Kevin, M.D. - Medical Weblog

It would help medicine if we were like the military. Scripted what to say and do, just follow orders, no subjectivity. No "art" of medicine. If it meant keeping out of the public's view and keeping out of trouble, I'd do it in a second.
 

It would help medicine. This whole thing is baffling to me. If doctors could just nag people effectively about their obesity and their smoking then we could probably eliminate a good deal of everything else and come out ahead.
 

Dr Bennett actually makes me ashamed. For the last ten years, I have never dared to speak to my patients about their weight, althoug my patients are PREGNANT and their excessive weight harms not only themselves but also the fetus. I wish I had the nerve to be more like Bennett, but under the repressive medico-political regime in this country (Norway) I would have my licence yanked immediately, and what would my patients be then? Even fatter, and their fetuses even worse off.
 

At least you can publish your name on your blog. In the US, md's like me are so paranoid we don't dare to put our name on these blogs because the lawyer sharks google us when they sue us and use our comments against us. Welcome to 1984.
 

In the US, md's like me are so paranoid we don't dare to put our name on these blogs because the lawyer sharks google us when they sue us and use our comments against us.

Not according to CJD and Dr. Elliot who are the foremost experts here on all medical and legal matters. They say that posting anonymously is only done by chickens because lawyers are honorable people and never would stoop so low.
 

Let me type slowly for the brain injured: p s e u d o n y m.

It's useful for distinguishing comments from each other.

Too lazy to register, too stupid to think up a pseudonym, too cowardly to own their own words.
 

Does anyone know what obese physicians say to their obese patient? Or for that matter, the few physicians who smoke when they health counsel their smoking patients? What can a doctor say to overcome the obvious very personal conflict of interest? ..Maurice.
 

I continue to be amazed that any medical doctor defends Bennett, but mostly they seem not to concentrate on anything but "he got in trouble because he told her she was fat". It isn't true, but I guess i's past arguing the truth now.

Just how SHOULD physicians speak to their overweight patients, especially those having health problems as a result of their obesity?

It might be a stress release or personally satisfying to vent your disgust with sloth and gluttony and a patients unattractive stretch pants, but seriously..

S
 

S, they are in defense mode. No one is qualified to judge physicians but other physicians. And in the event that other physicians find their actions wanting, they are not qualified either.
 

I thought that was only true for lawyers, CJD.
 

"If doctors could just nag people effectively about their obesity and their smoking then we could probably eliminate a good deal of everything else and come out ahead."

Elliott, if your post represents your thinking, then I am sorry to see you miss the notion of personal responsibility in maintaining a healthy body weight.
Doctors are not and cannot be the ones responsible for patient's maintaining a healthy weight. I can't limit what they eat, or choose what foods they buy, or force them off the couch or take away the pork rinds. People have to choose to do those things themselves. I can warn, I can advise, I can suggest and refer, but I cannot force.

Obesity is not a problem for which nagging alone is a sufficient solution. The idea of there even being something as "effective" nagging is a fallacy. Addressing obesity necessarily has a moral component wherever people are free to act on their own will. Too bad no one wants much to acknowledge this fact. Fat people have to own their problem, they can't simply expect to "medicalize" their personal failing and demand that someone else deal with it.
 

That's an enormous leap from what I posted to suggesting that I don't believe in personal responsibility. I suggested that education or counseling or reminders if effective would be a better use of physician time than a lot of other stuff such as physicals or even PSA testing. Studies show that nagging generally is an effective tool whether it be for drug compliance, exercise, diabetes control, smoking cessation or weight management.
 

A couple of thoughts for Elliott:

How can doctors effectively nag if doing so proves to instigate patients to file complaints against us?

And how, exactly, would me taking extra time to register and create a false identity under which to post be ANY less cowardly than posting anonymously?
 

This post has been removed by a blog administrator.
 

A pseudonym is preferrable to anonymous because it facilitates the discussion by tying comments to a particular person. I can converse with the pseudonym over a series of posts while ignoring, incorporating, or responding to points in other posts , but not conflating two different peoples' opinions. A pseudonym, in my opinion, tends to increase the signal to noise ratio since, I believe, it puts a social constraint on insults and encourages value-added comments in an effort of the pseudonym's owner to gain influence. One downside of a pseudonym is it does create a target for insults as you can see on this thread. Finally, a pseudonym serves to provide others with useful information so that they can choose to ignore or pay more attention to posts depending on their past experience associated with that pseudonym. All of the named posters at this site garner more respect from me than any anonymous poster and yet I don't know the last name of any except the ones who have included it (i.e. Dr. Maurice Bernstein). The line "too lazy to register, too stupid to think up a psuedonym, too cowardly to own their own words refers to three different situations. Initially, I was too lazy to register until I realized that I was actually typing more keystrokes by not registering. Too stupid to think up a pseudonym is perhaps a bit harsh, but it encompasses my belief that a pseudonym is preferrable to anonymous. Finally, too cowardly to own their own words refers to people who make bogus arguments, insult, and generally act like jerks, but cannot be held to account because they are mixed in with all the other anonymous tags.

As to your first question, that was the point of my first post. I am baffled by the complaint. I must be personally insensitive to the kind of verbal abuse that Dr. Bennet was alleged to have inflicted on his patient (perhaps it's training from commenting on the Internet). I guess I can imagine situations where it would be possible to sustain the charges, but I'm having a hard time. Hence, I used the word "baffling". For example, would a African-American complain if a doctor were to focus on a health issue such as hypertension, or a Jewish person if he or she suggested genetic counseling for a pregnancy? I suppose if racist terms were used, but did Dr. Bennet's interaction with this patient rise to a level that would be equivalent to racism?
 

Well, there ya have it. It looks like Dr. Elliot is a world-class expert on pseudonyms as well as medicine. Is there anything this superdoc can't do better than everyone else?
 

Here's what I say about Dr. Bennett and the First Amendment:

http://christopher-king.blogspot.com/2005/10/youre-so-obese-only-black-men-will.html
Let's get a grip, here folks. Dr. Terry Bennett's comments, in lilly-white New Hampshire, are not the same as a doctor telling a skinny black woman, "you're so skinny only white boys will like you," and if you can't see that, or comprehend why it's different in a context like this, you may be cursed with another physical ailment beyond the Good Doctor's bailiwick: Myopia.

Having dated leggy blondes to short brunettes and women of many body compositions between 4'10" to 6'2" and in between, I appreciate all sorts of women. But apparently some white professionals in the "Live Free or Die" state don't appreciate black men appreciating white women in that way because he used it as a scare tactic. Well that's pretty scary to me, folks, so I'm gonna file a complaint with the Seacoast Branch of the NAACP later today. Peace.

PS: His speech is not entirely protected by the First Amendment, as mine was and is in Jaffrey, New Hampshire. He relinquished a degree of his First Amendment Rights by agreeing to be subject to a regulatory board -- and he may even be governed by commercial, rather than general, Free Speech doctrines. I, on the other hand, was exercising a Fundamental right as a free negro (or caucasian) citizen to seek redress for a man who faced three (3) drawn guns, arrest and a body cavity search from undercover police who rousted him and eventually charged him with "loitering," which he beat. See my 16 Oct. blawg, "Open Complaint to NAACP Legal Defense Fund," which still has not been answered substantively.
-c