Is our patients learning?

Dr. Doug Iliff carves up a sacred cow, to wit, the “quasi-religious faith in the power of education to change behavior.”

[T]here is good evidence that education can increase knowledge; some evidence, over a long period of time, that it can change attitudes; and very little evidence that it can change behavior.

There are some things that our patients really, really need to know. Those essential things can get lost in a wash of irrelevant information. The perfect is truly the enemy of the good. Maybe the good is the enemy of the mediocre.

[Patients] need a little instruction, and a lot of accountability.

Don’t throw out the baby with the bath water, now. I’m not saying education is worthless; I’m saying you have to apply it with discretion, like antibiotics. Keep your powder dry; wait till you see the whites of their eyes; discern the teachable moment. Otherwise, save your breath, and your time.

I’ve thought much the same thing over the years, but I don’t think I could have phrased it as well as Dr. Iliff has.  Many of the “lifestyle” health problems we see — smoking, overeating, lack of exercise — are not the result of ignorance.  The trouble is the adverse consequences of engaging in certain behaviors are distant potentialities, the benefits are immediate realties: smoking might cause COPD or lung cancer decades from now, but it definitely satisfies one’s craving for nicotine now.

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