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Tame Your Advice Monster Doctor

Giving advice without considering the context or the receptivity to that advice may be akin to prescribing drugs without checking for potential drug interactions or allergies. At best it may be unhelpful and at worst it can cause harm.

In his book on ‘The Advice Trap’, Bungay Stanier asks us to consider the circumstances in which we are tempted to issue advice. There is a very helpful table on page 43 in which he outlines the type of person and the type of situation in which we are tempted. Doctor’s reading the book would clearly recognise the risk: Someone apparently seeking advice and time is short; someone who doesn’t ask for advice when there is a lot at stake; and someone who challenges you and ‘that thing’ keeps recurring.

What is the evidence that doctor’s advice to lose weight achieves any results? A startling conclusion from a recent study:

There were no significant interactions between Health Care Professional’s (HCP) advice and attempts to lose weight. Obese adult’s attempt to lose weight, and not HCP’s advice to lose weight, was a predictor for healthy eating behaviors. Interventions in medical practices should train HCPs on effective strategies for motivating obese patients to adopt healthier lifestyle

Preventive Medicine

The issue of health promotion needs to take account of the circumstances of people’s lives and the complexity of the aetiology of many such problems:

Social ecological models that describe the interactive characteristics of individuals and environments that underlie health outcomes have long been recommended to guide public health practice. The extent to which such recommendations have been applied in health promotion interventions, however, is unclear. The authors developed a coding system to identify the ecological levels that health promotion programs target and then applied this system to 157 intervention articles from the past 20 years of Health Education & Behavior. Overall, articles were more likely to describe interventions focused on individual and interpersonal characteristics, rather than institutional, community, or policy factors. Interventions that focused on certain topics (nutrition and physical activity) or occurred in particular settings (schools) more successfully adopted a social ecological approach. Health education theory, research, and training may need to be enhanced to better foster successful efforts to modify social and political environments to improve health.

Shelley D. Golden, MPH and Jo Anne L. Earp, ScD

You may enjoy my podcast with Michael Bungay Stanier

Photo by LinkedIn Sales Navigator on Unsplash

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