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[ElysiumHaven]

I think you can still help as a doctor; on a side note, this can also be done with more attention in some kind of home healthcare system, maybe?
It's just a thought. With some more individualized attention in a home healthcare support system for certain individuals who cannot walk due to their diabetic condition or age, you could potentially help them (may need to coordinate with their family as well and with their food preferences or culture). It is a bit difficult sometimes though I'd imagine... (In terms of someone possibly craving or going back to certain behaviors....)

I also think it can be targeted (this goal of "healthy eating") by looking into several possibilities:

1) Maybe on the business/culinary side, help with supporting some kind of "healthy eating" options and nutritional education?

2) On the research side, help with checking the genetics related to certain people's responses to certain diets? Sometimes diet needs to be individualized to some extent, taking into account of biological, psychological, sociological factors... et cetera (For example, cancer cells typically exhibit the "Warburg effect" meaning that cancer cells typically rely predominantly on glucose, upregulate glucose transporters, and the cancer cell's mitochondrial activity seems to be impaired, i.e., cancer cell's mitochondria not being able to process lipids for beta-oxidation and amino acids for ketogenic purposes as efficiently compared to normal cells, but instead seem to rely mostly on glucose.) Carbohydrates are still important to some extent of course, but maybe some kind of education on different kinds of carbohydrates? Oh well. Maybe finding some kind of balance of providing some low-carb options (useful for some diabetics and those looking for a keto-related diet) that an individual will find palatable and thus likely to at least adhere? . . .

3) Starting early with childhood education? We have to be careful of course, nutrition guidelines tend to change over the years and it can be difficult for some people to take the general advice (again, individualized attention may help, with respect to cultural foods, questions, genetics) -- what are some things that you want to see changed? How can you help feed the children healthy food? How can you help educate the children and their parents on finding the "right" kind of foods to eat? (Just some questions that I'm thinking about.)

Just brainstorming. I hope your day goes well. 🙂

 

[Nontrad_FL_LGBT]

Don't think about patients as symptoms. Of course they have symptoms, but you're treating their life. A lot of the things you're mentioning such as diet and exercise and walkable cities etc are not available to many, many people in this country. When you work two jobs and have kids, coming home to cook a healthy meal is not top of the list.

You just have to acknowledge that a vast majority of people are unwilling or unable to change their ways; that's on them, not you. But if putting someone on Metformin/statins means that they get to spend another 5-10 "good years" with their grandkids, you made an entire world of difference.

Doctors can't save the world alone, though. Larger structural changes require political, and more importantly, societal support. Be a doctor, do good in the world and improve the lives of individuals, and use your power and influence to affect change. That's all we can do.

 

[Med Ed]

It makes me excited and passionate and obsessed, as opposed to helplessness and despair from treating the 10000th case of spinal degeneration caused by a sedentary life. I’d love being a thorn in the side of the FDA.

You may have better luck attending law school and going after the USDA, followed by a career in politics. Or perhaps architecture/urban planning.

 

[Mr.Smile12]

Does anyone else have this fear of only treating the symptoms but not the disease? ...

You can be a union-member handyman/person who professionally rehabs/flips out-of-code houses. Of course you can't easily fix a lifetime of bad circumstances and habits like you can rebuild a foundation of an old house.

That's the difference between having a sense of humanism and giving someone dignity versus just doing a total reset. People who can't afford to fix the roof have to make do with buckets on the floor, and you'll have a similar mindset with patients who would rather take pills than quit smoking. This is why Empathy is essential in health care.

 

[Rachapkis]

Medicine is a bit like marriage. You need to find the type of crazy you're okay with and fully commit to it.

 

[cj_cregg]

I don't fault your thought process or motivation, but this is much harder to do than you think it will be in the modern US healthcare system. Your employer will not give you time to counsel patients about this stuff. Many of your patients won't be motivated to change, and some of those that are will be hindered by systemic issues that take enormous effort to change. But also, lifestyle habits take years to build and take effect. even provided with all the right info and resources, they are not going to come back a month later and be cured. I would love it if all my diabetic patients could cut back on carbs and exercise more and lose weight and not need medication anymore...and some have! But while they are working on those changes, they need metformin and statins to reduce their risk of morbidity and mortality. It takes many visits over a long time to do this work.

I wonder if you might be better suited for something like an MPA or MPH and a career in public health or public policy. If you are confident in medicine, I'd consider direct primary care so you have more control over your own schedule and a smaller panel, and of course you can always find opportunities to engage in advocacy and community outreach.

 

[SahilMehtaMD]

Hey there!

I think one of the keys for you will be channeling this passion for preventative/holistic/lifestyle-oriented care into concrete, positive actions that actually help people live better lives. Identifying the issues is only the first step and one that you seem to have already taken on your own. Now it might be time to consider: what can I do to help the situation?

Many on this thread have recommended looking into other career options besides medicine. That's definitely something you should do if you're unsure about medicine in the first place. But if you are certain you want to become a doctor, I see no reason why you shouldn't pursue that. We need doctors who are aware of the larger issues. The trick for you, I think, will be finding a way to transform this negativity you're feeling (and rightfully so) into positive actions that contribute to the change you'd like to see.

Lastly, don't discount the power of "reactive" medicine as a force for good. Would preventing disease be better than treating it? Yes. Do we spend an inordinate amount of resources dealing with illness emergencies rather than focusing on wellness? Yes. But the fact is that these interventions save lives. People coming into the ER with an MI, diabetic emergency, etc. get to go home to their families assuming they receive the right intervention.

Anyway, that's my two cents -- food for thought at least.

All the best,
Sahil

 

[Angus Avagadro]

Wow! Those are some high aspirations and lofty goals. I applaud your passion and commitment to engage in change. Maybe consider becoming a dietician working for a large medical group counseling patients. A dietician is a serious major based around nutrition. With overweight people who have unhealthy lifestyles, it is best to understand their personal relationship with food. Why do they overeat? Did they have an abusive childhood? Are they nervous eaters?Fat tastes good and we are genetically wired to eat fat. Affordable healthy food sounds good but might not be the answer. If brussell sprouts were a penny a piece, I doubt we would see an outbreak of slimness across the country. It sounds to me like your heart is in other professions than medicine. Follow your heart and you can't go wrong. Good luck and best wishes!

 

[Fluidity of Movement]

One of the things I rarely hear people talk about is what the income of a physician can allow you to do outside of the office. I remember a story a while ago about a doctor who spent over a million dollars to a small research team and they were making a big impact. The guy was just living in a 2 bedroom apartment didn't have a bunch of kids etc, and was like "I didn't really have anything else to spend it on."

And yes, people also neglect the fact you can start a private practice and charge whatever you want (high or low). You don't have to make xxxk a year. You want to spend an hour with a patient but only bill for 15 minutes? Who cares. You will have that freedom. Or go work somewhere and make the big bucks, then start a free clinic, be an educator, work part time doctor part time whatever else.

But also, I've recently come to terms that you don't have to make your passion your career. Some things can be really close to you, almost too close, to where working with it every day does make you miserable. Sometimes the things you care about most are best in smaller doses, or where you can support them outside of making it your 8-5. Or where you can incorporate them into your life, but not directly make them your life.


Circling back around, if you are still interested in medicine, but want to be involved in other things, I think there is plenty of opportunity. Hell, there is an entire specialty devoted to Preventative Medicine. And many folks gather MPHs as well, do clinical research. They are involved. Physicians are needed You could be a psychiatrist and work with folks on their underlying issues as well, (although that typically falls more to therapists, but I digress.)


Best wishes!

 

[stebgbby]

The world we live in can be depressing. I sympathize with you. I think the compassion you have for people will make you a pretty great doc or a someone in policy, as someone else said. Explore your options, there's more ways to help people than just becoming a physician.