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Should doctors practice what they preach?
July 26th, 2011
07:10 AM ET

Should doctors practice what they preach?

Anthony Youn, M.D., is a plastic surgeon in Metro Detroit. He is the author of “In Stitches,” a humorous memoir about growing up Asian American and becoming a doctor.

What do you call a chain-smoking, morbidly obese, soda addict who just graduated medical school?

Yep. Doctor.

How would you feel if he were your doctor? Would you listen to him if he asked you to adopt a healthier lifestyle?

My third year of medical school during my family medicine rotation, I was assigned to follow Dr. Ben, one of the residents in the outpatient clinic. Dr. Ben didn’t look like any other doctor I’d met. He was 5 feet 6, weighed well over 300 pounds, chain-smoked during his lunch break and hauled around a twelve-pack of Mountain Dew, which he polished off by the end of his shift.

Dr. Ben was also well-read, intelligent, dedicated and caring.

My first day with Dr. Ben, a steady flow of patients arrived in the clinic with conditions ranging from ear infections to sprained ankles. They all listened to his advice carefully and agreed to undergo any necessary tests and take the proper medications to treat their ailments.

Then in walked Joe, 55, an overweight desk jockey with hypertension and type 2 diabetes. Joe smoked, drank and the only exercise he got was lifting himself off the couch to waddle over to the fridge for another beer. He came to the clinic for a follow-up visit to check on his high blood pressure. Dr. Ben and I entered the exam room, introduced ourselves and looked over Joe’s chart. After a brief physical, Dr. Ben shook his head.

“Joe, I have to be honest with you. Your blood pressure is way too high. You need to eat healthier, lose weight and stop smoking. You’re putting yourself at risk for a heart attack, lung cancer, or stroke, and I’m just getting started. Do you exercise?”

Joe raised an eyebrow. “Me? No.”

“If you don’t change your lifestyle, there’s nothing I can do. All the medication in the world won’t help you.”

“Are you serious?” Joe paused. “Look at you. No offense. When’s the last time you skipped a meal?”

I felt my checks redden. I’d never heard a patient talk to a doctor this way.

Dr. Ben blushed. “I’m not the patient,” he said.

“Fine.”

As Dr. Ben scribbled a prescription refill for a hypertension medication, Joe tapped his foot impatiently. Once Dr. Ben ripped the prescription from his pad, Joe grabbed it, flung open the door, took a last look at him, and rolled his eyes. As he lumbered down the hall I heard him mutter, “When’s the last time you saw your feet?”

Out of earshot, Dr. Ben barreled into the kitchen, popped open his sixth Mountain Dew of the day, chugged it and belched.

Fifteen years later, I offer full disclosure: I am not Dr. Perfect. Far from it. I try. I have a healthy BMI, I don’t smoke, and I exercise regularly. I also enjoy a Bud Light or two, drink a Pepsi every day at lunch, and - I admit it - my name is Tony and I’m a fast food addict. To me, the height of decadence would be to fly to Los Angeles for lunch just to gorge myself on In-N-Out cheeseburgers “animal style.”

As physicians, we are advocates for our patients’ health and well-being. But what if we’re not advocates for ourselves? Does that make us lesser physicians? Will our patients follow our recommendations? Are we supposed to be role models?

I think we should be. Dr. Ben was an outstanding doctor, but the way he looked interfered with his ability to practice medicine. If we don’t work at attaining a healthy lifestyle, why should we expect our patients to? Do as we say, not as we do? That doesn’t work for parents or doctors.

And I’m kidding. I’d never fly to In-N-Out for lunch.

But I’d love them to deliver.

Editor's note: The doctors’ and patients’ names and other identifying details have been changed to protect their privacy.

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soundoff (742 Responses)
  1. doc

    As a male OB/GYN does this mean I cannot offer pregnancy advice? Come on Tony. We all make choices, and meet certain needs in our patients; albeit not always the role model need...

    July 26, 2011 at 08:05 | Report abuse | Reply
    • Dee

      No, not at all, but it would be nice if you too had been through some variety of surgery so you can understand just how painful something like a c-section or abdominal hysterectomy can be. PS: I love my male GYN–way more than the female I used for the birth of my son–but by his own admission, he's never had so much as a broken bone and admits he's terrified of surgery.

      July 26, 2011 at 08:41 | Report abuse |
    • Josh

      Though, when he tells you that natural child birth really isn't all that painful, I would temper that with your own wisdom and experiences.

      July 26, 2011 at 09:01 | Report abuse |
    • Sean

      With that poor of an analogy… I really hope you’re not really a doctor.

      July 26, 2011 at 09:24 | Report abuse |
    • Jim

      Having trouble believing you are a doctor..... Did you become a male or were you born a male? If you were born a male then it isn't a "do as I say not as I do" situation for you. If you were originally a female and somehow became a male throuh your actions and then were telling women that they shouldn't be doing what you are doing then you comment might make some sense. But it would be a safe bet that you weren't born a female.....

      July 26, 2011 at 12:26 | Report abuse |
    • linda

      I loved my male doctor – but when I was birthing a 9 lb 6 oz, 22 oz baby when your all of 5'2 ...he told me it doesn't hurt that bad I thought he wasn't going make it through the ordeal. Fortunately he did apologize at the end when he was told how large she was.

      July 26, 2011 at 12:31 | Report abuse |
    • Katie

      I knew an OB-GYN who was hundreds of pounds overweight. No kidding. He used to slap the hands of his pregnant patients for gaining too much weight, Can you say hypocrite?

      July 26, 2011 at 14:29 | Report abuse |
    • mstrmcds

      Sorry, "doc", but too many male ob/gyn's have treated me like I didn't know what was going on in my own body. The male doc who did my hysterectomy was the the first male ob/gyn I never felt the urge to slap. He admitted that he had no idea how awful I felt, just that it wasn't normal! Geeze what a concept. I prefer to have my "female" health needs cared for by someone with more than a textbook understanding of my anatomy and how it works.

      July 27, 2011 at 09:17 | Report abuse |
    • Colleenarn

      The analogy doesn't fit. When you can make a difference your credibility isn't there, if you really don't take your own advice.

      July 27, 2011 at 11:51 | Report abuse |
    • intothefire

      sean ur an idiot. You saying its a poor analogy does not make it true.

      July 27, 2011 at 14:01 | Report abuse |
    • Accountant

      Your analogy is not really effective. Would you go to a financial adviser or accountant who cannot keep his own books or manage his own finances? That's really the point. That's why people don't go to a fat personal trainer. Sure a fat guy may know as much or more about diet and exercise than the absolutely ripped guys, but they don't look like they know what they're talking about.

      July 27, 2011 at 19:23 | Report abuse |
    • also a doc

      I can totally relate to the In N Out Burger. That being sd, I have mine w. mustard and ketchup instead and split the fries w. friends and try to balance out the rest of my meals. I love sweets and I love the worst kinds of food, but I also have hypertension, diabetes, high cholesterol and heart disease in my family,inc a sibling who had to have a stent in their 40s. The thing is, healthy habits require a lot of discipline and a certain amount of sacrifice, and I don't think that as drs. we can impress upon our patients the importance of these habits if we don't practice them ourselves. I don't know if doc really is an OB but his point does not seem relevant. Tim is right-my patients know how hard I work to eat hard, keep the weight off, stay off the BP and cholesterol meds the rest of my family is on-and they feel I can relate.

      July 27, 2011 at 23:26 | Report abuse |
  2. Mountaingirl

    I could see an overweight, chain-smoking doctor as having an advantage in empathizing with patients who struggle with these problems. It might become less of a pedantic lecture and more of an empathetic conversation if your doctor can say "look, I understand what you're going through because I battle these things too, but as hard as is is, you NEED to quit smoking."

    July 26, 2011 at 08:07 | Report abuse | Reply
    • iminim

      I agree, It sounds like Dr Ben lost an opportunity to relate to his patient on a personal level. "Hey, I can really understand how tough it is to change your life, but we both need to realize what we are doing to our health and make some changes." Dr Ben's failing is this setting was not his size and poor health habits, but his inability to use his situation as a way to empathize with & relate to his patient.

      July 26, 2011 at 08:31 | Report abuse |
    • Sean

      Sure .. that sounds great and all. However I wouldn’t take my car to a mechanic that I knew drove a 2009 model car he himself kept in such poor shape it’s considered a POS at the ripe old age of two

      July 26, 2011 at 09:28 | Report abuse |
    • NotADoctor

      My physician actually asked my dieting friend if she'd like someone to walk with her after work (meaning HE would walk). Both my friend and the doctor were struggling with weight issues, and this was his support to help them stick to their diets.

      July 26, 2011 at 12:23 | Report abuse |
    • Babs

      I agree...they do empathize with you more so than those that don't face those challenges. I am overweight and so was my doctor who has managed to loss quite a bit of the weight. We have talks all the time about how he did it and has inspired me to change my ways and live a more healthy life style. To watch your own doctor go throgh the transformation in lifestyle is very inspiring and the only encouragement I need.

      July 26, 2011 at 12:23 | Report abuse |
    • Jim

      @ Sean,

      As anyone in the car business knows, the majority of mechanics don't care for their vehicles just like the contractor's house is always the last one finished.

      July 26, 2011 at 12:28 | Report abuse |
    • My take!

      I agree!

      July 26, 2011 at 17:04 | Report abuse |
  3. Dr. Ben

    Do what I say or you'll end up like me!

    July 26, 2011 at 08:16 | Report abuse | Reply
  4. iminim

    Doctors are human. Some have poor dietary & exercise habits and some make other poor personal health decisions just like in other professions. Most doctors are people who are going through life like every one else, trying to do the best they can for their "customers", their staff and their families. If you are uncomfortable with the perceived hypocracy in the situation above, then don't go to this doctor. Unlike patronizing an accountant who has shady accounting practices or a lawyer who breaks the laws in his work, this doctor's hypocracy does not harm the "clients" (I presume he is not smoking in the office.) Only he is being harmed by his actions.

    On the other hand, I am unsure why people become so upset when their weight is identified as a risk factor for disease when they are in a medical setting. Frustration? Hurt feelings? Memories of childhood teasing? Insecurity born of a poor self image? Neither person in the example above responded well to the topic of obesity. The doctor would have been remiss if he did not bring it up during a medical evaluation. This doctor's own doctor will also be remiss if he/she does not address his destructive lifestyle habits when he seeks medical care himself. Obesity is a modifiable risk factor for diabetes, heart disease, stroke, some cancers, bone & joint issues, perioperative infections, and the list goes on. It needs to be treated as such. The patient's weight issues & their complications do not magically disappear simply because the doctor also has obesity issues.

    July 26, 2011 at 08:21 | Report abuse | Reply
    • MacMadame

      They become defensive for two reasons. The first is, they are used to the medical profession not taking their problems seriously and blaming everything on their weight. When you have mysterious pains and aren't given basic diagnostic tests because you are fat, when even in-grown toe nails are blamed on your weight, you learn to shrug it off and not take the "it's because you are fat" diagnosis seriously.

      The second reason is that 99.9% of the people getting this advice to lose weight have tried to lose weight before, usually many times, and have not been able to either lose the weight or to keep it off if they did lose it. And, they have been told over and over that it's because they are weak (even though science knows differently). Why wouldn't you get defensive if given advice you know won't work and know comes with a kind of built-in disapproval?

      Obesity is a complex disease with many intertwined causes and just being told to "move more and eat less" - which is your typical advice from the medical profession - doesn't do anything to put it in remission, let alone cure it. The medical community needs to learn to understand this disease and to treat it effectively and lose their own prejudices towards the obese. Until then, they are part of the problem.

      In my own case, I did lose over 100 pounds and I did get off my blood pressure meds. BUT I still have issues with high blood pressure. The weight didn't help my blood pressure, but it wasn't the main cause of my issues. Luckily I didn't have a doctor who harped on my weight as the cause of everything and who prescribed my blood pressure meds without a lecture, because I would have been livid if I had been told to lose weight constantly as the cure for my blood pressure issues and then ended up still having to take the medication - which I am on the borderline right now of having to go back on.

      July 27, 2011 at 16:22 | Report abuse |
  5. my2cents

    Empathy??? The US is full of empathetic people. We need 10% more empathy and 90% more action. Empathy is just a feel good tactic for the wimpy whatever happened to "tell it like it is" and then do something about it. Whatever happened to tough skinned people who could take the truth. Now everyone needs empathy and the nations BMI rate, blood pressure, depression and diabetes continues to climb. If it ain't workin, change it. Empathy is part of the reason we are in the health situation we are in now. Parents empathized with their children about eating healthy "I didn't like veggies when I was growing up so why should I make my child eat them", well maybe because "it's good for them" and it would be good for you! We need a nation of doers and not talkers.

    July 26, 2011 at 09:38 | Report abuse | Reply
    • c'est moi

      The problem isn't that people are too empathetic, they are too apathetic! And a little bit pathetic 🙂

      July 26, 2011 at 09:56 | Report abuse |
    • intothefire

      lol nice moi

      July 27, 2011 at 14:02 | Report abuse |
    • Chet Morrison

      Couldn't disagree more. We need 90% more empathy – and look up the definition, because I am not sure you really kow it, givwen the tone of your post – and 10% more action

      July 27, 2011 at 17:20 | Report abuse |
  6. deb

    I hate to tell the doc this, but smoking nazi, marathon runners are even harder for most patients to relate to.

    July 26, 2011 at 09:40 | Report abuse | Reply
    • Claire

      I think you're onto something. People don't hide out in their homes and become morbidly obese because of empathetic people.

      July 27, 2011 at 01:51 | Report abuse |
  7. charls

    Dr Ben the human versus Dr Ben the doctor. What a dilemma. My brother told me a similar story about his doctor. She was overweight/obese but told him that he needed to lose some weight. Her response was that she was the doctor and he was the patient. Doctors have been taught to emotionally distance themselves from their patients. Thus Dr. Ben's patient seemed to beleive that his prescription to lose weight was somehow false.

    It happens all the time in advertisement seen on TV. The prescription drug commercials has a voice over saying what it does and the a long list of side affects ("sometimes death") but the pictures shows a smiling and pleasant looking man or woman doing every day things like playing with their children/grandchildren or walking on the beach. The visual images overwhelm the audio message. So Dr. Ben's patient hear the voice message but see this fat/overweight man preaching about the benefits of losing weight. The visual of the fat doctor overwhelms his preaching to lose weight. The patient needs to find a new doctor. Dr. Ben needs to find a new doctor too.

    July 26, 2011 at 09:43 | Report abuse | Reply
  8. RB

    Why should they? Congress doesn't.

    July 26, 2011 at 09:59 | Report abuse | Reply
  9. Jugger

    My doctor, who is 3 inches shorter and at least 40 lbs. heavier than me, told me that I needed to lose about 60 pounds. I politely reached out and shook his hand and said, "Dr. Pot, I'm Mr. Kettle, what color are we today?". He laughed, but had a sour look on his face. I went back to see him recently after about a year and after loosing 50 lbs. He had lost 65 lbs. after our last meeting. He said that I had made him feel like a hypocrite, so he started practicing what he preached. When we departed, he shook my hand and said, "Mr. Kettle, Dr. Pot here, today we are colored gold."

    July 26, 2011 at 10:23 | Report abuse | Reply
    • Cathy W

      Great story, Mr. Kettle. 🙂

      July 26, 2011 at 10:36 | Report abuse |
    • Kim

      That's awesome! I wish I could give your post a +1!

      July 26, 2011 at 18:26 | Report abuse |
    • Leo

      Excellent. And the result is that BOTH of you ended up in better health. It's a win for everyone.

      July 27, 2011 at 08:27 | Report abuse |
  10. Crystal

    I have to admit, when my doctor tells me I need to lose a few pounds, I have to bite my tongue to stop myself from calling her out on her being at least 50 pounds overweight. I'm slightly offended that she considers me "overweight" (which I know is crazy – she's just trying to work with me to keep me healthy) when she's clearly got me beat in that departmen. Maybe losing 5 pounds would make me healthier, but taking advice from someone who clearly doesn't "practice what they preach" can be difficult.

    July 26, 2011 at 10:33 | Report abuse | Reply
  11. JEN

    I NEVER UNDERSTAND DOCTORS WHO KNOW WHAT IS GOOD AND BAD FOR THEIR HEALTH BUT THEY DON'T CARE OF IT. ALL DOCTORS I SEE IN PUBLIC OR TV ARE OBESE, SKINNY, OR SMOKERS

    July 26, 2011 at 12:02 | Report abuse | Reply
    • IgM

      Just about everyone knows that smoking is bad for them, but 20% of the population does it anyway. Doctors are not immune from this sort of thinking

      July 26, 2011 at 12:55 | Report abuse |
    • Belinda

      I'll soon be a physician. I'm not obese, nor emaciated, and I don't smoke. I have a healthy BMI, eat a balanced diet, and exercise regularly. Most of my own physicians are the same. If you look for the unhealthy ones, you'll surely find them, but it's unfortunate to have such a jaded view of the entire profession.

      July 27, 2011 at 00:14 | Report abuse |
    • Dr. Jon

      I have to say generalizing all doctors as fat, skinny, or smokers is fairly broad! This goes along with a lot of other professions too. What most people don't realize is that the profession drives medical students, residents, and new physicians down a road of un-healthy living. Medical schools give excessive amounts of studying, residencies are averaging 80 hours a week, and patients get up set when physicians take days off or have cush hours. This leaves physician and a lot of other health care workers in a catch-22. I agree physicians should do a better job taking care of themselves but all of us as patients shouldn't find excuses to not take care of ourselves because our doctors don't. In the end, whether our physicians are hypocrits or empathize with us, we are the ones living with certain conditions that could've been avoided had we been more proactive in taking care of ourselves.

      July 27, 2011 at 16:00 | Report abuse |
  12. Crystal

    yes I believe so. . . I cannot stand a DR sitting there that is nearly 300 LBS themselves & telling me I need to LOSE WEIGHT!!! I remember in HS our Nutritionist in Home EC class was HUGE, and here she was supposed to be teaching us to eat healthy.. I'm sorry but I didn't take the class very seriously. Just like when a DR tells me to stop smoking altho they smoke, I'm definitely not going to take them as serious & think the risks are not nearly that bad especially if my family DR smokes..

    July 26, 2011 at 12:50 | Report abuse | Reply
  13. Romesq

    My beloved wife was a pediatric pulmonologist and intensivist who smoked. She had a gift for taking care of the most seriously ill children and their families. She tried to quit many times but never put herself at the top of her priority list. When asked about the disconnect between her personal life and her advice to the families of her patients about smoking around children, her response was "Never presume that my personal judgment is anywhere near as good as my professional judgment." I lost her to sudden manifest lung cancer almost three years ago. She was almost 70 and still practicing. I'm still grieving about that personal judgment problem, but I know how much she did for so many others.

    July 26, 2011 at 12:51 | Report abuse | Reply
    • Churchill

      What a wonderful response from your wife. Could not have been stated better. Teachers fail to learn from past experiences, as we all do, police men and women break the law, and mechanics drive old beaters. This is the result of the human experience known as life. However, ones failings should not become another's excuse to repeat the perceived err.

      July 27, 2011 at 00:08 | Report abuse |
    • charls

      I am sorry for your loss. Please take of yourself.

      July 27, 2011 at 16:19 | Report abuse |
  14. slyalys

    With the health care problems we should be thankful for any doctors who still practice.
    My doctors have been quitting because of obamacare

    July 26, 2011 at 14:07 | Report abuse | Reply
    • Katie

      Yeah, that darned Obama care .... Of course, most doctors left their practices long before Obama came to power, because the GOP allowed insurances to set rules, prices, and mandates, and the GOP felt government money was better spent on wars and big businesses back in their home states instead of refunding doctors and hospitals for Medicare....

      July 26, 2011 at 14:36 | Report abuse |
    • Belinda

      ummm... it has very little to do with Obama, actually, and everything to do with the rising cost of malpractice insurance, and that's been going on since long before Obama was elected into office. If our culture weren't so intent on suing for every little thing, malpractice insurance wouldn't be so costly, especially in certain specialties. When I was in Samoa for part of my medical schooling, the people were just happy that someone was there to help them, who would do their best, even if it was a losing battle.

      July 27, 2011 at 00:11 | Report abuse |
  15. Katie

    Too many medical personnel smoke. I used to work in the OR and you couldn't get away from it – disgusting!! Then they changed the rules so no one could smoke in the building. We used to laugh at all those doctors and nurses huddled out on the roof, the only place they could go, getting their nicotine fix. While those of us who didn't smoke did the work in their absence, and we did the long, hard, involved jobs, because WE didn't need a break every other hour.

    July 26, 2011 at 14:32 | Report abuse | Reply
    • My take!

      I used to live with my mother who had Parkinson's disease. In the final year of her life we got an aide, a woman who smoked. We were told that Connie would smoke only outside. Every time I went to my mother's part of the house, I would ask my mother, "Where's Connie?" She'd move her head to indicate: out there on the back porch smoking. A lot of good it did for us to get an aide. I ended up doing as much work but Connie got the paycheck from Medicaid , it was more than I got which was nothing. I don't smoke so I was able to keep taking care of my mother 'til she died. The man who drove the funerial van across two states to bring Mother's body home was a smoker, always needing to stop and get out to smoke.

      July 26, 2011 at 15:17 | Report abuse |
  16. My take!

    The sickest person I ever met in my life was once my doctor. No, he was not physically ill. He was in very good shape in his body,but he was the angriest , nastiest, ugliest human being I have ever known. I despised the man. He couldn't keep his staff and he had been divorced four times because wives kept leaving him. Yes, I'm fat. But I'm a kind, loving, happy person with lots of friends, a good love life.... and I'm almost never angry. I'll take my kind of unhealthy (being fat) any day of the week over that of someone who is so angry , nasty and snarly that he can't keep employees or a lover. Also his patients kept leaving him, me included. We wanted friendly doctors.

    July 26, 2011 at 15:12 | Report abuse | Reply
    • MacMadame

      Right, because the choice is between being unhealthy and nice or healthy and nasty. :eyeroll:

      July 27, 2011 at 16:29 | Report abuse |
  17. jimthejet

    medicine has nothing to do with being healthy; for most MDs, it's about money–ordering unnecessary tests, MRIs, CT scans, and of course, doing unnecessary surgery–back fusions, heart bypass, hip and knee replacement. Imagine if all these unnecessary tests and surgeries were denied how much money would be saved. until medicine teaches "health" care (okay, stop laughing), we'll continue to wallow in an expensive, "disease" care industry.

    July 26, 2011 at 15:21 | Report abuse | Reply
    • kyle

      Yes, good thing doctors learn to set aside personal feelings or you would never receive health care.

      July 26, 2011 at 19:49 | Report abuse |
    • Belinda

      I'm certainly not going into medicine to be wealthy. I'm going into it because I truly care about others and want to help. At the same time, I will agree on one thing... there isn't enough done as preventative medicine. Hospitals and doctor offices should offer healthy living programs, with incentives for participation, and the health care workers should be encouraged to participate in those very programs themselves, be it a social walking group, yoga, etc. Not every physician is out for themselves. In fact, most physicians truly DO care about the people they treat.

      With my desire to do charity work as a physician, I have no visions of ever being wealthy. I just want to help others regain their health, and help them to sustain good health if they already have it. Maybe I'm altruistic, but that's just who I am.

      I eat healthy and exercise regularly. In fact, nearly a year ago I ditched my car and replaced it with a bicycle. I've never once looked back, and I feel great!

      July 27, 2011 at 00:03 | Report abuse |
    • Churchill

      Keep on parrotting what you hear. Your ignorance is my bliss.

      July 27, 2011 at 00:11 | Report abuse |
    • syd

      If people stop malpractice suits for ridiculous reasons, doctors will have no reason to practice defensive medicine. Many doctors are forced to order unnecessary tests; an MRI if there is a 0.01% chance of something, because there is always the slightest chance and that is enough to get you sued. Also, Medicare only pays 1/3 to 1/2 of what an MRI actually costs so often they lose money

      July 27, 2011 at 10:47 | Report abuse |
    • DocJCP

      yeah, its all about the money. we spend a decade learning a trade to work long hours. I enjoy meeting most of my patients, but when patients, who have the same mindset as you do, walk into my office its all about CYA

      July 27, 2011 at 16:31 | Report abuse |
  18. T3chsupport

    You go to a doctor to tell you what's wrong with you and how to remedy it. You don't go to the doctor for a pep-talk or inspiration.

    As soon as your doctor is looking for advice on how to quit smoking or being so fat, then he'll go ask someone. Until then, you're the one doing the asking, so he's the one doing the telling. If he decides he wants to lose weight or stop doing whatever, then that's his choice, and has nothing to do with his patients.

    July 26, 2011 at 16:43 | Report abuse | Reply
    • cjellis

      You may not go to your doctor's office for inspiration, but I do, as do others I know. I admit personal and professional judgement are 2 different things, but people are more likely to accept professional judgement from someone who has at least somewhat good personal judgment. Would you use an accountant or financial analyst who had just filed bankruptcy?

      July 26, 2011 at 17:23 | Report abuse |
  19. Fuyuko

    I think doctors are people and I do not really care what a doctor does in his personal, private, or out of office life, as long as he/she does his job and gives me good advice!

    July 26, 2011 at 17:21 | Report abuse | Reply
  20. Joe

    It all depends on how it is projected by the physician. A physician that smokes can sympathize with a patient, stress how difficult it is to quit and that he/she has also tried and failed previously. IAn over-weight physician can comiserate with a patient about the difficulties of maintaining a healthy weight while still underscoring its importance. It's less preach from the pulpit.

    July 26, 2011 at 21:27 | Report abuse | Reply
  21. Philip

    The healthcare provider loses credibility if he or she isn't following their own advice. Maybe they are too overworked or work such long hours that they don't have the time nor energy to plan and eat healthy meals. But all I see is the unhealthy person telling me to do what they are obviously not doing. My current Doctor is my age (58) and in great shape. My goal is to get in as good a shape as possible. I don't if I could ever get in as good share as my Doctor but I'm trying. At least, when I ask for his advice on how to get healthier, I know he knows what he is talking about.

    July 26, 2011 at 22:25 | Report abuse | Reply
  22. Belinda

    I've said for a long time, physicians SHOULD practice what they preach. How can we effectively advise our patients to do things we're not willing to do ourselves? We're supposed to be teachers and role models... and we should embrace that role with our entire beings.

    July 26, 2011 at 23:53 | Report abuse | Reply
  23. Beth

    My doctor isn't my role model, my teacher, or my friend. He's a paid adviser that sounds reasonable and intelligent and I pay him to pass on knowledge that he gained during the course of his education. I don't think he's a god and if he were "perfect", it would not be likely that he would be able to relate to anything in my far from perfect life. I like that he's just a human that is good at what he does and his beer belly is his to contend with and really none of my business.

    July 27, 2011 at 01:47 | Report abuse | Reply
  24. Schmick

    "You oughta be shot. Or stabbed, lose a leg. To be a surgeon, you know? Know what kind of pain you're dealing with. They make psychiatrists get psychoanalyzed before they can get certified, but they don't make a surgeon get cut on. That seem right to you?"
    -Jubal Early, Firefly

    July 27, 2011 at 02:36 | Report abuse | Reply
    • syd

      I would rather have a smart, knowledgeable and talented surgeon who I can trust than one who knows what I'm going through but is crap at the operating table. My 2 cents

      July 27, 2011 at 10:49 | Report abuse |
  25. Audrey Silk

    Skip the lectures, treat the patient. Even if that means their lifestyle choices leaves NO treatment available. Then THAT is the conclusion and you've done your job. That job is not to preach it's to fix with medicine what you can. Just like a car mechanic is to fix what's wrong with your car if he can and whose job is not to lecture you on the proper care and demand that you do so. Doctoring is a business, not a religion. I have more respect for doctors who get that and detest any who dare try to tell me how to behave.

    July 27, 2011 at 05:26 | Report abuse | Reply
    • Ken

      What if changing your behavior is part of the medical "treatment"? Shouldn't that be broached? I think what you mean to write is that you don't appreciate being judged for your behavior. There's a difference between saying "your hypertension is not going to improve without weight loss" and "your obesity is ridiculous, and to prove it look at your blood pressure numbers."

      Obesity, smoking, and a long list of other things are unhealthy. That's not judgement, that's fact.

      July 27, 2011 at 20:22 | Report abuse |
  26. MannyHM

    The physician can say "I know that I'm not successful in my struggles with my bad habits...I would be negligent if I don't give these reminders...These reminders are not meant to insult you. The patient here would see his physician as a fellow human being, though obviously knowledgeable and caring, has the same weaknesses like any other.

    July 27, 2011 at 09:14 | Report abuse | Reply
  27. SoulCatcher

    I love the logic here. I wish it would apply to terrorists. They should blow themselves and their families up first before they are allowed to practice terrorism on another family. The logic is impeccabile.

    July 27, 2011 at 09:15 | Report abuse | Reply
    • Anne

      Maybe they -should- practice on their families first instead of harming innocent people in the name of their "peaceful" religion.

      July 27, 2011 at 10:55 | Report abuse |
  28. Emily

    It's not about my doctor's health, it's about MY health. I don't go for them for their lifestyle, I go to them for their wisdom and knowledge. I don't care how my doctor is, but if they know how to keep me healthy and fit, then I'll take their advice.

    July 27, 2011 at 09:55 | Report abuse | Reply
  29. WWRRD

    People should choose their own doctors applying whatever criteria they want. The state should make sure the doctor is qualified to practice medicine. After that the patient as the customer can decide which doctor to go to, man , woman, fat , thin, smoker, non-smoker, young , old, etc.

    I personally could not go to a fat, smoking doctor, but that is my choice. Others may choose differently.

    July 27, 2011 at 09:56 | Report abuse | Reply
  30. The_Mick

    My sister, a research-nurse at Johns Hopkins, calls our PCP "sent by God." The rest of us who see him agree. He's incredibly competent and when discussing meds with me, a chemist, he'll draw graphs and chemical equations all over the tissue paper covering the examination bench to show me how they work and what their pros and cons are. He's also overweight and has type-II diabetes. Me too. That does NOT prevent me from following his recommendations. I began bicycling 2-3 days/week in May and in July had my best every-3-months blood test in two years. Now he's thinking of getting a bike. The way I look at it is that we're in this together but he's the expert on interpreting my condition, my progress, and the best ways I might conquer the "demons" affecting my health. If it finally comes down to "do as I say not as I do" then so be it: it took me 15 years to quit smoking, so I know how difficult those demons can be and I don't expect him to become a lean body-builder.

    July 27, 2011 at 10:33 | Report abuse | Reply
  31. Anne

    I am in good shape, exercise regularly and eat a balanced and healthy diet, as such I expect the same from my doctors. I quickly find a new physician if mine does not practice what they preach. If you are heavily overweight, you are in no position to tell me I need to lose 5lbs. If you chain smoke, drink heavily or otherwise live an unhealthy life, you are not qualified to be responsible for my health care. Ask yourself this – would you accept fitness advice from an obese personal trainer? Nutrition information from a clearly unhealthy and obese nutritionist? Of course you wouldn't, because you would question their judgement on what is healthy. Why should physicians be any different? Practice what you preach. Same goes for people responsible for our safety – too many times I see obese cops or military sitting around instead of staying active to keep up safe. Obesity is costing every taxpayer an increasing amount of money due to their chronic health conditions.

    The argument of "men shouldn't be OB/GYNs because they can't get pregnant" is just absurd. Many of the male GYNs I have had are more considerate and listen better compared to women. Many of the female GYNs I have had all tell me "oh it's not THAT bad" when it comes to explaining my female health concerns. In many of these cases, it has led to hospitalization because they were more likely to compare my complaints to their personal menstrual complaints and rule mine out as "nonsense" whereas men would have to go based on textbook examination, leading to finding the problems faster.

    July 27, 2011 at 10:48 | Report abuse | Reply
  32. Ralph in Orange Park, FL

    Back in the 1970s I had a doctor who weighed in at about 300 pounds. At least he was honest enough to admit he did not follow his own advice.

    July 27, 2011 at 11:01 | Report abuse | Reply
  33. Kat

    My Ob-Gyn was grossly obese and it was very hard to take her seriously. When she would talk to me about diet and exercise she would be leaning on the counter with her head almost laying on her arms. She would complain about being so worn out. Now I realize that Doctors work crazy hours and that they give and give of themselves, but really ... come on. Doctor heal thyself – you would tell me to "make time" to do the things needed to be healthy, but you are too busy ... hmmmm

    July 27, 2011 at 11:02 | Report abuse | Reply
  34. Steve

    Kudos to the good doctor for raising the issue with a fine, thought-provoking article. I once went to one of those overweight, chain-smoking doctors and every time I saw him, my underlying thought was always "do you really expect me to take you seriously?". "Do as I say, not as I do" just don't cut it.

    July 27, 2011 at 11:06 | Report abuse | Reply
  35. paul pinsent

    Thefunction of a signpost is not to move in the direction it is pointing.

    July 27, 2011 at 11:30 | Report abuse | Reply
    • Ruby

      Well done Paul!

      July 27, 2011 at 18:52 | Report abuse |
  36. Andrew

    It's really not any different from a physical fitness trainer who is overweight or out of shape. It's a credibility factor. If you don't practice what you preach, then why should I listen to your advice? Sure, everyone has vices, and no one is perfect - I wouldn't expect my doctor to be the epitome of health in every way. However, I expect that someone who is intelligent enough to become a doctor should take care of themselves. Does unhealthy living make someone unable to provide relevant advice? Obviously not, but it is hard to convince someone to take care of themselves when you aren't doing the same.

    July 27, 2011 at 11:51 | Report abuse | Reply
  37. Linda

    My boyfriend is an emergency medicine doctor who could stand to lose a few pounds. Before his residency began, he was at a very healthy weight: he worked out regularly and ate sensibly. Then the madness of working shifts that last somewhere between 10 – 24 hours (if he's on call) 6 days a week threw all that out the window. Working in medicine is an INSANELY stressful and time-consuming lifestyle, so he eats what he can, when he can, and if there's a McDonald's in his hospital's cafeteria, you can bet that's where he'll get the quickest meal so he can get back to his patients. Don't forget that stress does CRAZY things to your body, and may be a significant part of the weight gain. And I'm sure many doctors rely on cigarettes as a form of stress relief. Certainly, these are not excuses. Lots of hospitals have gyms on campus for their medical staff to use, and most hospitals (even the massive, urban county hospital my boyfriend works at) offer SOME sort of healthy option for meals – lots of campuses are smoke-free, too. But keep in mind that your doctor may not have had a day off in over a week, may have been at work since 9 pm the night before, and quite possible didn't have the time to sit down and eat a salad when he/she could walk and eat a cheeseburger at the same time.

    July 27, 2011 at 12:10 | Report abuse | Reply
    • charls

      Something is wrong with a medical system that drives a doctor to becoming sick. I appreciate what doctors do but until they change the current medical system and makes it more reasonable, your boyfriend will be flirting with death. Unfortunately our medical system treats too many doctors like they are running a MASH unit. No one can work crazy hours with endangering themselves and their patients. I understand that emergencies happen but it cannot be a constant full time work schedule.

      July 27, 2011 at 16:29 | Report abuse |
  38. JT

    Should religious leaders practice what they preach?

    July 27, 2011 at 12:44 | Report abuse | Reply
  39. Carolyn

    Yes, doctors should practice what they preach, esp. when it comes to weight and smoking and drinking. AND they should be more confrontive with their patients who live unhealthy lifestyles instead of just giving them a pill – on them if they need to be told to lose weight, stop smoking, or make some other health-related change in their lifestyle! Those are the doctors I respect.

    July 27, 2011 at 12:47 | Report abuse | Reply
    • Linda

      So the 4 years of medical school, 3-5 years of residency, and all the years of active practicing aren't worthy of your respect? Your doctor – regardless of his/her specialty or field – dedicated somewhere between 7 and 10 years of their life to studying and practicing medicine before he/she even landed his/her first job. Medicine is a LIFESTYLE, and your doctor eats, breathes, and lives the knowledge and advice that you've turned to them for. Being overweight, smoking, etc. doesn't diminish their knowledge and experience.

      July 27, 2011 at 16:22 | Report abuse |
  40. OncDoc

    As a practicing oncologist, I find this article interesting. I do not smoke and am not overweight. It is difficult to find time in a busy and stressful schedule to exercise regularly and always eat the healthiest food. However, I find it interesting the standard that physicians are held to. Can a dentist never have had a cavity? Can a police officer never speed? Should all chefs be fat, then, by this logic? Must a maid keep the cleanest house? I'm not using these examples as an excuse for physicians, just to provoke thought. I think that physicians should try to relate to their patients and set a good example whenever possible. I even willingly submitted myself to have a bone marrow biopsy (the most common procedure I perform on patients) just to see what it was like. I can now relate to my patients when I do the procedure on them.

    July 27, 2011 at 12:55 | Report abuse | Reply
    • bacos

      "I even willingly submitted myself to have a bone marrow biopsy (the most common procedure I perform on patients) just to see what it was like."

      I'd be even more suspect of a doctor that thought unnecessary tests were a keen idea...

      July 27, 2011 at 16:16 | Report abuse |
    • Linda

      Oh, come on, Bacos – you've missed the point of OncDoc's comment. He/she said nothing to suggest that he/she performs unnecessary procedures. He/she PRACTICED WHAT HE/SHE PREACHES by subjecting him/herself to the patient's experience. Would you rather have an oncologist who's rough and brutal performing the procedure because they don't understand what it feels like on your end?

      July 27, 2011 at 16:27 | Report abuse |
    • bacos

      Linda,

      I realized OncDoc's point, but still question the judgement of subjecting ones self to it just to see what it feels like (granted, in a facetious manner).

      A bone marrow biopsy is certainly not like giving blood and serious complications are not uncommon.

      I would rather have a doctor that understands the risks associated with unnecessary testing–and that it is FAR too common. Same with prescribing antbiotics.

      Since we are talking about 'practicing what you preach' then shouldn't he/she set an example by not going through unnecessary testing that was not medically justified?

      July 27, 2011 at 16:42 | Report abuse |
    • Linda

      Bacos, I continue to disagree with you on this example. I appreciate the sentiment about over-prescribed antibiotics, but I don't think it's akin to a biopsy, and is thus an irrelevant complaint. The flood of prescribed antibiotics has consequences to our society as a whole, whereas one doctor subjecting himself to a biopsy does not. The argument about unnecessary testing is a financial one – the more tests a patient is subjected to, the more the hospital can bill insurance, Medicare/Medicade, etc., which is why it's unfortunate that so many patients are put through erroneous testing. Plus, doctors often order unnecessary tests to protect themselves from law suits accusing them of neglect – which has nothing to do with this doctor's decision. One doctor trying to put himself in his patient's shoes so he can treat others with care, sympathy, and compassion is an example of precisely the kind of doctor you'd want – not one who's a part of the insurance-game problem.

      July 28, 2011 at 14:30 | Report abuse |
  41. Larry

    My doctor is about my age (early 50's) and very fit. I'm definitely more likely to follow my doctor's advice because it's obvious it has been working for him.

    July 27, 2011 at 13:03 | Report abuse | Reply
  42. JimTX

    I saw a doctor who was at once. I never went back. I am not going to follow advice of someone who has no self control and an unwillingness to exercise. Fat people disgust me.

    July 27, 2011 at 14:57 | Report abuse | Reply
    • MacMadame

      Stupid people disgust me...

      July 27, 2011 at 16:46 | Report abuse |
  43. MacMadame

    The doctor in this article should have handled the situation differently and by that I don't mean he should lose 150 pounds and quit smoking (even if it would be great for himself if he did). Because I don't think he would have gotten that patient to listen even if he was fit and trim.

    What could he have done?

    First, he could have told the guy that losing just 10% of his body weight would have a dramatic effect on his blood pressure. It is possible to lose 10% of your body weight without invoking the famine response that causes our bodies to sabotage our weight loss and it's a lot less daunting to lose 10-25 pounds than to lose 150 pounds. Secondly, he could have emphasized the dietary changes without harping on the weight. Just lowering sodium intake can improve blood pressure without weight loss. Third, he could have told the patient about weight loss surgery which is the only effective and durable cure for obesity we've got right now. Many WLS patients come out of the hospital off their blood pressure meds.

    Instead, he blamed the problem entirely on the patient's weight, gave him a useless lecture about losing weight with no helpful advice on how to accomplish it and then wrote him a script anyway. In fact, he acted no differently than the majority of doctors who aren't obese and he had the same result - to not have his advice not taken seriously.

    July 27, 2011 at 17:04 | Report abuse | Reply
  44. Sandi Butler

    I very much appreciate the oncologist who underwent the bone marrow procedure, as I had to undergo this after being in the hospital for over 6 months with no diagnosis. My oncologist was wonderful, as I could have NO LOCAL anesthetic due to many serious allergies. He actually had tears in his eyes as he hated doing it cold turkey! That and the fact he came daily just to help me cope with the long time with no answers.

    July 27, 2011 at 17:07 | Report abuse | Reply
  45. ctb67

    I don't think the problem here was if the doc was fat or not. It was his bedside manner, he missed out on a great teaching moment there. BTW, I am 40 lbs overweight and I am tired of docs who have never had to struggle with weight, pain or lung problems. This doc could have used that moment to say, "yea I'm fat, and I haven't seen my feet since '92, my love life sucks and my knees hurt all the time." Instead he just dismissed him, that would make me question his judgement on other things....not the fact if he is fat or not. If I get a doc that is patronizing or abusive, I take my money to another doctor. Like my Osteopath doc says...."yea it sucks if you drink or smoke or are overweight...then again, if the patients didn't, they wouldn't be coming to me as much and I would have to take on a second job for my mortgage payment>"

    July 27, 2011 at 17:19 | Report abuse | Reply
  46. Mike

    First-you go to your doctor to ask for his/her advice. They have not gone to you to ask for yours. Most would view it as inappropriate if someone offered unsolicited and unflattering opinions about another person's weight, but somehow it is okay here. Secondly-I think many people who battle with obesity are offended when the subject is brought up because they know that this is a problem(a difficlult one) that they have immense control over. Calories in vs calories out. People above have said that doctors only say"eat less exercise more"-guess what if you did that you'd lose weight. The majority of health problems today and self inflicted wounds- take responsibility

    July 27, 2011 at 17:25 | Report abuse | Reply
  47. Yoruko

    Hi everyone,
    I found out I was diabetic three years ago and lost 20 pounds. My doctor gave me the basic advice and it was up to me to take it. I would rather take advice from someone who I feel could understand what I was going through. How can someone who, I feel, has an easy time managing their weight understand what it is like for someone who finds it more difficult?

    July 27, 2011 at 18:06 | Report abuse | Reply
  48. McGuffin

    A rude patient doesn't mean a doctor has to practice what he preaches. There's a difference between caring what you do to your body and knowing what the right thing to do is. What difference does it make to a doctor's professional medical opinion if he or she is overweight? You're not going to the doctor to be judged or to get a pep talk; you're going to get an evaluation of your health and a recommendation of how to improve it.

    July 27, 2011 at 21:31 | Report abuse | Reply
  49. Tim

    I'm in the camp that says doctors should be pretty good role models, but some flaws don't hurt. We are people too and we have problems just like everyone else. I think it's hard for patients to relate to the perfect doctor with the perfect life. When I was in med school I followed a family practice doc who apparently had recently lost 30-40 lbs. When I (a young skinny guy) counseled people about weight loss, I could tell I wasn't really getting through. They couldn't relate to me. When the attending counseled them about it and stressed the fact that he recently lost that weight himself? The patients really listened.

    July 27, 2011 at 23:12 | Report abuse | Reply
  50. Emily Caskey

    My doctor,ANA PERE', is by far the best I have ever went to. She truely practices what she suggests. I have no problem taking her advice because she stresses healthy lifestyle which you can see she practices.I could never listen to any doctor who could not control their eating or any other unhealthy habits.==Would you want a minister who commited adultry,or a police officer who broke the law?Everyone can make their own decision, but I beleive all doctors take an oath to not harm. What are the doing to themselves by being unhealthy? Isn't that sort of hypocritical?

    July 28, 2011 at 00:08 | Report abuse | Reply
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