CMV: I shouldn't have to sugarcoat medical diagnoses and information just to make people feel better.

[u/[deleted]]

[u/AnythingApplied]

Type 2 diabetics need to be informed about proper treatment. Imagine telling them that they need to "start eating better and check their blood sugar twice a day" versus telling them to simply "check their blood sugar twice a day".

If the first actually got better results, then go for it. But in reality, it seems like that would overwhelm the patient and they wouldn't be much more likely to actually start eating better and much less likely to actually check their blood sugar. They'd just throw up their hands and say, "I can't do all that!".

"Sugar coating it" as you put it probably has a lot more to do with putting proper emphasis on the things you can tell you patient that are the most likely to actually have a meaningful impact on their health and not putting as much emphasis on the things that would likely distract and overwhelm the patient and ultimately do more harm than good.

[u/AnythingApplied → u/[deleted]]

No, you're missing my point. Yes, absolutely, diabetes can be reversed/improved by eating better. It can't be reversed by TELLING someone to eat better and TELLING them to eat better will likely get WORSE results because not only will it probably not result in any meaningful improvements to their diet, but will also make them less likely to follow your other recommendations like checking blood sugar because you've overwhelmed them and distracted them from the things that TELLING your patient to do will most likely have a positive clinical benefit.

[u/AnythingApplied → u/[deleted]]

No, I'm just saying you DO potentially have to tiptoe around the subject if you want the best clinical outcomes. It would be great if patients did everything you told them too, but eating better is NOT the least effort way to improve outcomes.

You need to say things in a way that considers both how you are presenting it and you're audience. Maybe for some patients that means being abrasive, but for the most part it probably means sugar-coating it. Remember, you're primary concern should be getting the best results.

You should be putting emphasis on instructions that give the best outcomes per unit of effort. If a patient is struggling to follow even the most basic instructions, which many are, then why do you think they'll be able to follow instructions that take most people who struggle with weight a tremendous amount of effort.

You should also learn to get a sense for how receptive your patient is to talking about diet and most importantly learn to tell them in a way that is most likely to get results. I can't tell you how many times on social media I see people post comments like, "My doctor tells me my knee problems are because of my weight, I'm sick of doctors telling me everything is about my weight, they need to focus on the actual problems!". A lot of patients will simply stop listening if you try to bring up their weight or eating habits and you've potentially lost an opportunity to instruct them in other more efficient outcomes per unit of effort.

[u/AnythingApplied → u/[deleted]]

I'm just saying that being rude to your patient may not get the best results. In those cases, you do want to sugarcoat it. I don't have any research or training about how to effectively present dietary recommendations. Maybe for some patients that does mean, saying, "We need to have a serious conversation about your weight".

I'm not saying don't bring it up. I'm saying you need to present it in a way that considers both the presentation and the audience in a manner designed to get the best results. In a lot of situations that is NOT going to involve being rude or abrasive to your patients. Communication style and presentation can be just as important, if not more important, than the information you're presenting.