What Prevents Doctors from Counseling Their Patients to Lose Weight, Exercise, and Quit Smoking?

There is a nice summary of a recent report on why more doctors don't promote lifestyle changes even though they think they are supposed to by the University of Haifa (as reported by Diabetes In Control) at: http://www.diabetesincontrol.com/modules.php?name=News&file=article&sid=4571

Upon reading this it brought up some personal observations and opinions that I wanted to throw out here for comment. These are pure conjecture and opinion and go well above that which was reported in the study.

First off, check out this fact from the article, "Ninety-nine percent of doctors believe that part of their job is to encourage their patients to live a healthier lifestyle, but only 20% actually do it."

While the University of Haifa sought to answer this very question I had a few ideas and conclusions of my own that were not necessarily in the article. First off, I have to imagine that many of the doctors don't have the innate interpersonal skills required to offer truly successful lifestyle coaching (but I DO think there is a need for this especially with Diabetes and Heart Disease where so much can be done at a lifestyle level alone). By this I mean, it takes a charismatic-leader type individual to inspire and convince. Yes, the doctor has the "authority" figure role for many (but that seems to be dwindling as more and more lose confidence in their medical professionals based strictly on evaluation of outcomes produced) but beyond that in many cases it takes a bit of inspiration and motivation to get people to institute lifestyle changes. In addition it takes a true teacher (educator) which is not as we would think--the ability to truly teach is not that common in my opinion. I believe that part of the reason for a doctor not pushing lifestyle changes could impart be the lack of these essential lifestyle coaching qualities. I think it is imperative to elevate the position of lifestyle coaches for certain ailments as they could probably do far more healing then a doctor without these skills who is merely providing drug treatment.

But what about those unique doctors that actually DO have the unique interpersonal skills required as well as the desire to participate in that sort of coaching I wonder how many are deterred by a lack of confidence in their actual abilities to heal.

Don't laugh, but I know for a fact that most endocrinologists focused on diabetes are apathetic. Lets face it, the ADA has given them a recipe for disaster with respect to guidelines on how to treat a disease that many of them focus on. From what I have seen many of them resort to merely "treating" their patients and are unable to present them with a means for achieving normal blood sugars (even for those that are trying like crazy to do so--it just can't be done on the ADA and typical high-carb/low-fat diet that most medical professionals in the field are pushing). So my thinking is that after some time they come to think that the best they can do is prescribe medicine and treat the illness, with no power to actually solve or heal it (even though those of us using low carb with normal A1Cs know this not to be the case). I wonder if a doctor who practices in a field that has very low success rate in treatment and mostly just sees progression of the disease ultimately loses confidence in themselves such that making lifestyle recommendations seems futile, since in the case of diabetes you can make a lot of lifestyle changes but if you continue to eat the high carb diet you WILL have higher then normal blood sugars, and the disease WILL progress.

Anyhow, these were just a few thoughts on the article which I thought was interesting in and of itself. Makes me feel like there needs to be a Jenny Craig / Weight Watchers type business for the low carb, exercise, component of diabetes as this will be far cheaper for society then having half the population on drugs (I am sure the pharmas would rather see the later).

Until next time.