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Sunday, December 9, 2012

We are not always right (you are not always right)

One thing we in the medical field need to remember -- or realize -- is that we are not always right.  We will often see what we think of as flaws in the way people live, and we usually see a solution.  We give advice, and our advice is rejected.  Why?

The reason is because we are not always right. What we see as a flaw may not be a flaw to that person.  So you offer a solution and the solution is rejected.  The person is offended or unhappy, and this creates tension between you and your patient.

Usually when you have a patient complain about a doctor in the hospital, this is the reason.  And generally it's the same doctor being complained about.  Or it could also be a coworker, or it could be you or me that's the culprit.  We overstepped our bounds and offer advice perceived as inappropriate.

Yet no advice is wrong, they say, and all advice is free.  And they also say opinions are always right.  So why would a patient get so mad.  The reason is usually because the patient lives in a different universe than the doctor offering the advice.  It's because the doctor fails to have empathy for the patient, and the doctor believes he knows what's right and believes we should all live as he lives.

He is a progressive and he believes if you aren't living the right way, the way he thinks is the right way -- because he's the expert after all,  it's his job to nudge you in the right direction.  If the patient get upset that's because he's refusing to accept reality.  If the patient gets upset the doctor refers to the old adage:  "The truth hurts before it makes you better."

Sometimes it may make the patient better.  Other times it results, as we often see, in an irate patient.  The reason is usually, I think, because many people have stress the doctor doesn't have.  They have money problems that need to be dealt with.  They have marriage problems due to the money issues.  They have to work hard and stressful jobs.  They work with people who are ignorant and live poor lives, and the peer pressure is strong.

So this is why many people find a release in eating too much and drinking too much on Friday evenings.  It's this release from stress that's needed.  It's this release in stress the doctor doesn't need because he's had everything handed to him on a silver platter his whole life.

There's people in the political world who are the same way. They tell you, and even try to pass laws, that you can't eat too much salt.  They try to require restaurants to limit salt in food, to make it taste less good.  And who wants to pay money to go to a restaurant when the food is healthy and tastes bitter.  People go out to eat to relax and have fun.  Such people -- which is most of us -- set aside good habits for purposes of stress release.

Sometimes an afternoon trip to McDonalds is a necessary break from slaving in your kitchen all day.  Sometimes an evening at the bar with friends is a needed break from the stress of work and raising kids.  Sometimes a meal at Dennys is a nice way to socialize with your friends.  These are choices we make because we can, and this is the life we live in.  And just because you don't, just because that doctor or politician lives above all this, doesn't make him the expert.

See what I mean?  One thing the founding fathers understood when creating this great nation, in creating a constitution that limits and doesn't empower the scope of government, is that every person has a unique opinion; that all people are right in their own minds.  People don't want to be told they are living a lie.  People don't want to be forced to live how you live.  That's why they have a right to choose.  And, so it is, they choose not to live like you.

The good thing about living in America is a person can choose to live an unhealthy life.  We have a god given right to be stupid.  And we have a god given right to be wrong.  And just because you think a patient should limit salt, alcohol and greasy food, doesn't mean that's the right decision in the other universe that person lives in.

I'm not saying people shouldn't try to make better choices, I'm saying there's a reason people make the choices they do, and it's our job in the medical profession to understand that.  We should educate, set a good example, and have empath

Plus what we see as facts may be myths.  An example here is a recent study showing people who assume "too much salt by our standards" live longer than those who limit salt intake.  So while the powers that be may be trying to limit salt in our food, they may be forcing people to eat yucky food that doesn't doesn't soothe the heart of the eater, and doesn't release their stress.

So we are not always right (you are not always right).  And it's for this reason we must keep an open mind when treating patients, making laws, and judging others.

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