Through school I have been anticipating a medical career, but eventually got cold feet as I was putting my application together. One fear has been a general decline in support for the thinking, listening generalist. Your blog, among several in the online community, indicate to me that role models who enjoy their primary care work still exist, even if their numbers are waning.

One of the big questions that I have wrestled with is the degree to which I could help patients achieve behavior change as a physician. I am more passionate about healthy living and wellness than science. Is it naive to think that taking my training to the highest level (MD) will allow me the most liberty with my patients? Currently I think the opportunities to develop relationships and foster behavior change would be greater with a lower level credential like an RD or even a personal trainer.

I’m not trying to put you on the spot to make any decisions for me, but I think your experience could help answer a couple of my questions. As a physician, do you feel like you are in a good position to encourage behavior change? Or do you feel limited by the time-intensive nature of lifestyle coaching, that efficiency prompts you to spend time diagnosing and treating disease?

Thanks for sharing your thoughts in this blog,

Drew

Drew: Excellent question. Not being either an RD or personal trainer, it’s hard for me to know to what degree they’re able to influence behavior change. As a physician, however, I’ve been astounded by my ability to influence the decision-making processes of my patients (note I didn’t say behavior change—that’s harder, and I’m not certain any one profession really has an advantage in it over any other). What influences people, I think, isn’t so much what you say but who you are to the person to whom you’re saying it. The real power I have as a physician to influence patients comes from the the trust I’ve been able to build with them over the years with regard to one of their most precious possessions: their health. Patients of mine have submitted themselves to dangerously invasive surgeries that required months to recover from at the hands of doctors they barely knew because I advised them to. The influence a doctor has (especially a primary care doctor) represents an awesome power that demands constant accountability. I’ve also found that after a number of years in the medicine game you get efficient enough to be able to attend to the psychospiritual aspects of health care as well as the diagnosis and treatment of disease if you care enough to do so.

Hope that helps bring some clarity to your deliberations. The world needs more doctors who care about not just the health of their patients but their happiness as well!

Alex

I will take your suggestion and leave the url to my site here: http://holisticdivorcecounseling.com. As I mentioned, it’s not just for divorce, but for all life’s challenges and transitions.

Wishing you every goodness,
Nicole

Wonderful food for thought. I’m glad I found your website! Thank you.

Susan: Glad you found the article interesting. Thanks for stopping by.

Alex

I have also found that changing one small habit at a time, leaving time for the new habit to become more and more automatic, makes it easier to make big changes than if I overreach with my first goal. That doesn’t work with smoking exactly, but it works with establishing a healthier diet or more ambitious work plans.

Thanks again.

Vivian: Another person made a similar comment re: Jennifer James. I’d not been familiar with her work. The Stages of Change Model was developed in 1977, around the same time I think Jennifer James was working on her model. I wonder if there was a mutual influence?

Alex