I'm not going to weigh in on whether the new Surgeon General, Regina M. Benjamin, should be thinner. Of course you'd have had to expect that controversy to erupt nano-seconds after she assumed office on January 11, and it did.
Instead, I want to push Benjamin's platform even further forward. Benjamin talks about changing the national conversation. I say we have to change how we conduct that conversation.
Benjamin says, "As America's family doctor I want to change the national conversation from a negative one about obesity and illness to a positive conversation about being healthy and being fit."
I whole-heartedly agree, let's focus on where we want people to go rather than where we're stuck.
But then Benjamin says, "Let's start with healthy choices. Eat nutritious foods, exercise regularly and have fun doing it."
Disappointingly, this is the same type of conversation we've had for decades. The type where people in uniforms and white coats tell us what to do. This type of conversation doesn't motivate or inspire. The proof? More Americans are fat -- 67 percent of the population -- and unhealthy. This type of conversation rolls off patients' shoulders as soon as they walk out of their doctors' offices because it hasn't addressed them personally in their unique lives. Overwhelmingly, doctors treat disease, not patients.
We have to change the conversation from doctors and patients talking at each other, to talking with each other. Physicians who truly listen and help patients discover a small step they feel they can take to improve their overall health, now that's moving the conversation in a new and positive direction.
While Benjamin says doctors must teach, actually doctors must facilitate a conversation with their patients, one that creates a meaningful dialogue. One that helps both do their jobs better-doctors to help patients get or stay well, and patients to help doctors to help them do what they need to do to achieve health.
While this pertains to any health condition, it is essential for chronic illnesses. Diabetes, cancer, MS, MD Parkinson's, rheumatoid arthritis, chronic fatigue syndrome, Crohne's disease, AIDs, fibromyalgia, lupus and, we might also have to consider obesity a chronic illness, are growing in number as Americans are living longer. Experts estimate that by 2020 almost half of all Americans will have a chronic illness and 24 percent will have more than one. For these, a new way of interacting has to emerge beyond doctors' traditional training to cut and cure. That does not work here. We need our doctors to coach us in our conversations. And to uncover what we feel we are capable of doing, and willing to do, because it's important to us.
Health care providers would benefit spending more of what precious time there is to ask questions, and to listen. To probe how we mere mortals feel in general, not just the symptoms we walked in with. To speak in our language, not theirs. To watch when we answer a question whether we look pained or relaxed, shift our eyes down or smile. These things are especially hard to see when you're staring at a computer screen or writing notes on a clipboard. And while we may be the tenth person they've seen today, it would help if we felt we were the only one that mattered during our fifteen minute visit.
Jerome Groopman tells us in his book How Doctors Think that doctors interrupt patients within 18 seconds. He wrote the book because he noticed while conducting rounds, guiding his team of trainees in their care of patients, that he felt disturbed.
These very bright and affable medical students, interns, and residents all too often failed to question or listen carefully or observe their patients keenly. They were not thinking deeply about their patients' problems. Something was wrong with the way they were learning to solve clinical puzzles and care for people.They were being trained to use statistics that can only embody averages, not individuals. Their all-guiding data, and care guided solely by the numbers, cannot substitute for seeing and probing the person before them.
Excerpt from How Doctors Think
Of course, we patients must play our part. We should come prepared to describe our ailment to our doctor, ask questions when we don't understand what our doctor is saying, or why he has come to a conclusion. We should say anything our gut tells us to, even if we think it's non-sensical. As patients we know our history, our abilities, our tendencies, and based on the world in which we live, what's doable for us-vital information if a doctor is listening.
In one way it's disheartening to read Beth Comstock's report in "Treating The Patient-Doctor Disconnect." 70 percent of 2,000 patients taking a GE/Cleveland Clinic/Ochsner Health Systems survey said they take actions to avoid going to the doctor, including walking around in pain or asking friends for medical advice. And when Americans do go for a checkup, 77 percent of health care professionals say at least one-fourth of their patients omit facts or downright lie to them about their personal health. But, then, maybe this is because of the one-sided conversation we've been having for so long.
To GE's credit, they developed "The Better Health Conversation" which walks users through questions to ask their doctor about what ails them, and points to information they should have before they get to the doctor's office. Their goal is to help people have a more collaborative, more honest relationship with their doctor. Amen.
If we as a nation are to get our weight and our health back in order, we need our doctors to stop telling us what to do. Who hasn't heard it already? Then let's take the conversation over to our politicians who hand out farm subsidies. Let them subsidize healthy food and tax junk food so we make healthy food a more available option.
It wouldn't be bad either, if we're having new conversations, if the Surgeon General provided a way to converse with her. Her website doesn't allow you to even send her an email. Trust me, I know.
Follow Riva Greenberg on Twitter: www.twitter.com/diabetesmyths
To solve this problem, I suggest the formation of an Office of Illness Prevention (OIP). It must be independent of: the food industry, the industry-controlled FDA/EPA/USDA triangle, Big Pharma, the medical community, the Surgeon General, and the NIH. It would conduct government funded university research into areas that have been completely ignored, such as using nature as a paradigm for health.
The OIP would include an anti-revolving-door policy to avoid being compromised by other institutions. All of the research would be posted free, with an open dialog with consumers via the web. New professional designations would be created for Illness Prevention Practitioners. Nature-based prevention (as opposed to "preventive medicine," an oxymoron invented by BigPharma to sell drugs) would be taught in every school. Ultimately, true illness prevention could become a worldwide initiative, changing the face of illness care as we know it.
Roy Mankovitz, Director
http://www.MontecitoWellness.com
Feel free to contact me: http://repairstemcell.wordpress.com/contact-me/
Are you a patient? Are you a self-advocate for your own health? Can these things coincide? The word "Patient is derived from the Latin word patiens, the present participle of the deponent verb pati, meaning “one who endures” or “one who suffers”. It's extremely telling when anyone seeking medical help will have to endure and suffer. Was this what Hippocrates had in mind? Not likely."
via http://repairstemcell.wordpress.com/2009/03/22/on-patients-and-patience/
Redefine the conversation, sure...but redefine your attitude, your own role in the conversation, your goals for your health and life, your longevity and vitality, your attitude towards your health. It's time to be an active player in the script of your life and your health, not a sometimes pawn taking no responsibility for your well-being until you get ill, at which point your options are extremely limited and you have to give up that responsibility to someone else.
It is packed with Integrity and Dignity. Why is it okay to Bash Obese People? You can join my web site and see Obesity Bashing on FB.. We need a new plan and I fail to see how the Let's Move plan is going to address the complex issue . Let's Move will cause a spike in Eating Disorders, and the Big Brother argument is weak . We need a serious education plan when it comes to food .Perhaps we can start with food labels people can understand.
We need more Farming and a lot less Pharming.
Paul 2fat2fly on Twitter