January 25, 2007


I was in a study group session this past weekend and we were discussing a farmer w/ pneumonia who didn't go in to see the doctor until it got really bad.

The question came up: "why do some people refuse to see doctors?" I was responsible for writing that part of our study guide up and I just wrote a few notations about the topic.

Be 2) Why do some patients avoid going to the doctor?
· Support (from partner, low finances, etc.)
· Not help-seeking
· Afraid of diagnosis – “not sick until the doctor tells them that they are”
· No time, lot of work = stress + better things to do
· No trust in physicians

I wanted to talk a bit about #3 here. "Afraid of diagnosis."

People have ths idea that we are born perfect and healthy into this world, but unfortunately, that is not true. It has been said that we start dying the minute we are born. Technically, we start dying even before that while we are still in the womb.

We fight a constant battle to acheive tenuous homeostasis.
We have to work to stay healthy.

I think a big reason why people with high blood pressure, high cholesterol and high glucose don't want to see the doctor is because they feel healthy. They don't want to hear how their sodium, fat and sugar might be affecting them. They don't want to hear how eating right and exercising might save their life and positively affect their quality of life.

They don't want to be sick.

Are they sick? Diagnosing someone with "Hypertension", "Coronary Artery Disease" or "Diabetes Mellitus" doesn't change who they are. It doesn't necessarily change how they feel either, though the hope is that their feelings will change their behavior.

The approach I think that should be used is to tell them that if they don't feel sick, then they aren't sick. However, they do have a problem that could be fixed with some lifestyle modification. Too much influence from environmental or genetic factors might require pharmacologic intervention. On this, I'd say the following:

"Just because you're taking medication it doesn't mean that you've got a disease or an illness. You're taking these pills to prevent you from getting sick. "

This apple a day will keep the doctor away... the single ounce of prevention that'll be worth a pound of cure.

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