Angry Doctor

Sunday, November 13, 2005

Let him who is without vice...

... give the first advice.

Like I said, I've never quite been of that school of thought.

Especially when it comes to advice rather than stones.

And I believe that if you insisted on that principle when it comes to giving medical advice, many doctors will have awfully little to say to their patients.

Here are the numbers:

There are about 6500 doctors in Singapore. Let's say 5000 are male, and 1500 female.

Now given that 24.9% of men and 4.1% of women in Singapore smoke, that makes (assuming the ratio applies to doctors) about 1300 smoking doctors.

And 784 doctors who drink regularly or frequently.

And 2200 doctors who are overweight.

If they were the same doctors (i.e. the smoker is also a drinker and overweight), you have at least 2200 doctors who are disqualified from giving advice against these 'vices'.

If they were all different doctors (i.e. doctors only ever smoke, drink, or are overweight - an unlikely scenario), you end up with almost 4300 doctors who are 'into vices'!

In other words, if you assume that doctors are not more immune to vices than the average person, fully a third to two-thirds of us are disqualified from giving 'healthy lifestyle' advice.

So where does that leave us?

To milk the religious theme further, I would say it's a matter of whether you expect your doctor to be a saint who gave you the message through his viceless living, or an angel who is just here to give you the message. Whichever the case, at the end of the day you must remember it's really between you and God.


I'm no saint, but I have been called the Angel of Death.

6 Comments:

  • Good point.

    Perhaps it would help if I toned down my call a bit?

    Perhaps the doctor who is dishing out advice should be actively trying or doing the same himself? Eg if you want your patient to quit smoking, then the doctor should also be trying to quit too. Perhaps ask the patient to join him in the endeavour.

    Or if he is trying to lose weight etc.

    It just doesn't sit down well with me when someone is telling me to do something because he says it is good and all but he doesn't do it himself.


    Imagine a priest telling the congregation not to seek material wealth for the poor are the rich in heaven, and his parishoners find out he is doing MLM as a side line thinking of becoming a millionaire.

    Good advice sure but if the prophet is a false one, where's the moral to that?

    By Anonymous Dr Oz bloke, At November 14, 2005 9:11 am  

  • I think then you ned to look at where the mesage is coming from.

    The benefits of weight-loss, exercise, etc. is not from the doctor, but research and studies. The doctor merely passes it along.

    If the doctor/priest does not heed the advice he hands out himself... well, then you just won't be seeing him in heaven. :)

    By Blogger angry doc, At November 14, 2005 10:02 am  

  • Well you're right.

    Just a question. For the doctors who dish out the scientifically proven advice but does not follow it.

    Why does the doctor not follow it? Let's say the reasons are,"very difficult, addicted already", "no time work many hours cannot exercise", "I am genetically predisposed to being obese etc"

    What happens when the patient gives an excuse that is identical to the doctor's excuse? Then what?

    I would be interested to see what the doctor's answer to that might be.

    It goes back to sales principles. As doctors we are also salespeople pitching treatments and health ideas to our patients. Sales people deal with rejections. So do doctors. I used to say "No I am a doctor I am NOT a salesman" and I had a terrible time as a doctor. The day I accepted I too was also a salesman I became a better doctor almost immediately. I saw patients differently. I did not get angry with them. I understood it was their choice or my failure to show them the benefits of the program. (being a salesman is not a bad thing contrary to what people think. Sell comes from the word "sel" for "to serve")

    Salespeople know that if they do not use the product they sell, it is difficult to sell it to their prospects. When the prospect's objection to buying the product is the same as theirs (eg too expensive) as to why they wouldn't buy the product either, they would be in a fix to answer that objection effectively.

    By Anonymous d, At November 14, 2005 10:19 am  

  • To be fair I would have to say they are both stupid then. Perhaps the doctor is stupider because he knows the risks involved better than the patient.

    But to use your analogy, when you buy a BMW, you know it's a good car regardless of how stupid the car saleman was. :)

    I think doctors who are less than viceless in their own life probably feel that they can afford to be sick since they make a lot of money, and their colleagues would waive consultation fees for them. :p

    By Blogger angry doc, At November 14, 2005 10:55 am  

  • Is BMW a good car?

    I personally prefer Toyota. If you asked me which care to buy, I'd day Toyota cos I drive one.

    Tsk tsk. Doctors...sigh

    By Anonymous Dr Oz bloke, At November 14, 2005 11:08 am  

  • I think the advice is given under a given context. For example a healthy fat doctor tells an obese diabetic with high blood pressure and arthritis of the knee. In this case the diabetic needs to lose weight more than the fat doctor. Of course one might argue that being slimmer is healthier but we shouldn't assume that fat people are definitely unhealthy.
    I think doctors are there more to give counsel than to sell an idea. But I guess that is just a a matter of semantics.

    By Anonymous Anonymous, At November 15, 2005 6:24 pm  

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