By Goh Lee Gan
We spend a lot of time telling patients what to do. Is our advice effective?
Sometimes, in order for our advice to be effective, we physicians need to do what is needful, and get our own house in order, first.
One-Act Play
Doctor: To succeed in losing weight, you have to eat less and exercise more.
Patient: (Verbally) Yes, doctor. (Thinking) This must be a joke! I am not going to lose much weight under his care. He is a failure himself! Look at him — eat less, exercise more ??
Commentary
It is a worthy exercise to consider how we give our advice.
First and foremost, consider our demeanor, our physical appearance, and our message. These need to be aligned to what we are seeking to achieve for our patient. In this case, it is helping the patient to lose weight. The doctor needs to be an example for the patient.
The fat doctor is drinking a sweetened beverage. He has some food (a burger!) tucked into the pocket of his white coat. The doctor does not appear to have fixed his own problems. How is he going to be able to give advice that will be followed? A doctor may be all ready to treat others, yet he may not have taken the first step to efficacy.
One more point is to be noted for reflection. Doctors say, eat less, exercise more. This is the counselor’s script. It has been commented that a coach’s script may be more effective. A coach says, have you thought about how you could lose weight? This gives the control back to the patient.
The doctor in the drawing may wish to ask himself the coach’s question.
——- A/Prof Goh Lee Gan
A/Prof Goh Lee Gan is a past president of the College, the Singapore Medical Association, as well as the Asia Pacific chapter of the World Association of Family Doctors. He started the academic Family Medicine program in NUS in 1987 and also the Master of Medicine training programs. He considers himself the midwife of Family Medicine in Singapore although many of us think of him as the father!
The commentary and vignette were reproduced with permission from the book “Being Human, Stories from Family Medicine” edited by Cheong Pak Yean and Ong Chooi Peng and published in 2021 by the College of Family Physicians Singapore.
Pictures of illness experiences were drawn by NUS medical students in workshops conducted from 2012-2017 by A/Prof Cheong Pak Yean. Senior family physicians subsequently shared vignettes and commentaries based on the pictures.
Dr LG Goh
Dr GOH Lee Gan is a retired Associate Professor in the Department of Family Medicine, National University Health System. He has an interest in learning and teaching how we can age well everyday (AWE).
