Life

‘Stop Eating Sugar’ And More Tough Talk From A Doctor

Going to the doctor isn’t ever pleasant. Whether you’re sick or just getting an annual check-up, we can all agree that only a select few fetishists enjoy being measured, poked, and prodded while wearing crinkly paper gowns. But it doesn’t have to be that way. In fact, doctors — most of whom love their jobs and want to help you live a happier life — have it just as hard as their patients. They have to contend with real illness, fake illness, difficult to diagnose maladies, drug abusers, malpractice issues, resources, insurance… it’s no walk in the park.

In the spirit of making everyone’s life easier, one doctor spoke to us about some of the things she wishes she could tell anyone about to visit the doctor’s office. Priyanka Wali is a San Francisco-based physician who sees all types of people and has treated and diagnosed every illness under the sun. There’s pretty much nothing she hasn’t seen before (including that rash you’ve been wondering about). She gave us the lowdown on what patients should do, what she wishes they’d stop doing, and how to make your appointment as pain-free and productive as possible.

Don’t come in with a WebMD diagnosis, just take a deep breath and relax

“Don’t come to the doctor’s office and tell me what you think it is,” Wali says. “If you’re coming to me with a cough, don’t tell me what you think it is because you’ve googled the worst-case scenario. Let me figure it out, that’s my job. Just relax. All you have to do is try and answer the questions that I’m asking and just relax.”

That may sound like it’s taking some of the control away from the patient, but Wali isn’t against people being well-informed. The issue, she says, is that WebMD heightens the anxiety already present just from needing to see the doctor. “Patients come in believing that they’re afflicted with something very serious. Most of the time, it’s not as bad as they believe.” WebMD, Wali says, “basically doesn’t know what it’s talking about. And it’s only going to make things worse.”

What is helpful, Wali says, is to think of your visit beforehand and create a list of things that you want to make sure to talk about. Bring it in with you, maybe even hand it to the doctor, and you’re going to have a much more productive meeting because you’ll be focusing on the real issues and not mindless small talk about how much your landlord sucks (something that Wali says is a far too common occurrence).

Don’t apologize for your body

“Don’t apologize for needing to get undressed,” Wali says. “Lots of people reflexively say ‘I’m really sorry, this is super gross’ when they have to take off their clothes and show a doctor something they’re concerned about.” But doctors, Wali says, have seen it all. “Your body is your body. Don’t apologize for it.”

It’s part of your doctor’s job to tell you things you might not like hearing

One of the biggest fears that patients have is being told that they’re unhealthy. We’re not talking about unhealthy with a capital U (like cancer or diabetes), but the kind of unhealthy that’s much more routine. If you’re overweight or engage in activities that are detrimental to your health your doctor is duty-bound to tell you.

“I will tell you to quit smoking if you’re smoking,” Wali says. “I will tell you to stop doing bad things if they’re harmful to your body. That’s my job. But don’t be ashamed of who you are. My goal is the same as yours. I want to help you, I want to make you better. I’m not here to shame you or make you feel worse.”

Doctors don’t want to make you feel bad about yourself and they don’t have the time for it either.

“I don’t have the time to shame you,” Wali says. Even if she did, though, Wali says most doctors know that humiliating someone into being more healthy doesn’t work. “In real life,” she says, “motivational interviewing is a much more effective strategy for initiating change.”

“If you asked a person, ‘are you ready to quit smoking?’ and they say, ‘No,’ there’s literally nothing you can do,” Wali says. “There’s no point in moving further in that conversation. The only thing you can say is, ‘well, let me know when you’re ready to quit,’ and move on. I can’t change your habits for you. I can only meet you where you’re at.”

Doctor House was right, everyone lies. And they need to stop.

“Don’t hide anything from me, because you’re doing yourself a disservice,” Wali says. “I know you’re probably hiding it because you’re scared, but it’s in your best interest to tell me everything. First of all, remember that appointments are confidential and I won’t judge and it’s okay. Second, the more I know, the better for me, because there might be things I didn’t think of because I didn’t know.”

That applies to drug use too. Wali says that most people don’t recognize that drug addiction is a medical issue and a doctor’s job is to help, not report patients to the authorities. “The only time I break confidentiality,” Wali says, “is if the person is a threat to themselves, a threat to others, or if I suspect domestic violence or child abuse.”

Nothing is more important than your diet.

“Because of the obesity pandemic, I think getting people to stop eating sugar is the hardest thing right now,” Wali says. “Sugar is super prevalent and it’s not yet socially accepted that it’s bad for you.”

“It’s literally killing people, but getting people to quit doing something they don’t realize is bad for you is much harder than telling someone, ‘Hey, smoking kills. Don’t smoke,’ because there’s a lot more data behind smoking.”

“I tell more patients to stop eating refined carbs and sugars than I do to tell them to quit smoking,” she adds.

“I think what you eat makes a much bigger impact on your weight and how you feel than how much you exercise,” Wali says. “That’s something that people don’t understand. 9 times out of 10 when I tell people, ‘You need to lose weight,’ the first thing people tell me is, ‘I know, I have to exercise, I really need to hit the gym,’ and I tell them, ‘it’s not about exercise; It’s about what you’re eating.’ People often don’t understand how important a healthy diet is.”

Doctors believe in your pain, but painkillers aren’t always the best option.

How to get your doctor to prescribe the drugs you want or need — usually for pain — is a topic that’s been widely written about. But Wali wants you to know that your doctor isn’t being stingy with the narcotics. It’s not that your doctor doesn’t believe you or is against your treatment, it’s just that many drugs are addictive and there may be better solutions to the problem than prescribing Vicodin.

“I do believe you’re in pain,” she says. “Whether that pain comes from an emotional source or a physical source, when you tell me you’re in pain I believe it, and I know it’s real to you. Whether or not painkillers are the correct treatment, that’s on a case by case basis.”

Wali says she doesn’t ever immediately assume that someone asking for painkillers is just seeking drugs, but part of her job, she says, is to educate as well as prescribe. So if you’re asking for something that’s more heavy duty than prescription Ibuprofen, she’s definitely going to take a few moments to sit down and discuss the risks with you.

Same goes for antibiotics.

Feeling sick? It’s likely that the first thing a friend might ask you is if you’ve gotten antibiotics from your doctor. But antibiotics aren’t always the best way to treat an illness, even if that’s what you’ve always been told/given. In 2015, The Centers for Disease Control and Prevention released a document that detailed when and why people should take antibiotics. If you’re fighting a bacterial infection? Those antibiotics might come in handy. Anything else, though, and you’re just risking giving bugs a chance to learn how to resist treatment. Especially, if you’re coming in with a sinus infection.

“I wish people knew that there’s no reason to prescribe antibiotics for sinus infections unless you’ve tried conservative therapies for at least 10 days,” Wali says. “If you think you have an infection, try to alleviate the symptoms more conservatively before you ask for antibiotics. If it hasn’t gotten better by then, then antibiotics may be a reasonable choice.”

Does that mean you should wait to go to the doctor if you feel sick? Absolutely not. Make an appointment if you’re not feeling well. But also understand that the medications your doctor prescribes for your illness may be quite different than what you expected.

You’re never wasting your doctor’s time.

Google “I don’t want to bother my doctor” and you’ll discover that thousands of people are worried that their doc has way more important stuff to take care of than their health. It’s a popular thought, but it’s also very, very wrong. That’s because you are that doctor’s important work. Their whole job is centered around making you feel better.

“The only time you’re wasting my time,” Wali says, “is if you show up for an appointment and don’t know why you’re there. Your health isn’t a trivial matter. And you should never feel like you can’t make an appointment because something’s unimportant.”

Wali understands that appointments may seem rushed — she sometimes sees up to 15 patients a day — but she says that her intentions are always good. “There may be times where it may seem rushed, but please understand that doctors are taking every patient seriously.”

It kills your doctor when you don’t turn off your phone.

If there’s one thing that does annoy Wali, it’s people who refuse to turn off their cell phones, even in the middle of the consultation.

“For me,” she says, “it’s super distracting when you’re trying to understand someone, you’re trying to examine them, you’re trying to connect with them and then their ringtone goes off and they have to decide whether they’re going to take the call.”

“Your health is really the most important thing that you can deal with. Your phone call from your friend can wait.”

Your doctor gets that your insurance company sucks. And they’re not just ordering tests to bill you.

“I hate insurance companies just as much as you do,” Wali says, “but there’s very little I can do about that. People often complain to me about their deductible, and I get it, but it’s also completely outside my control. I’m going to order the tests that I feel are medically indicated so that you can continue living your best life. No more, no less.”

Not even doctors believe in medical science 100 percent of the time.

“Just because I’m a doctor,”Wali says, “doesn’t mean that I believe medical science is 100 percent foolproof. Medicine is constantly changing. What we learned 20 years ago is totally different than what’s applicable now. I don’t buy into it 100 percent. What I endorse now may change that in the future.”

Never leave the office before you understand exactly what the doctor is saying.

Even doctors — people who have trained for years to understand the many medical terms you’re sure to be inundated with — don’t always know what the hell other doctors are talking about.
“Don’t pretend like you get what I’m saying and then walk out of the room and be really confused,” Wali says. “Just tell me you don’t understand what I’m talking about. I won’t be insulted and will do my best to make it clearer.”

“I recently went to the dermatologist about a mole,” she adds. “I read up on what I thought the mole was and I was ready, but even after all that research, when the doctor talked to me, there were things that I was not 100 percent sure about. If that’s my experience, I can’t imagine what it’s like for other people.”

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