I can agree with a lot of this. But when a patient goes on a tangent on how they don't trust western medicine, but engage in very western terrible lifestyle choice I find it very frustrating.
Theres some, but it was near endemic level in the FM clinic I was in. The physician was super pro preventative medicine, but it seemed like he just attracted really not compliant patients who liked the idea of not taking medicine, but nothing else he would suggest. I found this highly discouraging, as this provider had set up his office in many respects similar to how I would do a FM practice. He did scopes, procedures, emphasized preventative medicine, had his own gym. He had a wall for people to sign who lost 10 lbs or were able to come off their medicine. It was cool and he was the man as far as I'm concerned for primary care.
But its seemed like half his patients heard he tries to get his patients off meds, and decided thats all they needed to do (i.e. just stop taking the meds). They loved supplements (which is fine), but then they would make no effort towards lifestyle. Especially as someone who has lost quite a bit of weight, and knows the struggle, I have a hard time dealing with excuses on that front. Its a lot easier for me to stabilize someone in the hospital, optimize them while their there focusing on a specific problem and then release them knowing I did what I can. When I am outpatient and doing my best to cover everything else and half the people don't listen... Thats a war of attrition I don't want to fight.
