<p>So, I don’t really think my kid needs a doctor to tell him to be careful crossing the street. That doesn’t mean it’s not good advice but calling it medical is a stretch. imho.</p>
<p>Well, there you go - that is the typical attitude. I’m not interested in dropping my weight or even hear about it, but I’m interested in fixing my diabetes. Just gimme a pill.</p>
<p>Okay, that’s not me but I’m sure you’re right about that being the typical attitude. As a rule, I happen to think we are all way over-pilled.</p>
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<p>Well, if statistics show that too many kids are getting hit when they cross the street, I think it IS the doctor’s job to mention being careful. A lot of kids will pay more attention to adults other than their parents.</p>
<p>That’s why the American Academy of Pediatrician advises parents NOT to buy a trampoline for their kids. That is a big source of accidents. It doesn’t matter if you put a net around it. Kids get hurt even when they don’t fall off the thing.</p>
<p>Trampolines. Sidewalks. Guns. Swimming pools. Domestic violence. This is becoming quite the discussion. </p>
<h1>1 - Medical schools are training doctors. Having protocol in place of standard questions, etc. to ask a patient is what helps to develop safe medicine for both patients and doctors. Giving anticipatory guidance - advice on a particular topic - is the basis of preventative medicine. There is a reason those residents ask those questions. After they ask them, there is learning that occurs with their preceptor (an experienced physician) that helps the resident further their knowledge and development to assist and access patients.</h1>
<h1>2 Doctors cannot assume what a patient or parent of a patient knows. The level of understanding/education of a patient or parent of a patient that walks into a doctors office runs the gamut from very uneducated to very educated to very educated but not knowledgable about health related matters. There ARE people and children who need to hear how and why you should cross the street safely and practice safe swimming.</h1>
<p>Being a doctor is crazy hard. Requires crazy knowledge, continuous education, amazing confidence - for the chance to help people (hopefully most of the time) but also to be held to a level beyond what any human could possibly meet and excel at. </p>
<p>(disclosure - work at a medical school)</p>
<p>Now, I’ve fallen to my own criticism - not staying on topic for the thread. Sigh. 
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<p>Trees are another problem. My kid fell out of tree and broke both of his arms. Yes, I knew climbing trees could be dangerous but boys like to climb trees. This was called an accident. Thus, preventive counseling would likely have failed. No disrespect intended at all but I do think at some point it gets silly to insist on providing this kind of advice to everyone who comes in with a fever or flu.</p>
<p>Is climbing trees a significant cause of serious injury and death in children? I doubt it. But drowning and firearms are significant causes of injury and death.</p>
<p>We’ve been asked some of those standard questions. D has asthma, which she is “growing out of” but when she was younger, was not well controlled. We made number of late-night trips to urgent care. I never minded the questions-it seems sensible to make sure a kid is safe. But one Dr. threw us with her questions and to this day we wonder where she got them. </p>
<p>We are a reading family. At 2 a.m. all three of us-H, me and D were sitting there with books. D was maybe 10 or 11. The doctor kind of cocked her head at D and asked what she was reading. D has always been an advanced reader-it was some book usually read in HS or college. Doctor looked at us and said, “Do you think her asthma might be caused by the stress of having to read like this?” WHAT? We assured her that no, D, like us, simply likes to read. It was bizarre.</p>
<p>CF - Teenagers shooting each other in drug related skirmishes is not a medical issue. Most importantly, a physicians advice simply will not fix this very real problem. They know it’s dangerous and criminal. I don’t have a problem with the questions, really. But, helpful, not so much. </p>
<p>Breathing is a problem. You could inhale gasses. Eating is a problem. You could ingest a toxin or get food poisoning. Walking is a problem. You could get hit by that kid falling out of a tree.</p>
<p>** Acting is a problem because you could fall off the stage (happened to a friend’s daughter). Playing a large instrument is a problem because you could drop it on your foot.</p>
<p>Thats just wrong actingmt - medicine is not just writing scripts off a prescription pad. A person’s overall health - be it physical, mental, behavioral, emotional, developmental, social, etc. - all of it effects their health and well being. </p>
<p>Back to portion control… Controlling and figuring out portion size is easy. What seems to be hard is sticking to the routine and not eating too many of these correctly sized portions! :)</p>
<p>People miscalculate how much they eat. They also miscalculate how much they burn while exercising. Many times I have been told that since I ran marathons I could eat any crap I wanted… Well, when I tell them that a body of my size burns 100 cal/mile ran, give or take a few cal, and there are 26 miles in a marathon, and to burn off a pound of fat one needs to spend 3500 calories… Jaws drop. Run for 4 hours to lose 2/3 of a lb?! And these are educated folks, some with PhDs in biological sciences! It is not that they did not know these basics, they simply did not do the math until I put it all in one sentence. </p>
<p>Yes, I do get that. But, it cannot possibly be assessed by a routine list of questions on visit one. This would only work if we were taking about a developing relationship which in many cases is not at all how it works, unfortunately.</p>
<p>In some states, we are mandated to report abused nursing home patients. I’ve only reported one person in my career. A parent of a patient who was having outpatient surgery. The mother was visibly very high on drugs, which turned out to be methamphetamine. She drove the child to the hospital and was planning to drive the child home. No way could I allow that.</p>
<p>For people who need help–it seems that just asking the questions wouldn’t be enough. Most doctors today are overworked and don’t have time to spend with the patient who need guidance in these areas.</p>
<p>So, should we advise the OP to get a referral to a nutritionist? Or will the OP be turned off by all of the non-associated questions the primary care physician may ask? My advice is to get the referral and have a history and physical performed to make sure you don’t have any unknown health issues.</p>
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<p>I think this hits the nail on the head. You can eat all the healthy food in the world but if you’re eating too much of it, you’ll gain weight. I use a kitchen scale. They are inexpensive and will really help until you are more knowledgeable about how much a serving size actually is. A food journal is also very helpful. H will tell me “I burned 10,000 calories on the elliptical” or some equally unreasonable amount- no, honey, you sure didn’t, so those beers you rewarded yourself with are going straight to your belly. </p>
<p>I eat around 2000 calories a day now and I am still losing weight. I am not overweight - I am 5’7 and around 130 pounds. Every morning I eat one of three breakfast options: </p>
<ol>
<li> Fiber One English muffin, egg fried in Pam, slice of sharp cheddar, slice of Canadian bacon (faux Egg McMuffin).</li>
<li> Steel cut oatmeal with raisins, raw sugar and cream (yep, cream) </li>
<li> Polenta cooked in milk with dried fruit and honey </li>
</ol>
<p>Lunch I usually eat a salad or chili. </p>
<p>Dinner will depend - but usually some type of homemade chicken tender, steak or salmon and a vegetable (broccoli, spinach or beets are popular). I also really like sushi. It is a lot easier for me to lose weight if I’m getting regular exercise and I have certain “reward” foods - like chocolate milk - that I allow myself when I’ve really pushed myself. </p>
<p>For snacks I will have fresh berries or a KIND bar. Saturdays are usually a “eat what I want” day. I drink very little diet soda now, I do drink beer and wine on occasion. It seems to be working. </p>
<p>Well, I don’t think portion control is a medical issue. either. lol. OP should keep track of what she eats and cut down if she wants to drop some weight. OP mentioned Jenny Craig, Weight Watchers is really good, too. Or just plain old-fashioned calorie counting. Diets do work. The key is finding something you will stick with and that is personal. A nutritionist can tell you what to eat but unless you can actually follow the plan it is useless. This is a DIY project, imho.</p>
<p>I would advise anyone looking to lose weight and body fat to cut back on all portions containing sugar, starting with the total elimination from the diet of all sugar beverages: soft drinks, fruit juices, sports drinks, sweet tea, coffee with sugar, milk shakes, etc. Stop drinking sugar.</p>
<p>Even is this only works as a result of calorie reduction (and there is considerable evidence regarding liver metabolism of sugar to suggest that it’s more than calories), then cutting sugar consumption is reducing calories with a food that has zero nutritional value beyond the calories.</p>