Scott Porad

The post I wrote last week about hot chocolate was one of the most commented ever.  Comments on the blog, messages and comments on Facebook, and even some direct e-mail.  Here’s one of those e-mails that was sent to me by a friend who is a physician in Seattle:

Scott,

Your post about your deliberations with your hot chocolate reminded me of conversations that I have with my patients daily. I struggle with what is the most effective method to convey that the answer to the problem(s) is that he/she needs to change his/her behavior. Typically, one of three basics needs adjustment: nutrition, physical activity, and/or sleep. Unfortunately, after patients have paid their co-pay, many are disappointed to hear that I do not have or recommend a pill or procedure to fix “it.” Some even accuse me of being a “bad” doctor because I think that a pill is not the best medicine. This sets up an uncomfortable adversarial conversation.

My question to my husband last week was: “How do you tell your morbidly obese patients that the reason that they have knee pain is because they are fat?”

Behavior change – the simple, yet personally challenging answer.

I suppose that the answer to is that you have to just tell them. That’s the job. It must be horribly uncomfortable, but that’s the answer they need to hear.

For me, it was the answer I needed to hear.

After years of trying every medicine under the sun, my doctor finally just told me to change my diet.  When he did, I sat quietly for about 30 seconds, my mind racing to see if there was some way I could get around it.

Finally, I realized that there was no escaping—if I wanted to be healthy, I needed to change.  I looked up and asked, “So, about what percentage of your patients is the only solution to their problem changing their lifestyle and habits?”

His answer? 85%.