Practicing What We'll Preach...

[Joe Joe on da Radio]

To what extent should we, as future physicians, strive to be "healthy"- in the sense that we don't smoke, do drugs, watch what we eat, or drink excessively?

On a more personal note, i have a friend who's completing a MD/PhD in CANCER research. he smokes 2 packs a day.

Is this hypocritical or simply ironic? Is knowledge of medicine an obligation to not only advise on it, but to personally abide by?

what are your opinions?

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[NineSixteen]

•••quote:•••Originally posted by Joe Joe on da Radio:
•
Is this hypocritical or simply ironic?•••••I don't know if it's either hypocritical or ironic...I think it's just pretty baffling! I do liver research and just the sight of a cirrhotic, shrunken liver is enough to curb any thoughts of drinking way too much! Has your friend ever seen a blackened, lesion filled lung? I don't know how anyone who has could still smoke!?

I definately know unhealthy doctors, but the majority seem to try to practice good health behaviors. On a side note to that, has anyone ever taken note of the fact that almost every female med student (I'm sure there are exceptions) is a runner? Someone once mentioned that to me and I have found it to basically hold true...there's definately a higher proportion of runners than the general population.

 

[leorl]

I also think it's baffling. I've wondered why for the longest time, nurses and singers (operatic) smoke. It just doesn't make any sense, and if I was a patient, I wouldn't want any nicotine-stained fingers on me, gloved or not.

A lot of doctors are athletic or have been involved competitively in the past. I don't smoke, do my share of drinking occassionally, and don't really toke up. I don't forsee any of that changing in the future.

 

[mpp]

I was asked about this specifically in an interview. The interviewer first asked whether it is important to set an example and "practice what we preach." When I answered in the affirmative they then asked in what ways do I do this with my day-to-day activities. They also asked my previous and current use of alcohol, tobacco, and illegal drugs.

I think it is hypocritical to suggest to someone to do something that I am not doing (that is the definition of hypocrite is it not?) which would prevent some unhealthy condition.

Although I have seen diseased lungs, livers, and hearts before they are not a deterrent for me. A better deterrent for me is seeing ill people and untimely deaths that could have been prevented. I've been a smoker, drug-user, and have abused alcohol before. But, never again...

 

[Diogenes]

Physicians that smoke are bad enough.... I once knew a physician that smoked WHILE SHE WAS PREGNANT! I was pissed off when I saw that.....

 

[Dr. Will]

I agree with all of you that this type of activity is hypocritical. This is one of my motivations for getting back into shape. I don't want to lose the respect of potential patients because I don't practice what I preach.

 

[Deforciant]

When I was working in a hospital a few years back, I knew some respiratory therapists who smoked. On the plus side, those people will be able to give themselves breathing treatments.

I think that not practicing what they preach is ironic, but I really don't think that they are true hypocrites.

The principal goal of a medical doctor is to treat people. It is not the primary goal of a doctor to ensure the well-being of other people. This other goal is better fitted for someone like an epidemiologist. Based on this, I believe that doctors aren't betraying their physician duties when they participate in life-endangering activities. If they are doing anything, it's giving other doctors opportunities to provide treatment.

It is ironic that health care workers smoke, drink, etc. when they have seen first hand the detrimental effects of these behaviors.

 

[mpp]

•••quote:•••Originally posted by Deforciant:
•
I think that not practicing what they preach is ironic, but I really don't think that they are true hypocrites.
•••••Only up until the point when they tell a patient not to smoke, or to stop drinking excessiviely, or to reduce fat in their diet, etc. when the the doctor doesn't do the same. Obviously a doctor doesn't need to do everything they tell their patients to do but they should stop doing anything that they tell their patients to stop doing.

 

[Vader]

This should make anyone realize that physicians possess the same human frailties, traits, and bad habits as the patients they treat. Shocking, but true...

Neither medical school nor residency is exactly a health-promoting environment. Students and physicians are sleep-deprived, eat meals at irregular times (or sometimes not at all), encounter an immense amount of stress, and all the while are expected to perform at a very high level. <img border="0" title="" alt="[Eek!]" src="eek.gif" /> It is no wonder that these people sometimes develop bad habits, including drinking, smoking, drugs, and other means of coping or reducing stress.

Physicians have a horrible time trying to change their own behavior. Imagine how hard it is for patients, who have some medical problem that they want solved, and on top of it you are asking them to change their lifestyle. It definitely undermines your credibility if you advise a patient to quit smoking and then go out back for a few puffs.

However, there are also many other reasons for patient non-compliance, which may have nothing to do with the "role-model effect". I don't know if there are data available on reasons for non-compliance... if anyone has any references, please enlighten us.

 

[Diogenes]

Vader

There are other reasons to avoid hypocrisy than patient non-compliance -- like integrity and self-respect. I'm not sure how someone that knows they are being a hypocrite lives with themselves.

 

[reesie0726]

I think it is important for physicians to practice healthy lifestyle practices. It is one of the reasons I am trying to get back in shape. How can I tell other folks to exercise and eat healthy if I am all out of shape? But physicians are humans just like everyone else. We can't expect doctors to be totally perfect. And it's true, med school and residency are not very good in promoting healthy lifestyles.

 

[florisio]

I find it quite comical that you all talk about some notion of a "perfect" lifestyle that means you don't drink or smoke, eat 12 servings of broccoli and exercise every day. Whatever happened to people doing what they want for themselves? It is not the least bit hypocritical for a doctor to smoke or drink anything he or she chooses. That is why it is a choice. To tell a patient the risks of smoking is what is called part of the job. It has nothing to do with personal preference. Wouldn't it be great if more priests practiced what they preached? But that doesn't happen much either.

 

[amp]

Of course it's always admirable to live by what you teach. As a doctor, you should know a lot more about the ways in which behaviors affect health than the average citizen, and this should be enough to prevent you from self-destructive behaviors. If not in the spirit of showing your patients what healthy living can accomplish, then at least in the somewhat less noble spirit of self-preservation. Why should you trust someone to heal you who is addicted to junk food or cigarettes or crack or whatever? Well okay, the crack part answers itself. But really, there still is such a thing as free choice. People are not dogs; you don't have to teach them how to do things by showing them how to do them. I am still convinced that most people are intelligent enough to make their own choices in life, and don't need some authoritative guide to show them the best way to live. My own boss is a big fat slob and a great pediatrician. Most of his patients are not going to grow up to be either. I think most of the problem is cultural. Of course we know that drinking and smoking are bad for us, we've known that all our lives (unlike our parents' or grandparents' generation) but until the fun wears off, people are still going to engage. My grandma smoked a pack or two of menthols (menthols! of all the disgusting crap! whenever I think of her I think of a minty ashtray smell) a day for the last thirty or so of her 87 years (it was regular rolled cigarettes before that). It was disgusting of course, and gave her emphysema and all kinds of problems, but ironically it wasn't what ended up killing her. But even as a future doctor I would never take away her smokes, which were her last little pleasure in life. I know this sounds horrible coming from someone who professes to want to save lives, but it's just how I feel. If all the doctors in the world were the model of health, it still wouldn't deter people from engaging in risky behavior. And dammit, they should have that right or we're all out of a job in twenty years. peace.

 

[mpp]

For me it is me being the hypocrite that is the problem...not others. Telling people not to smoke while myself being a smoker is unacceptable to me (I smoked for more than 12 years and have only recently quit) and I am certainly not against the choice that others make to smoke or do any unhealthy thing.

But I would also rather go to a physician that makes healthy choices in their personal life. I would never take my children to a pediatrician that is a "slob" no matter how good others might think they are. And if I found my priest not adhering to the ethics to which he asks others to live their lives by, I would find another place to spend my Sundays.

To me, the choices that a person makes are part of what makes them good at what they do. I prefer to be assisted by people that make choices that are not so obviously detrimental to themselves.

 

[amp]

But I would also rather go to a physician that makes healthy choices in their personal life. I would never take my children to a pediatrician that is a "slob" no matter how good others might think they are.

My boss is a great doctor not because of his reputation but because he's extremely well-trained, thoughtful, and excellent with children. I didn't mean to imply that his unhealthy lifestyle spills over into his work, which it doesn't. He just doesn't take care of himself. My boss's primary concerns are his work: 12 hours a day, 6 days a week, and his family: 3 young kids. It's no surprise to me that eating right and exercising don't figure much into his schedule. I don't think it's a blemish on his credentials at all, just a measure of his commitment to his work and a result of just not having the time to do it all.

 

[katiep]

I think the point of smoking cigarettes is that they are extremely addictive. Physician or not, I've never met anyone who smokes and didn't know that it greatly increased their chances of dying prematurely. They all say "I know..."

The addiction is much stronger than self-preservation, let alone ethics or morality or even setting good examples for patients, which all come maybe twentieth after more salient choices like breathing, nourishment, or reproduction.

 

[PelicanMan]

Great thread

I get really pissed off everytime I see a nurse or a doctor smoke. I'm like WTF. I think that they are being hipocrates and that it reflects poorly on the person.

Plus the thing with the fat pediatrician. You can be dedicated to your job and still live healthy. One of the most important lessons in life is balance. Your health should be more important than anything else because without it your f888ed. just the pelicans views

 

[none]

I've never understood the problem of one being a hypocrite. If something is inherently wrong...isn't it better that a person speaks out against it, regardless of whether they do it? You can attack what the person does, but I find it morally abhorrent that you attack them for speaking out against evil.