](http://en.wikipedia.org/wiki/Fatal_familial_insomnia) No matter how easy a problem may seem to treat, there are always exceptions to the rules. No exceptions. 🙂 ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [January 7, 2010, 6:37pm UTC](https://boards.straightdope.com/t/why-dont-doctors-get-it/523815/80 "2010-01-07T18:37:41Z")
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