The U.S. Preventive Services Task Force (USPSTF) has suggested that patients be screened for obesity by physicians.

The panel has suggested measuring the BMI ( Body Mass Index ) of adult patients.

A BMI of 30 or more would indicate that a patient is obese while a BMI of 25 or less is normal.

For patients whose BMI is 30 or higher, the task force advises physicians to refer them to weight-loss programs that use multicomponent behavioral interventions — in other words, those that combine nutritional counseling with exercise and support groups. In reviewing current studies on such programs, the government panel found that on average, they helped participants lose up to 11 lbs. over a year, or 4% of their starting weight. Even such seemingly modest reductions in initial weight can significantly improve health for obese people.

Overall, the task force found that the best weight-loss programs include 12 to 26 sessions of behavioral counseling during the first year; help patients self-monitor their eating and exercise, using food diaries or a pedometer, for instance; focus on setting realistic weight-loss goals; and help patients understand what may be preventing them from meeting those goals.

While it is projected that by 2030 forty percent of American adults will be overweight or obese, doctors are not trained to counsel patients on matters of nutrition or weight management.

Doctors who are struggling with weight issues of their own have even greater difficulty addressing weight with their patients.

If you are expecting to get the truth out of your doctor then think again.

Physicians aren’t being completely honest especially when it comes to medical mistakes.

With fears of medical malpractice a real concern, physicians may hold back on the whole story with their patients.

“Our findings raise concerns that some patients might not receive complete and accurate information from their physicians,” the researchers write in the February issue of the journal Health Affairs. The findings also question whether patient-centered care — which is a philosophy of medicine that respects the preferences, needs and values of patients — is possible without more openness and honesty, the researchers from Harvard Medical School said.

Asking questions, doing your research and being an informed consumer of medical services is the best way to achieve a positive outcome with your care.

We all expect doctors to make us well but can they do harm?

Dr. Otis Webb Brawley, the chief medical officer of the American Cancer Society wrote, “How We Do Harm: A Doctor Beaks Ranks About Being Sick In America”.

He describes the ways in which the whole medical system is broken and who is responsible.

Spoiler: We all are.

It is amazing the number of health care professionals who seemingly reject the scientific method. They prescribe treatments they believe to be appropriate as opposed to therapies that are known to be appropriate based on objective scientific evidence. This form of ignorance is a root cause of much of the overuse of medical therapy.
Too often, doctors fail to distinguish what is scientifically known from what is unknown, from what is believed. This is beyond mere disagreement about interpretation of the science. There is often selective reading of the science, especially by those trained in a specialty wanting to advocate for it.

What your doctor knows about dying might influence your end of life care decisions.

Shannon Brownlee’s book, “Overtreated: Why Too Much Medicine is Making Us Sicker and Poorer”, Bloomsbury USA; First Edition edition (September 18, 2007) sheds light on what physicians know about extraordinary measures used in the ER and in intensive care units and why many physicians opt out of such care.

Dying in a hospital bed attached to tubes is not how many in the medical field would choose to die.

Why would doctors be so anxious to avoid the very procedures they deliver to their patients every day? For one thing, they know firsthand that these procedures are most often futile when performed on a frail, elderly, chronically ill person. Only about 8% of people who go into cardiac arrest outside of the hospital are revived by CPR. Even when your heart stops in the hospital, you have only a 19% chance of surviving. That’s a far cry from the way these procedures are portrayed on TV, where practically everybody survives having his heart shocked and undergoing CPR.

Conversations doctors don’t want to have include the end of options for the terminally ill.

Whether it’s lack of training or cultural resistance to discuss death and dying there are huge gaps in patient care at the end of life.

In this country, we tiptoe around the D-word until so late in the game that even now, when more than 40 percent of Americans die under hospice care, about half do so within two weeks of admission. Even expert hospice teams can’t provide many of the elements of a good death — and they believe there is such a thing — in mere days.

We can blame some of this evasiveness on physicians, trained to save lives. But families bear some responsibility, too; they may not seek or seem to welcome a frank assessment. Either way, while many patients do have breakpoint conversations, ignorance often rules.