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?
How would you feel if he were your doctor? Would you listen to him if he asked you to adopt a healthier lifestyle?
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.
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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Skinny, rude people named Jon disgust me. Yeah, I am a fat girl, but I'm doing something about it. I had the lap band surgery and have lost 50 pounds. Not where I want to be, but because my overweight, smoker doc is supportive, the journey is so much easier.
Do you have any articles on hypnosis? If not I would be happy to help you out. http://florida-hypnosis.com
Melissa overweight people who try to throw a guilt trip and dump their resentment down my throat because I'm skinny disgust me even more. Some people have as much trouble gaining weight as you and people like you have in losing it. Some skinny thin people just might be feeling the same type of disgust towards you for the same fraking reason.
We all have rights to eat what we want. Who cares about what people think.
You may have the right to eat what you want, but you don't have the right to put the medical costs of your poor choices onto everybody else. Eat as much as you like, smoke all you like, and take all the drugs you like, but don't expect me to pay for it – either through increased health insurance premiums or taxes for medicaid/medicare.
With priviledge comes responsibility, so you can choose to be responsible for either your own health, or your ability to pay for the consequences.
Doctors are just overpriced nurse's who can prescribe med's every time I go to the doctor they just give me what I already know there going to. If i could prescribe my own meds i wouldnt be out $$$
I think every DR. who prescribes heavy pain medication should take it for 6months and then be cut off. Then "THEY" would know what it feels like to be hurting and sick from addiction. Too often, people are cut off their meds. because they can't pay or a Doctor just cuts them off. To me it's inhumane.
Bobby, if you know you won't be able to pay for more medications of any kind, you should tell your doctor AHEAD of time and wean yourself off of them. It isn't your doctor's fault you can't pay. I have weaned off several times and I've done ok. You are responsible for your own health. Your doctor is just an advisor, not your mother.
However, I agree that it would be justice to have physicians take the medications they prescribe so they are fully cognizant of the effects those medications impose, both desired and undesired.
People in general, doctors or not, should not be taking medications that they do not need. That said, you should be weaned off of your medications. As the above poster said, if you are having trouble affording your medications you need to tell your doctor. She/he won't automatically know that unless you tell them!
There is a reason the phrase "Physician, heal thyself!" came about...
I am a physician. The other side of the coin in nutshell: yes, we are also human beings with human faults. Our mission is the heal the patient. Healing ourselves is NOT part of our mission, it is simple as that.
Gabor, I am a scientist as well as a patient and "do as I say, not as I do" is frequently unattractive. If boosting compliance among a specific patient population is important to a physician, self-compliance to applicable guidelines is necessary. We do seek out and pay for advice and we are responsible for our own compliance but seeing someone advocate unpleasant lifestyle changes while not conforming themselves doesn't sell well.
I'm a pre-med student. I would hope my background of overcoming obesity and living a more healthy lifestyle will help me to set an example for my patients. I think that living a healthy lifestyle counts towards a physician's experience, just as years of practice do.
So, if you want to see me. just keep on what you are doing, and get ready.
And don't blame the docs.
The fact that doctors get almost no training on nutrition should be the first sign you shouldn't have any faith in them to begin with.
So you've been to medical school, then?
We as physicians should "practice what we preach" whenever possible. That said, we are also human and it's more difficult for some than others to keep the weight off. I think that a physician who has personally struggled with an illness would be more empathetic and compassionate to their patient than one who has never struggled. When you can say, "I have been there, i really know what you're going through – here are some things that worked for me..." I think it's very effective. We are only humans, not gods like some want to believe, and we are subject to the same vices as our patients.
That's right, Poodles. Just go to your "spiritual healer" and follow what they say. Just don't go crying to a doctor when their "alternative medicine" fails.
As for your "faith" in humans, that is where people fail. I NEVER have faith in any person.
Doctors should also recommend the Taking a Break app for their patients who need a break from Twitter and Facebook.
Yes, doctors should practice what they preach, but the communication has ended with patients and now some doctors enforce the fear tactics to patients forgetting that patients make a choice in their lives.
If you can't afford your medication tell your doctor AND your pharmacist! A lot of times doctors don't know what each individual has to pay for a certain medication as insurance plans vary greatly. I work in a pharmacy and we will happily let you know when a cost savings generic is available. We also will let you know when a similar drug in the same class has a cost savings generic. A good example is Lipitor compared to Zocor. Lipitor has no generic at this time, however Zocor does. If you are on Lipitor and cannot afford your medication we will happily let your doctor know that by switching you to simvastatin (generic Zocor) you could save x amount of money in a year and will be much more likely to take the medication as prescribed. Just this past week I helped a mother whose son's nasal allergy medication was about $60 with the insurance. Based on their insurance information we contacted the doctor and were able to have them switch the prescription to one that cost them only $7!
What role do residents play in healthcare?
Do we really need them?
Please join the discussion!
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