Do as I say, not as I do
A comment on one of the posts asked if doctors should lead by example when it comes to the matter of maintaining a healthy lifestyle.
I am not actually a big fan of the 'lead by example' or 'practise what you preach' school. It’s not that I don’t think you should not lead by example or not practise what you preach, but I don’t think someone should be deterred from a right course of action simply because the person advocating it is not living it himself.
If a smoker advised you not to start smoking, would you ignore him and start smoking just because he is not practising what he preaches? Conversely, if a smoker asked you to start smoking, would you do so just because he is leading by example?
I believe that any advice should be judged on its own merit, and not by the person giving it.
As for the matter of giving healthy lifestyle advice, I think some 'healthy' doctors do inspire and some 'unhealthy' doctors nonetheless do manage to convince patients to adopt healthy habits. However, I suspect most of the time the more likely scenarios are:
Fat Doctor: Mr Tan, you need to reduce your weight. You must watch your diet and exercise more often, OK?
Patient says: OK, doctor. I try my best.
Patient thinks: What the heck? You yourself so fat ask me to lose weight… you lose some weight first then we talk lah! Hmm... now which burger joint should I go to for lunch?
Fit Doctor: Mr Tan, you need to reduce your weight. You must watch your diet and exercise more often, OK?
Patient says: Easy for you to say, doctor! You work in an air-con room all day and make so much money, sure free to go California Gym to work out and buy expensive organic food lah. We all have to work long hours to make ends meet, eat cheaply at hawker center where the food is all unhealthy, and at the end of the day we are too tired to exercise!
Patient thinks: Hmm... now which cha kuay tiao stall should I go to for lunch?
In both cases, the thought pattern is immature and not helpful. The doctor's state of health has nothing to do with whether the patient ought to keep a healthy lifestyle, and to use that as an excuse to not keep yourself healthy is stupid.
I think until the system is willing to hold patients accountable for their own diseases, things will not get better. But given the fact that healthy lifestyle is not 100% disease-proof, and the impracticality of monitoring everyone's lifestyle habits, I can't see that happening in the short term.