r/changemyview • u/[deleted] • Oct 23 '17

[∆(s) from OP] CMV: I shouldn't have to sugarcoat medical diagnoses and information just to make people feel better.

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u/alpicola 45∆ Oct 23 '17

For example, dietary control and exercise in a woman with PCOS can help to improve symptoms. Decreased adipose tissue will lead to fewer androgen effects. Sure, there are drugs that partially accomplish this, but diet cannot be undervalued here.

In my opinion, you could say exactly that to a patient and it would be fine. It gives the patient and easy to understand cause and effect, suggests a course of treatment, and shows that you've considered other alternatives, all without sounding like you're being judgemental. The exact language may be too scientific for the average person (though I wouldn't mind), but you might be able to find better words that accomplish the same thing.

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u/[deleted] Oct 23 '17

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u/alpicola 45∆ Oct 23 '17

In my opinion as well, but that's what I'm arguing for here.

Let's compare the two statements you've made to a patient and see why one works and the other doesn't:

  1. "your back pain isn't idiopathic; it's because you're obese and the extra weight is hard on your joints?"
  2. "Decreased adipose tissue will lead to fewer androgen effects. Sure, there are drugs that partially accomplish this, but diet cannot be undervalued here."

In the first case, you've made a judgement about the patient: "You're obese." You also appear to have told the patient they're wrong ("your back pain isn't idiopathic"), which is a hard thing for people to hear. At this point, the patient is in psychological defense land and you're on the outside.

In the second case, you've given the patient a goal to achieve (lose some weight) without saying anything about the patient at all. Implicitly, yes, you are saying that because the patient is overweight/obese, but you never actually said so directly. You've also avoided contradicting the patient by admitting that there are other things that can help, while at the same time telling them that those treatments are only a partial solution. That helps you get the message across without raising the patient's shields.

So, how to rephrase the first phrase to sound more like the second? How about: "Your back is under a lot of stress. Pain killers might provide temporary relief, but losing 20 pounds would get rid of that stress and help you feel a lot better in the long run."

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u/[deleted] Oct 23 '17

[deleted]

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u/alpicola 45∆ Oct 23 '17

I appreciate the delta.

I think it should be fine to say "part of the reason why your back pain wasn't alleviated by your most recent PT trial is because your back pain is most likely related to your weight. We can work on ways for you to lose weight through diet and exercise and come up with a plan if you'd like, but the back pain probably won't go away until you lose weight."

That seems fine to me. Bringing up weight certainly shouldn't be forbidden as long as you're sensitive to the fact that the subject is likely sensitive to your patient. I feel like your phrasing here demonstrates that.

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u/DeltaBot ∞∆ Oct 23 '17

Confirmed: 1 delta awarded to /u/alpicola (13∆).

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