“My doctor told me I needed to eat healthier and exercise. But to be honest, his stomach was literally dragging on the floor. If he can’t follow his own advice, why do I need to?”
I was taking the bus home from my hospital shift one afternoon, silently eavesdropping on two middle-aged women sitting in front of me. They had just finished a physical exam with their primary care doctor: a mid-forties man with an obtrusive out-pouching of Camper’s fascia, mostly attributed to the gallons of soda and food he guzzles throughout the day. Apparently, the cholesterol level of one of the ladies was higher than what it normally should be; therefore, he emphasized a regimen of healthy food habits plus regular, light exercise to keep her cholesterol, lipid and metabolite levels in check.
Clearly, the message was not so soundly received.
Is it our obligation as physicians to “dress the part” of health as well? We “talk the talk” of living healthy lifestyles, on how to be overall healthier human beings. However, do we necessarily “walk the walk” of health? Is it a choice or a necessity to the practice of medicine to be a model of health? Certain scenarios that I have witnessed played in my mind as I listened to those ladies:
A rather round, chubby dietician advises me on the harm of excess sugar and how too much sugar and fat can be stored in many adipose pockets. She starts giving me advice on how I can change my diet to live a healthier lifestyle.
A mid-fifties surgeon complains to me about yet another triple-bypass surgery he has had to perform, yet his BMI is well over 40.
A well-figured physician downs her fourth cup of coffee, then walks into a patient’s room and informs her of the effects of coffee and renal function. She advises against excess cups.
A physician reviews the harms of smoking with a patient. Later in the evening, he lights one up to relieve the stress of the day.
How would you react to such situations? Does the physical appearance of the doctor shape the validity of what he or she is saying, or would it not have an influence? I think of physicians as in-shape, well-structured promoters of health (then again, my image of a doctor has been shaped by “doctors” portrayed on shows like “Scrubs” and “E.R.”). However, some truth does lie within those constructs of physicians.
Patients are more willing to listen and believe physicians who actually look fit compared with those who are prime examples of what not to look like. In a random interview study I conducted, I asked a mixed sample group from my community on how compliant they are with suggestions made by their physicians and what influences why they do or do not follow them. A mixture of people stated that they were compliant with the treatment regimen suggested by their physicians solely because a physician suggested it. They accredited the validity based on his or her title. When asked about the general appearance of a physician, many of them revealed that the more put-together and in-shape a physician was, the more likely they were to follow through with the suggestions. One woman said, “I think, ‘Oh, it must make sense and be true…I mean, look at him. Clearly, she believes what she says, and it’s working for her.’” Patients don’t have much to go off of in first interactions with physicians other than the physician’s attitude, method of presentation and physical appearance. Whether we like it or not, physical appearance is a factor of judgment.
As physicians-in-training, we thus have to ask ourselves two questions: Do we practice what we preach, and is it our choice to decide whether we live our preached healthy lifestyle, or is it an obligation?