Monday, May 28, 2012

Health Advice: To Follow or Not to Follow

A large part of my practice involves giving health advice based on my expertise in Chinese medicine. I suggest ways to reduce stress, foods to "nourish Yin," "drain Dampness," and "move Blood"-which can be used to treat anything from headaches to infertility.

Most patients follow some of my advice, but not all of it. A few completely ignore everything I say, and a few follow my every word exactly to the letter.

While having sound advice ignored can be frustrating, I would be a hypocrite if I got too upset over it. I ignore advice all the time. And I seek a lot of advice. I subscribe to multiple blogs on everything from how to write to how to treat depression. I read professional journals, magazine articles, and books. I take classes. These information sources give differing advice on a daily basis--meat is good, meat is bad. Vitamins are useful, or useless. This diet plan works for everyone; no one diet plan works for everybody. I could not possibly follow all of this advice. Since most of my patients are also no doubt getting health advice from multiple sources, someone will have to be ignored, and sometimes inevitably it will be my turn.

So what guidelines should you follow in taking or ignoring advice? Here is my advice (which you can take or leave):
  • Be upfront with the person giving advice. I admit it: I get aggravated when I give simple advice that isn't followed. But I much prefer to be told this up front rather than to cajole, suggest, and give vast quantities of information, only to be told "I just don't eat vegetables" six months into treatment. I will give less advice, and have lower expectations for treatment. It is also useful to know if a patient simply does not have the time, money, or energy for some treatments. If I believe treatment will  not be successful if my advice is not followed, I can save everyone time and money by suggesting the patient seek other healthcare--but usually there is something that can be improved, even if important self-care is ignored.
  • Look at the source. As a trained Chinese herbalist, I spent several years memorizing and using incredible amounts of information so that I could treat people effectively, and then testing that information with clinical experience. Yet my advice often goes by the wayside because a patient has a friend (or hairdresser or neighbor who joined a multi-level herb company) who suggests some other product that usually costs more than what I suggest and doesn't fit the patient's particular problem. When anyone gives advice, look at their credentials. Have they had experience with your problem--whether treating it or living it? Perhaps the neighbor's advice is meaningful if they have the same health condition you do, and have seen great improvement with a new supplement. Do they have enough education to know the different options available for treatment, or what symptoms are dangerous and need further research? Especially when dealing with your health, you need to have many sources for information, and they need to be as reliable as possible.
  • Does the advice fit your outlook and beliefs? I often recommend different meats to my patients as part of the Chinese medicine view of health. If my patient is a vegetarian, and does not want to eat meat, I am happy to alter my suggestions to fit their beliefs. Other patients come to me because they do not wish to take medications or have surgery if it can be avoided. I encourage them to get the information they need to make their healthcare decisions--what will happen if they never get surgery or never take a medication? What are the dangers? What if they wait 6 months and try a more holistic approach?  What objective tests could be done to evaluate a holistic treatment to see if it works? Be open in sharing your beliefs with your healthcare team. A good doctor/acupuncturist/chiropractor will work within your worldview. If your practitioner refuses to acknowledge your right to make health decisions based on your beliefs, perhaps you need to find someone new for your healthcare.
  • Remember, at the end of the day, it's your call. No one truly knows exactly what is best for you. We all approach our decisions based on our individual expertise, experience, and beliefs. I give the advice I would want someone to give me if I had the same condition. Most health practitioners do the same. 
If you get health advice from someone, take the time to consciously make a decision whether to follow it or not. See if the advice fits the areas you are willing and able to change. Look at the track record and education of the person giving the advice. Make sure the advice is something in harmony with your values. Ask as many questions as you need to get enough information to make a decision. Then accept the responsibility for making that decision.

I hope you will find these tips useful the next time you seek health advice!

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