A thoughtful reply, thank you!

Unfortunately, I am required to be a skeptic as well. I have a number of rules which have served me well in my practice. Number 4 is always trust the patient. Number 5 is always trust the patient. I can’t give good advice without good information. And most of time time it is advice. As I have mentioned before most of the problems people have they can address themselves. Sometimes reassurance is needed sometimes tests. Rarely, medicine.

Agree with your concern about bad advice comment and the 2020 experience. I have dumped all of my admin duties for 90 er docs because I could not speak the corporate lines anymore. Just a plain old er doc now. I get outside a lot and work out enough. I encourage the same.

Love salt, and eggs and they go well together. Butter is a favorite with heavy cream. Especially with new potatoes, shallots, garlic, white wine, some broth, cheddar cheese and a little saffron. Won’t take a statin or a blood pressure med.

I fight vigorously against health care metrics and things like the devil Press Ganey.

But, unfortunately sometimes I do need to blame the patient. The US is a complete outlier in the world for obesity and all of the chronic conditions that come with it. I always say I may not have the answers but I will give you the best I have and sometimes I am not right.

In the middle of the night I had to wade through pages of google to find the cat and find TIOK as well! I am glad I did! Keep questioning your docs, if they don’t know the answer so be it. If they don’t like the question move on!