[aesclepius]

> Often, people expect to do whatever they want and then go to doctors to ‘fix’ them. It’s good for doctors, but not so great for you.

Hackernews doesn't realize they are the 0.000001% of patients we see. I'd love for all my patients to make the lifestyle, diet and habit changes I recommend in addition to the medications I prescribe. The reality is that users here do not recognize the privilege they have in terms of money, agency and knowledge. The vast majority of people I see are barely scraping by and have very little time/effort/privilege to make the changes I would like them to undergo.

[wolverine876]

> Hackernews doesn't realize they are the 0.000001% of patients we see. I'd love for all my patients to make the lifestyle, diet and habit changes I recommend in addition to the medications I prescribe.

That's excellent perspective. To add more: I'd love my doctors to respond to my interest in my health. They usually barely hear what I say, ignore my priorities, and rush me out the door. I can't even get a simple response from my general practitioner any more unless I am standing in front of them at an appointment. (And no, I'm not a nut asking bizarre or pedantic questions. I generally avoid seeing the doctor until it's clear I need professional treatment.)

[0xcde4c3db]

My experience has been that doctors don't actually even bother to recommend lifestyle change, they just vaguely cast aspersions on my lifestyle based on my weight and blood pressure, and that's the end of it.

[nradov]

Many doctors have given up on recommending lifestyle changes to patients because compliance is so poor. They see it as a waste of time and prefer to focus on interventions that seem more effective.

If you want to make lifestyle changes then it might be more useful to consult with a dietician, personal trainer, or therapist instead of a physician.

[chadcmulligan]

I believe many people don't follow those recommendations, because no one is told how. like lose weight and exercise - how exactly? There's a middle bit missing imho - an average joe's food and exercise centre if you will. personal trainers and nutritionists are next level in my experience, they're not really interested in telling average joe's walk a bit and do some exercises, same with nutrition - people need recipes that they can make easily, and healthy food they can buy when out easily. These things don't exist in my experience. The junk food industry is huge, as is the diet industry - saying do these easy things and you'll be sweet isn't really a money making proposition afaics.

[52-6F-62]

I’ve had both experiences.

Like anything, it’s a complex of the doctor’s personality, personal motivations and their own contentment or lack thereof and how it manifests in their work.

One of the finest bedside manners and wholistic approaches was a doctor I’d had growing up who moved up here from Kingston, Jamaica. The life he had led up until his career as a GP forced him to maintain a “big picture” approach.

One of the worst bedside manners and considerations is a doctor who I can’t name or point to because he’s one of rather high standing in Toronto. A truly brilliant physician and technologist. Awful manner, poor communication. That’s compounded in emotional effect as it’s your life on the line and not theirs.

People are complex and some doctors prioritize their work with patients, others prioritize their research, others their personal finances and so on.

If possible, it’s best just to seek out help and insight elsewhere. Sometimes that second opinion doesn’t change anything, other times it’s fundamental.

[chadcmulligan]

Even being in the 0.00001% its incredibly hard to find out what you should do. There is the health industry, who gives you pills and thats about it. My doctor gave me blood pressure pills, I asked what can I do to get off them, the response was nothing, live with it. That wasn't true, but finding out what I should do, took me a few years. I ended up with the hippie wholistic people who had things together. A lot of them had chronic health issues that medical health couldn't treat, and so they to did this. The answer is so simple and costs very little, but you just have to avoid pretty well everything food or health wise that you see in supermarkets, cook your own food, exercise a very small amount and thats it. I actually spend less on food than I used to. It's easy, but finding out is hard and the medical profession is totally unhelpful in telling people this, at least in my experience.

[seanicus]

I'm very curious what this diet looks like, moreso after you mentioned that you're not using supermarkets.

[Arete314159]

I'm guessing they mean processed foods. Like, vegetables: fine. Stuff that comes in a box/bag etc: not fine. Obviously you also can get vegetables at a supermarket.

[chadcmulligan]

yes, exactly. avoid the middle part - fresh and refrigerated food is on the outside usually. Processed in the middle. Anything that has a nutrition label on it, is probably not nutritious is my rule of thumb, there are exceptions of course, frozen vegetables, canned veg, grains etc.

[France_is_bacon]

Right, doc, I understand what you're saying. However, 90% of those underprivileged people probably would not make the changes you suggest, even if they had $20 million in the bank. They would still just sit on the couch all day, except it would be a much nicer couch. Most of them would react to you like they do to the Covid 19...."fake news" and curse at you. I'm not saying all would react that way, but my faith in humanity is low, low, low. So I think 90% would just sit on their asses anyways. I mean, 70% of the USA is overweight or obese. That covers more than just the poor. That's pretty much everywhere, across all social and income strata. The only subpopulation where I see that 90% of the people are in shape is at the gym. For some strange reason. Go figure.

My father, who is a physician, used to have a diet clinic as one of his ventures. Out of the thousands of people he saw, none, not one, person stayed with the program. Some did for a while. But then bam, fatso again.

It's really super sad. Back in the 1960s and 1970s and 1980s, everyone was thin. Everyone, except for a very, very few people who were horrifically fat to our eyes, although now they would be on the light side of overweight.

As the population started to get fatter and fatter, starting in the 1990's, I 100% knew, KNEW, back in the 1990s, that at some point in the future, things were going to change and fat women would insist that they are beautiful, and revile slender women. Which we see every day now. I mean, it's not guys, guys don't give a sh-t if you call them fat. You never read anything about men wanting to be called BBM or "curvy" or body acceptance or whatever the phrase of the day is. But women have it in their DNA that they want to be perceived as beautiful, in order to attract a mate, I guess.

[Mountain_Skies]

Connecting concerns about "fake news" to being underprivileged is extremely problematic and you should be ashamed for making it. The arrogance of making such a connection is astonishing.

[hedora]

Look at profession and education in this comparison of Fox News and MSNBC demographics:

https://pos.org/whos-watching-a-look-at-the-demographics-of-...

People should never be ashamed or accused of arrogance for pointing out objective truths.

[France_is_bacon]

Sorry you feel that way. I admit I am extremely cynical of humanity.

I don't necessarily only think this about the underprivileged. More like the uneducated and the credulous. This included all manner of Republicans. They put out confusing information, say that there's fake news. And the underprivileged don't know what to do. Despite almost every single person in the USA knowing for sure that all infectious disease and epidemiologist say to take the vaccine. Everyone knows this. Every single person, every single underprivileged person knows this after 1 1/2 years.

I understand that not everyone is as cynical as I am, so feel free to have your own view of how the world runs.