Most patients get mad at me for promoting plantbased

[StarchHEFP]

Here is a real example of an actual exchange. I've changed it slightly but the spirit is still there. This is a patient who is a health professional, overweight, smokes, and might have a mild diabetes (I can't remember). She brushes off my suggestions for diet. She has peripheral vascular disease and heart disease, and has had her chest cracked already to bypass her arteries:
Patient message to my staff: "What diet pill would the doctor recommend?"
My staff's response: "Dr. would most likely recommend a vegan diet and exercise"
Patient response: "I just want a pill"
My response to patient after getting the message: "Because of your heart attack, and bypass, it's not a good idea to take any diet medication because it can raise blood pressure and cause harm. Since you didn't like my suggestions on diet that we talked during the appointment (I'll let you guess what they were. She really got upset and ridiculed me, just like she does about her smoking), I'm at least going to suggest you see a dietitian at the hospital because maybe they can help you eat healthier than you are eating. If you want a diet plan that isn't fully vegan you can check out fullplateliving.com"
Patient: "Whatever, thanks!"

Patient, about 1-2 months after the above exchange (did not do anything we suggested)
"How bad would it be to just take 1-2 months of the diet pills?"
My response (you can just guess what it was)
Patient: "Never mind."

This is my world every.single.day.
I'm surprised I have a little hair left since I haven't pulled all of it out yet.

Oh, how I wish I could see patients who wanted to work with me instead of fight me! And you guys have stories of how doctors don't cooperate with you guys, now see my world from my point of view!

[C.R.MacDonald]

How frustrating. No wonder many doctors don't even bother advocating dietary changes to their patients. Not even the risk of impending illness, disability, surgery, and possible death, can motivate people to take their health seriously and change their behaviour. All you can do is inform and make educated suggestions to them, I guess.

[colonyofcells]

I would guess that the customer is always right.

[lucidguppy]

I think it goes both ways...

I just went to the doctor after 1 year of weight loss.

Dr.: I'd really like to know how you lost so much weight.

Me: I went on a whole foods plant based diet....Have you heard about Dr. McDougall?

Dr.: Yeah I've heard of him.

Quick chat about B12

Inquiry about how much more exercise I've done (which is a good amount - but not too crazy)

I felt like my example was going to be ignored. And us McDougallers are so rare we probably won't see to many examples of us.

[barryoilbegone]

I guess people have to be in a position of assuming maximum responsibility for their health possible when they see a physician, if they want to make genuine changes. This patient isn't at that place yet.

If you look at most Star McDougallers, it's sad to see that most people don't contemplate change until their life is on the line. That's to do with a massive culture of reactive, not preventative medicine. It's gradually changing, but it has to start I think often with teachers, parents and kindergarten education giving plant healthy messages. If I raise a plant based diet message with a patient (I'm also a health professional) somewhere inside they often feel I think that I'm doing nothing short of attacking their relationships with family and friends. Mocking us often is around that there's a shared history and feelings with those close to them, based around mutually risky eating. That history is "off limits" - and that's before we even think about how individually addictive the SAD diet can be.

This story from last year is one fascinating example of how this works culturally: notice how subtle, but powerful, these kind of unconscious messages can be. Hurting yourself through food can run mutually so deep, and has been eerily connected to love, it's taboo to even question it:

http://www.huffingtonpost.co.uk/2015/10 ... 29400.html

The key quote:

"When you took away her cellulite, you took away her love of baking and all the goodies we have eaten over the years."

[Kaye]

They say discussing diet is as personal as discussing religion and sex and I do think to accept you have been eating the wrong foods for many years that have contributed to ill health not only of yourself but possibly of your partner and your children is quite tough. Food means so many different things to different people, tradition, memories, culture, habits, comfort etc etc. I think all you can do as a health care professional is offer the information but in a non judgemental way and make clear you are always there to come back to should they want to persue this wonderful opportunity to shed weight, feel so much better and possibly come off a variety of meds and reverse disease processes.

There was a programme on our TV this week about the Diabetes epidemic and the strain this is placing on our NHS, its so sad to see people having their legs chopped off and facing kidney dialysis. I so wish we could come at this from a preventative angle and not let the health of our nation and the western world sink further and further into chronic disease. If anyone is interested it is here on iplayer - Warning it is quite graphic in places.

http://www.bbc.co.uk/iplayer/episode/b0 ... den-killer

[JuicerJohn]

Part of the problem may also be what I will call physician mystique, that idea that I have a problem, I go to my doctor, he prescribes pills, and the problem goes away. Big pharma is also a big contributor to this mystique. Just watch TV for an evening and you will find "cures" for almost anything.

I think we have a long way to go in replacing the idea that my doctor is responsible for my health with, "I am responsible for my health".

[StarchHEFP]

They say discussing diet is as personal as discussing religion and sex and I do think to accept you have been eating the wrong foods for many years that have contributed to ill health not only of yourself but possibly of your partner and your children is quite tough. Food means so many different things to different people, tradition, memories, culture, habits, comfort etc etc. I think all you can do as a health care professional is offer the information but in a non judgemental way and make clear you are always there to come back to should they want to persue this wonderful opportunity to shed weight, feel so much better and possibly come off a variety of meds and reverse disease processes.

There was a programme on our TV this week about the Diabetes epidemic and the strain this is placing on our NHS, its so sad to see people having their legs chopped off and facing kidney dialysis. I so wish we could come at this from a preventative angle and not let the health of our nation and the western world sink further and further into chronic disease. If anyone is interested it is here on iplayer - Warning it is quite graphic in places.

http://www.bbc.co.uk/iplayer/episode/b0 ... den-killer

Thanks for the wonderful quote and the sage advice! All I can do is tell the patient I'm there for them when they are ready to talk.

[StarchHEFP]

Part of the problem may also be what I will call physician mystique, that idea that I have a problem, I go to my doctor, he prescribes pills, and the problem goes away. Big pharma is also a big contributor to this mystique. Just watch TV for an evening and you will find "cures" for almost anything.

I think we have a long way to go in replacing the idea that my doctor is responsible for my health with, "I am responsible for my health".

Well said! The doctor does not make you healthy, you make yourself healthy! This is a racket that the medical profession has, that they alone control a patient's health.

[Skip]

You could give your pill demanding patients a magic pill (a placebo sugar pill) with the following conditions for the pill to be effective they must pledge to make one—and only one—addition to their diet: Eat more starch. Just add an extra 600 to 900 calories of starchy comfort foods daily.

This commitment means adding any one of the following to your regular diet:

3 to 4 cups of steamed rice
3 to 4 cups of boiled corn
3 to 4 mashed potatoes
3 to 4 baked sweet potatoes
2 to 4 cups of cooked beans, peas, or lentils
3 to 4 cups of boiled spaghetti noodles
6 to 12 slices of fresh bread

This idea was taken from Dr. Mcdougall: https://www.drmcdougall.com/misc/2011nl ... starch.htm

[barryoilbegone]

Definitely: taking as much control of your health as you can, by every means possible through prevention and self healing, is the way to greatest health. We've got teaching in schools on exercise, smoking, drugs, safe sex, sleep, citizenship, and increasingly, mental health and wellbeing (That last one has taken a while too, but it's getting there).

Science based nutrition is the poor relative of these right now, because of corporate interests, but we're closing the gap, little by little. Change is painfully slow in history, but it's getting there.

The patient of the future, if we can make the education to governments and fellow health professionals, is going to know about their risks fully. It's kinda refreshing and honest (albeit sad, I know) when faced with a patient who comes in with cancer for instance, and says "I smoked, and didn't exercise all this time, I need to take responsibility". Hopefully, young patients today will have the opportunity to come in and say in many years time "I got the right information, and I'm healthy at 100!" (as John Robbins has made an important book title of Failing that, that the patient of the future who has food addiction borne illnesses will at least know about it, not deny it, and know when they need to make important changes to prolong life.

Food addiction and "food poisoning" a.k.a McDougall I hope won't always be misunderstood by the public. We need to keep at it guys.

[Dougalling]

Hello

About 2.5 years ago, I heard about the Engine 2 diet on a local news show. I read the book, then watched the Forks Over Knives DVD. I then read The China Study. I've been reading about nutrition for about 20 years. In 20 years, I never came across any information about whole food plant based diets. Had I known, I would have started eating this way many years ago.

Whole food plant based diets are an unknown for most people. Most people have given up on diets.
I've heard "Diets just don't work."
I've also heard "I would eat like you if my husband/parent/family would not demand meat at every meal".

A lot more people would be on a WFPB diet if everyone knew about WFPB diets.
A lot more people would be on a WFPB diet if the food was already prepared and available at their grocery stores.
A lot more people would be on a vegan diet if they knew it would save this planet we live on.

Have you seen the cooking shows on TV. THAT is what people know. THAT is what is readily available to them.
THAT gets worse every year. When I was a kid, you either ate beef or pork or chicken or fish at a meal. Now it seems like the more variety of animals you can fit in one meal is the way to go.

We've all heard of vegan Monday. It has sadly never caught on. People do not want to be inconvenienced and they don't want to eat a salad.

People have no idea what they are missing out on. The WFPB food is awesome in every way; it is so flavourful, so healthy, so varied, so filling.

Doctors need to recommend the all WFPB pizza, WFPB burgers, WFPB potato salad and WFPB ice creem you can eat in a week diet.
All of which will be delivered to the patients (at the patients cost).

(P.S. I convinced my library that since they had cookbooks categorized under beef, pork, chicken, fish, etc that they needed to categorize their cookbooks as vegetarian, vegan, whole food plant based. As whole food plant based was a category as different from vegan, as pork was to chicken. I love the WFPB category at my library. I've recommended quite a few books for the WFPB category.)

[GrannyB]

What if you simply recommended they watch Forks Over Knives before you'll talk to them about diet pills?

[healthyvegan]

I wish I still sold my vegan weight loss pill, it was great! I just had a compounding pharmacy put a bunch of starch and b12 into a capsules and told people it was a weight loss pill, but I told them the ingredients in the pill should be eaten along with the pill for maximum effect.. brown rice, oats, sweet potato, beans, etc we had so many people curse at us that we made them vegan! It was great. When they ask how long they have to eat that way we'd just say Monday morning to Friday afternoon. After a week of eating clean their first plate of scrambled eggs would make them sick & they'd be back to eating healthy and feeling great! So you can just give them B12 & tell them its a weight loss pill, but they have to eat these starchy foods with it Monday - Friday & what ever they want on the weekend (people don't like feeling restricted). Seriously, we had an insanely high success rate, you just can't build a business on a lie or I'd still be doing it, lol. I'm going to make a video about it one of these days with some of the friends we duped into veganism telling their stories!

[roundcoconut]

I'm a little late to this thread, but I definitely have some thoughts on this!:

Mostly, I think that if you're going to be good at something, it's good to find the right framework for conceptualizing your task.

So, for starters, I think it's really important to realize that frameworks where you envision yourself in opposition to your patients -- who are morons -- this kind of framework isn't going ANYWHERE. It's a toxic framework -- step away from anything that smacks of, "I tell my patients things but they don't wanna listen" and "I'm giving them good advice and they get angry."

We gotta find some finesse. We've gotta find you some better frameworks -- ones that help you be happy and successful in your work, and ones that give your patients the benefit of the doubt.

(Keep in mind, I'm just brainstorming here!)

Here's one idea.
1. What if you repeatedly say and think (to yourself and to your patients): It is completely up to you. These kinds of decisions are entirely yours to make. You have some decisions to make about how to handle your (knee pain, blood pressure, fibromyalgia, etc.). You have a lot of different options that lead to a lot of different outcomes. You can go any way you choose with this. I'm not going to try to force any changes on you, but I want you to know what some of your choices are.

i think this is really important, because my suspicion is that patients are very much afraid of physicians bossing them around -- like, it really SUCKS to have a physician start to say, "I'm going to prescribe such-and-such toxic pills, and I'm going to order such-and-such tests, and I'm going to give you a referral to see a such-and-such surgeon."

As a patient, people don't want to feel that their donuts are being taken away from them, or their cigarettes, or their cheese, or their beer. Or their soy milk, or their bread, or their peanut-butter, or their protein powder. Again, health professionals are notorious for acting like decisions are theirs to make, like, "I'm going to ask you to stop running until we get your back pain under control" or "I'm going to put you on a high-protein diet" or whatever. Just: people like it when choice is where it belongs -- with the patient. (Paradoxically, I suspect that when people are given freedom of choice, it only then that they are able to say, "I WANT to be caffeine-free" or "I WANT to do everything it takes for my autoimmune condition"

So that's my first thought. Does that help any? I'll give you a couple other thoughts if the mood strikes me. But that one is my most important thought!

Can anyone else comment? I think there are answers! Multiple answers actually. I don't think you're stuck in the Land of Ineffective Medicine!