Doc Shame You? See Ya Later!

If you're anything like me, if a doctor says something that insults or embarrasses you, you may never go back, a new study has found.

I can remember when I was lugging around 30 post-partum pounds and a new internist I was planning to start seeing told me I really needed to lose weight.  I dropped the pounds (he was actually my incentive to join Weight Watchers) but I never went back.

But not everyone gives up on a doctor who challenges them.  Some people lie the next time they see the doctor ("Oh yes, I cut 'way back on my calories"), while others decide to draw the wagons around and take the advice.

Shame and guilt as a direct result of interacting with a doctor are quite common, says Christine Harris, professor of psychology in the UC San Diego Division of Social Sciences, as are both positive and negative reactions at 

Gaining insight into patient reactions is important, the she and her co-authors write, because “more than one third of all deaths in the United States are still essentially preventable and largely due to unhealthy patient behavior.”

Harris' earlier study showed that half of all patients queried felt shame at something a doctor said.  

In both studied groups, weight and sex were the most frequently cited shaming topics, according to Teeth came up frequently with the younger subjects as well. (Possible topics also included smoking, alcohol or substance use, not taking prescribed medications or following doctor’s orders, and mental health, among others.)
Family practice doctors, gynecologists and dentists were the specialties most often cited as shaming. This is probably because, Harris said, people generally see these types of physicians more than any others.
Emotional and behavioral reactions to the shaming experience were all over the map; some made a profound lifestyle change to improve health, while others avoided all doctors altogether.
Know what makes the difference, according to Harris? Whether patients condemn themselves and not just the behavior. Being able to look at the behavior separate from the self is what leads to better choices about improving health.
A couple of years later, I went to an allergist who said the same thing to me.  "You need to lose weight." The pounds had crept back up.  But again, I took control, and I just had my annual appointment with him last week!


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