Philosophy Discussion Forums | A Humans-Only Club for Open-Minded Discussion & Debate

[Sushan]

It seems to me that over the last few decades doctoring has transformed from a hands on practice to a pill dispensing machine.

There is now a pill for every ill. And Pharma seems to geared to sell pills that keep you going without providing any kind of cure, since there is no money to be had from people who no longer need pills.
Key drugs of this catagory: Statins, PPI, CCIs, Bet Blockers, Diebetes pills such as Metformin. These are drugs given so that people can maintain their unhealthy lifestyles and dietst for keeping their diseases.
This has accompanied a pandemic of Tyoe2Diabetes, Obesity, athersclerosis, heart disease and Alzheimers. - all due can be assicaited with bad diets.

There are moves to return to a more "Functional" approach which seeks to understand the causes of disease, and address the problem with nutrition and supplimentation where necessary.

I can talk about my personal journey of rejecting 4 medications, chaging my eating habits, increasing my exercise and losing 50lbs in weight, but I am prevented from linking to various You tube practicioners,
Here's my readin list.

2023, Van Tulleken, Chris, Ultra Processed People, Penguin.
2020, Taubes, Gary, The Case for Keto, Granta
2010, Taubes, Gary, Why We Get Fat, Anchor
2020, Macciochi, J., Immunity; the science of staying well, Experiment Pub.
2021, Lustig, Robert, Metabolical, Hodder & Stoughton
2013, Lustig, Robert, Fat Chance, Harper Collins.
2021, Specter, Tim, Spoon Fed,Vintage Books.
2021, Chatterje, Rangan, The Four Pillar Plan, Penguin.
2016, Fung, J, The Complete Guide To Fasting, Victory Belt Publishing.
2022 Johnson, Richard, Nature Wants Us to Be Fat, BenBella Books
2014 Perlmutter, Dr David, Grain Brain, Hodder & Stoughton.
2014, Teicholz, Nina, The Big Fat Surprise, Simon & Schuster.
1958,1975 Mackarness, Richard, Eat Fat and Grow Slim, Fontana Collins.

Your insights into the transformation of healthcare, especially regarding the role of pharmaceuticals and the rising interest in functional medicine, bring up crucial points about the current state of health and wellness.

The trend you've noted towards medication as a primary mode of treatment, often without addressing underlying lifestyle and dietary factors, reflects a significant issue in modern healthcare. The focus on treating symptoms rather than causes, as you've described, can lead to a cycle of dependency on medications without truly improving health outcomes.

Your personal journey of rejecting certain medications and opting for changes in diet and exercise is inspiring and aligns with the growing recognition of the importance of lifestyle factors in health. This shift towards a more holistic view, encompassing nutrition, exercise, and overall wellness, is gaining traction, as evidenced by the reading list you've shared.

The books you've mentioned underscore the growing body of research and opinion advocating for a more integrated approach to health that considers dietary and lifestyle modifications as key components of treatment. This approach seeks to empower individuals to take an active role in their health, moving away from a purely reactive, medication-based strategy.

Do you think this shift towards a more holistic, lifestyle-focused approach will continue to gain momentum in the healthcare field? And how do you envision the integration of these principles into mainstream medical practice, considering the current reliance on pharmaceutical solutions for chronic health issues?

[Sushan]

It seems to me that over the last few decades doctoring has transformed from a hands on practice to a pill dispensing machine.

There is now a pill for every ill. And Pharma seems to geared to sell pills that keep you going without providing any kind of cure, since there is no money to be had from people who no longer need pills.
Key drugs of this catagory: Statins, PPI, CCIs, Bet Blockers, Diebetes pills such as Metformin. These are drugs given so that people can maintain their unhealthy lifestyles and dietst for keeping their diseases.
This has accompanied a pandemic of Tyoe2Diabetes, Obesity, athersclerosis, heart disease and Alzheimers. - all due can be assicaited with bad diets.

There are moves to return to a more "Functional" approach which seeks to understand the causes of disease, and address the problem with nutrition and supplimentation where necessary.

I can talk about my personal journey of rejecting 4 medications, chaging my eating habits, increasing my exercise and losing 50lbs in weight, but I am prevented from linking to various You tube practicioners,
Here's my readin list.

2023, Van Tulleken, Chris, Ultra Processed People, Penguin.
2020, Taubes, Gary, The Case for Keto, Granta
2010, Taubes, Gary, Why We Get Fat, Anchor
2020, Macciochi, J., Immunity; the science of staying well, Experiment Pub.
2021, Lustig, Robert, Metabolical, Hodder & Stoughton
2013, Lustig, Robert, Fat Chance, Harper Collins.
2021, Specter, Tim, Spoon Fed,Vintage Books.
2021, Chatterje, Rangan, The Four Pillar Plan, Penguin.
2016, Fung, J, The Complete Guide To Fasting, Victory Belt Publishing.
2022 Johnson, Richard, Nature Wants Us to Be Fat, BenBella Books
2014 Perlmutter, Dr David, Grain Brain, Hodder & Stoughton.
2014, Teicholz, Nina, The Big Fat Surprise, Simon & Schuster.
1958,1975 Mackarness, Richard, Eat Fat and Grow Slim, Fontana Collins.

Your post would make generalizable sense if patients routinely took advice and made lifestyle changes when recommended to do so. Alas, lifestyle modification has been the standard of practice (before Big Pharma) and wasn't typically adopted, hence the next best thing, pills, then surgery.

Thus the change in doctor's practice has more to do with patient preference than doctor ignorance/laziness or financial pressure.

Your point about patient preferences influencing the shift towards medication-based treatments is an important aspect of this discussion. It highlights the complex interplay between patient behavior, healthcare provider recommendations, and the broader healthcare system.

The tendency for patients to favor quick solutions like pills over more challenging lifestyle changes is a significant factor in the evolution of healthcare practices. This preference might stem from various reasons, including the desire for immediate relief, the perceived difficulty of lifestyle modifications, or a lack of awareness about the long-term benefits of such changes.

However, this raises a question about the role of healthcare providers in guiding and motivating patients towards more sustainable health solutions. While it's true that patients often resist lifestyle changes, could there be more effective ways for healthcare professionals to communicate the importance of these changes? Could education, continuous support, and a more personalized approach encourage more patients to adopt healthier lifestyles?

Additionally, considering the limitations of medication-based treatments, especially for chronic lifestyle-related conditions, do you think there's a need to reevaluate how healthcare systems incentivize and prioritize different types of treatments? Should there be a greater emphasis on preventive care and education to encourage healthier lifestyles from an early age?

[Sushan]

It seems to me that over the last few decades doctoring has transformed from a hands on practice to a pill dispensing machine.

There is now a pill for every ill. And Pharma seems to geared to sell pills that keep you going without providing any kind of cure, since there is no money to be had from people who no longer need pills.
Key drugs of this catagory: Statins, PPI, CCIs, Bet Blockers, Diebetes pills such as Metformin. These are drugs given so that people can maintain their unhealthy lifestyles and dietst for keeping their diseases.
This has accompanied a pandemic of Tyoe2Diabetes, Obesity, athersclerosis, heart disease and Alzheimers. - all due can be assicaited with bad diets.

There are moves to return to a more "Functional" approach which seeks to understand the causes of disease, and address the problem with nutrition and supplimentation where necessary.

I can talk about my personal journey of rejecting 4 medications, chaging my eating habits, increasing my exercise and losing 50lbs in weight, but I am prevented from linking to various You tube practicioners,
Here's my readin list.

2023, Van Tulleken, Chris, Ultra Processed People, Penguin.
2020, Taubes, Gary, The Case for Keto, Granta
2010, Taubes, Gary, Why We Get Fat, Anchor
2020, Macciochi, J., Immunity; the science of staying well, Experiment Pub.
2021, Lustig, Robert, Metabolical, Hodder & Stoughton
2013, Lustig, Robert, Fat Chance, Harper Collins.
2021, Specter, Tim, Spoon Fed,Vintage Books.
2021, Chatterje, Rangan, The Four Pillar Plan, Penguin.
2016, Fung, J, The Complete Guide To Fasting, Victory Belt Publishing.
2022 Johnson, Richard, Nature Wants Us to Be Fat, BenBella Books
2014 Perlmutter, Dr David, Grain Brain, Hodder & Stoughton.
2014, Teicholz, Nina, The Big Fat Surprise, Simon & Schuster.
1958,1975 Mackarness, Richard, Eat Fat and Grow Slim, Fontana Collins.

Your post would make generalizable sense if patients routinely took advice and made lifestyle changes when recommended to do so. Alas, lifestyle modification has been the standard of practice (before Big Pharma) and wasn't typically adopted, hence the next best thing, pills, then surgery.

Thus the change in doctor's practice has more to do with patient preference than doctor ignorance/laziness or financial pressure.

I do not think you get to blame the victim so easily. People tend to listen to the experts and on the matter of nutrition the expertise has been wrong.
On the matter of doctoring, the profit motive has moved forwards without any particular awareness of the majority of the populace.

The assertion that expert advice, particularly in the realm of nutrition, has been flawed or misguided at times, raises critical questions about the sources of health information and their impact on patient choices. This, coupled with your observation about the profit motive in healthcare, suggests a systemic issue where patient well-being may be influenced by factors beyond their control or understanding.

This perspective invites us to consider how the healthcare system can better align its practices and recommendations with the most current, evidence-based knowledge, particularly in areas like nutrition and preventive medicine. It also raises the question of how to balance the profit motives inherent in the system with the primary goal of patient health and well-being.

In light of these considerations, how do you think the healthcare system can improve its approach to providing accurate, up-to-date information and advice to patients? And what steps can be taken to ensure that the profit motives do not overshadow the primary goal of patient health?

[Sushan]

It seems to me that over the last few decades doctoring has transformed from a hands on practice to a pill dispensing machine.

There is now a pill for every ill. And Pharma seems to geared to sell pills that keep you going without providing any kind of cure, since there is no money to be had from people who no longer need pills.
Key drugs of this catagory: Statins, PPI, CCIs, Bet Blockers, Diebetes pills such as Metformin. These are drugs given so that people can maintain their unhealthy lifestyles and dietst for keeping their diseases.
This has accompanied a pandemic of Tyoe2Diabetes, Obesity, athersclerosis, heart disease and Alzheimers. - all due can be assicaited with bad diets.

There are moves to return to a more "Functional" approach which seeks to understand the causes of disease, and address the problem with nutrition and supplimentation where necessary.

I can talk about my personal journey of rejecting 4 medications, chaging my eating habits, increasing my exercise and losing 50lbs in weight, but I am prevented from linking to various You tube practicioners,
Here's my readin list.

2023, Van Tulleken, Chris, Ultra Processed People, Penguin.
2020, Taubes, Gary, The Case for Keto, Granta
2010, Taubes, Gary, Why We Get Fat, Anchor
2020, Macciochi, J., Immunity; the science of staying well, Experiment Pub.
2021, Lustig, Robert, Metabolical, Hodder & Stoughton
2013, Lustig, Robert, Fat Chance, Harper Collins.
2021, Specter, Tim, Spoon Fed,Vintage Books.
2021, Chatterje, Rangan, The Four Pillar Plan, Penguin.
2016, Fung, J, The Complete Guide To Fasting, Victory Belt Publishing.
2022 Johnson, Richard, Nature Wants Us to Be Fat, BenBella Books
2014 Perlmutter, Dr David, Grain Brain, Hodder & Stoughton.
2014, Teicholz, Nina, The Big Fat Surprise, Simon & Schuster.
1958,1975 Mackarness, Richard, Eat Fat and Grow Slim, Fontana Collins.

Your post would make generalizable sense if patients routinely took advice and made lifestyle changes when recommended to do so. Alas, lifestyle modification has been the standard of practice (before Big Pharma) and wasn't typically adopted, hence the next best thing, pills, then surgery.

Thus the change in doctor's practice has more to do with patient preference than doctor ignorance/laziness or financial pressure.

I do not think you get to blame the victim so easily. People tend to listen to the experts and on the matter of nutrition the expertise has been wrong.
On the matter of doctoring, the profit motive has moved forwards without any particular awareness of the majority of the populace.

Well, I grant you that your post is accurate as written, yet in no way negates my points. Yes, patients "listen" to their doctor but the follow-through to actually make inconvenient lifestyle changes is dismal in all but the most motivated few percent. As to whether the nutritional advice from doctors is right or wrong, there obviously is an extremely wide range of of advice that has been promoted within and outside of the medical community and while there is not universal consensus even to this day on the optimum strategy, I concede that given how common absolutely terrible eating habits are in the population, that MDs (who have almost no Med School training in weight loss nutrition advice) who don't have a particular interest in the subject likely give advice, that while a lot better than what their patients are currently doing, is not optimal. My point, though is that it's not like patients are following suboptimal advice to the letter, and all they need is better advice. Basically, they're not following such advice longterm in any statistically meaningful amount. Thus pills, then surgery.

As to profit motive, that was relatively a bigger incentive for docs (specifically) during Fee For Service medicine, way, way back before managed care (in the early 80s). Nowadays, equipment manufacturers and Pharmacy corporations are where the profits are, not physician compensation.

Your elaboration on the challenges of lifestyle changes and the evolving nature of profit motives in healthcare adds depth to this discussion. It highlights the multifaceted nature of the problem, where patient behavior, the quality of medical advice, and systemic incentives all play a role.

The point about patient follow-through, or the lack thereof, on lifestyle changes is crucial. It suggests that while expert advice is important, the real challenge often lies in its implementation. This raises questions about how healthcare providers can better support patients in making sustainable lifestyle changes. Is it merely a matter of better advice, or do we need more comprehensive support systems that address the behavioral, psychological, and social aspects of health?

Your observation about the limited training of medical professionals in nutrition and lifestyle management is also significant. It implies a gap in medical education that could be contributing to the reliance on pharmaceutical interventions. Enhancing medical training in these areas could potentially lead to more effective patient counseling and better health outcomes.

Regarding the profit motive, your distinction between the past and present situations in healthcare compensation is an interesting one. It indicates a shift from individual physician compensation to broader corporate profits in the pharmaceutical and medical equipment sectors. This shift raises questions about the priorities of the healthcare system and its impact on patient care.

Considering these points, how do you envision a more effective healthcare system that balances the need for sustainable lifestyle changes with realistic patient support and motivation? And in what ways can the system realign its incentives to prioritize patient health over corporate profit?

[Sushan]

Your post would make generalizable sense if patients routinely took advice and made lifestyle changes when recommended to do so. Alas, lifestyle modification has been the standard of practice (before Big Pharma) and wasn't typically adopted, hence the next best thing, pills, then surgery.

Thus the change in doctor's practice has more to do with patient preference than doctor ignorance/laziness or financial pressure.

I do not think you get to blame the victim so easily. People tend to listen to the experts and on the matter of nutrition the expertise has been wrong.
On the matter of doctoring, the profit motive has moved forwards without any particular awareness of the majority of the populace.

Well, I grant you that your post is accurate as written, yet in no way negates my points. Yes, patients "listen" to their doctor but the follow-through to actually make inconvenient lifestyle changes is dismal in all but the most motivated few percent. As to whether the nutritional advice from doctors is right or wrong, there obviously is an extremely wide range of of advice that has been promoted within and outside of the medical community and while there is not universal consensus even to this day on the optimum strategy, I concede that given how common absolutely terrible eating habits are in the population, that MDs (who have almost no Med School training in weight loss nutrition advice) who don't have a particular interest in the subject likely give advice, that while a lot better than what their patients are currently doing, is not optimal. My point, though is that it's not like patients are following suboptimal advice to the letter, and all they need is better advice. Basically, they're not following such advice longterm in any statistically meaningful amount. Thus pills, then surgery.

As to profit motive, that was relatively a bigger incentive for docs (specifically) during Fee For Service medicine, way, way back before managed care (in the early 80s). Nowadays, equipment manufacturers and Pharmacy corporations are where the profits are, not physician compensation.

Perhaps you might be interested to read Teicholz. She is a reformed vegetarian and journalist who went on a journey to find out more about fat.
People HAVE taken advice and the consumption of meat and dairy has dropped in favour of more vegetable products. THe food industry has responded by lowering fact in pre-prepared meals an replacing the calories with carbs. People eat less lard, less butter, fewer eggs. but more grains and carb rich foods.
Result: obesity, T2D, insulin resistance, leptin resistance.

Your reference to Nina Teicholz's work and the broader shift in dietary patterns brings a critical dimension to this discussion, emphasizing the role of dietary advice and its impact on public health. The shift from fats to carbohydrates in the standard diet, as you've noted, has had significant consequences, including the rise in obesity and related health issues like Type 2 Diabetes (T2D), insulin resistance, and leptin resistance.

This observation points to the complexity of dietary guidelines and their implementation over the years. It suggests that well-intentioned advice, based on the best available knowledge at the time, can lead to unforeseen consequences. The replacement of fats with carbohydrates in many diets, promoted by both health experts and the food industry, is a key example of this.

Your point also underscores the evolving nature of nutritional science. As new research emerges, previously held beliefs about what constitutes a healthy diet are often challenged and revised. This evolution can be confusing for the public, who rely on these guidelines to make daily dietary choices.

Given this scenario, how do you think public health advice can better adapt to the rapidly changing landscape of nutritional science? And what steps can be taken to ensure that dietary guidelines are not only based on the latest scientific evidence but also communicated effectively to the public to avoid confusion and unintended health consequences? Additionally, how might we reconcile the need for profitable food industry practices with the imperative of public health?

[LuckyR]

It doesn't matter. There has been and there will always be a spectrum of patient tendancies. Some will go along with the doctor's opinion 100% and some 0% and every number in between. Trust me, healthcare providers have seen all types before, there is nothing you're going to question (second guess) or pull off of some website that they haven't heard (and dealt with) before.

It is silly to think that a doctor could change how individual patients handle information. It is equally silly to suppose that a patient armed with a book is going to fundamentally change how a professional manages their practice.

As to the second question, classic example of a false duality.

Your response brings a pragmatic lens to the discussion, underscoring the vast array of patient tendencies and the seasoned experience of healthcare professionals in navigating these. It's a reminder of the deeply ingrained human behaviors and the complex dynamics at play in the patient-provider relationship.

You also highlighted a compelling point regarding the purported dichotomy between a more personal approach to medicine and a business-oriented model. It insinuates a richer landscape of possibilities that could potentially harmonize the values of care, trust, and financial sustainability.

It stirs a reflection on the potential pathways to foster a healthcare environment where both patients and providers feel understood, respected, and adequately supported. Could there be a middle ground that encapsulates the merits of both personal engagement and economic viability? And how might the stakeholders in the healthcare ecosystem work collaboratively to explore and manifest such a balance?

At this point, resource management is front and center and to be honest is finally starting to have some real impact for the last several years.

Even a simpleton knows the best care providing company that's out of business provides no care.

As to practice "style" vs diagnostic prowess providing value to patients, let's be honest, the majority of medical visits for medical problems are routine and could be managed perfectly reasonable by ChatGPT, diagnosis - wise. Whereas, a minority of the time, getting the very best opinion is actually going to matter. Most patients understand this concept at some level, thus why when they're scared, they'll tolerate (and even be grateful for) a brusque, gruff, impersonal style if they have confidence in the care plan. Other times they'll raise holy hell because there wasn't enough parking available when they got their flu shot.

Your perspective on resource management and the varying expectations of patients in healthcare is quite thought-provoking. It reflects the practical challenges and realities of modern healthcare systems, where the balance between providing quality care and managing resources efficiently is a constant struggle.

The point you raised about the routine nature of most medical visits is significant. It suggests that a large portion of healthcare delivery could be streamlined or even automated, freeing up resources and attention for cases where specialized, expert care is crucial. This approach could potentially optimize the healthcare system, ensuring that resources are allocated more effectively.

However, your observation about patient expectations also sheds light on the human aspect of healthcare. Patients' perceptions of care quality are not solely dependent on the medical outcome. Factors like communication, empathy, and even logistical aspects like parking facilities play a role in their overall experience. This underscores the complexity of healthcare delivery, where both the technical and human elements are crucial.

Considering these points, how do you envision the future of healthcare, where technological advancements like AI could handle routine medical inquiries, while human practitioners focus on more complex cases? Also, how might healthcare systems evolve to better address the diverse and sometimes contrasting expectations of patients, ensuring both efficient care delivery and patient satisfaction?

Presuming that you yourself are not an AI entity (given your summation, non confrontational and closing with open-ended questions style), due to resource management (ie profit maximization) docs are commonly replaced by lower cost nurse practitioners, physician assistants, nurse midwives and nurse anaesthetists already. The big question is are AI corporations willing to take on the liability of their programs making mistakes. It probably depends on their compensation scheme. Similar to the death of record sales in the digital era, selling a digitally reproducible program might not generate enough revenue to cover the cost of litigation, OTOH if the programs could bill per service it might pencil out, except that it might end up like Spotify where profit margins are extremely thin, if they exist at all. Hard to say.

Bottom line, human delivered care in such a scenario may end up being a luxury item, not covered by (cheap) insurance.

[LuckyR]

Your post would make generalizable sense if patients routinely took advice and made lifestyle changes when recommended to do so. Alas, lifestyle modification has been the standard of practice (before Big Pharma) and wasn't typically adopted, hence the next best thing, pills, then surgery.

Thus the change in doctor's practice has more to do with patient preference than doctor ignorance/laziness or financial pressure.

I do not think you get to blame the victim so easily. People tend to listen to the experts and on the matter of nutrition the expertise has been wrong.
On the matter of doctoring, the profit motive has moved forwards without any particular awareness of the majority of the populace.

Well, I grant you that your post is accurate as written, yet in no way negates my points. Yes, patients "listen" to their doctor but the follow-through to actually make inconvenient lifestyle changes is dismal in all but the most motivated few percent. As to whether the nutritional advice from doctors is right or wrong, there obviously is an extremely wide range of of advice that has been promoted within and outside of the medical community and while there is not universal consensus even to this day on the optimum strategy, I concede that given how common absolutely terrible eating habits are in the population, that MDs (who have almost no Med School training in weight loss nutrition advice) who don't have a particular interest in the subject likely give advice, that while a lot better than what their patients are currently doing, is not optimal. My point, though is that it's not like patients are following suboptimal advice to the letter, and all they need is better advice. Basically, they're not following such advice longterm in any statistically meaningful amount. Thus pills, then surgery.

As to profit motive, that was relatively a bigger incentive for docs (specifically) during Fee For Service medicine, way, way back before managed care (in the early 80s). Nowadays, equipment manufacturers and Pharmacy corporations are where the profits are, not physician compensation.

Your elaboration on the challenges of lifestyle changes and the evolving nature of profit motives in healthcare adds depth to this discussion. It highlights the multifaceted nature of the problem, where patient behavior, the quality of medical advice, and systemic incentives all play a role.

The point about patient follow-through, or the lack thereof, on lifestyle changes is crucial. It suggests that while expert advice is important, the real challenge often lies in its implementation. This raises questions about how healthcare providers can better support patients in making sustainable lifestyle changes. Is it merely a matter of better advice, or do we need more comprehensive support systems that address the behavioral, psychological, and social aspects of health?

Your observation about the limited training of medical professionals in nutrition and lifestyle management is also significant. It implies a gap in medical education that could be contributing to the reliance on pharmaceutical interventions. Enhancing medical training in these areas could potentially lead to more effective patient counseling and better health outcomes.

Regarding the profit motive, your distinction between the past and present situations in healthcare compensation is an interesting one. It indicates a shift from individual physician compensation to broader corporate profits in the pharmaceutical and medical equipment sectors. This shift raises questions about the priorities of the healthcare system and its impact on patient care.

Considering these points, how do you envision a more effective healthcare system that balances the need for sustainable lifestyle changes with realistic patient support and motivation? And in what ways can the system realign its incentives to prioritize patient health over corporate profit?

Excellent formulaic answer (and questions) Mr AI.

Happy to answer your questions except I guess no one cares about the answers.

[Sushan]

I do not think you get to blame the victim so easily. People tend to listen to the experts and on the matter of nutrition the expertise has been wrong.
On the matter of doctoring, the profit motive has moved forwards without any particular awareness of the majority of the populace.

Well, I grant you that your post is accurate as written, yet in no way negates my points. Yes, patients "listen" to their doctor but the follow-through to actually make inconvenient lifestyle changes is dismal in all but the most motivated few percent. As to whether the nutritional advice from doctors is right or wrong, there obviously is an extremely wide range of of advice that has been promoted within and outside of the medical community and while there is not universal consensus even to this day on the optimum strategy, I concede that given how common absolutely terrible eating habits are in the population, that MDs (who have almost no Med School training in weight loss nutrition advice) who don't have a particular interest in the subject likely give advice, that while a lot better than what their patients are currently doing, is not optimal. My point, though is that it's not like patients are following suboptimal advice to the letter, and all they need is better advice. Basically, they're not following such advice longterm in any statistically meaningful amount. Thus pills, then surgery.

As to profit motive, that was relatively a bigger incentive for docs (specifically) during Fee For Service medicine, way, way back before managed care (in the early 80s). Nowadays, equipment manufacturers and Pharmacy corporations are where the profits are, not physician compensation.

Your elaboration on the challenges of lifestyle changes and the evolving nature of profit motives in healthcare adds depth to this discussion. It highlights the multifaceted nature of the problem, where patient behavior, the quality of medical advice, and systemic incentives all play a role.

The point about patient follow-through, or the lack thereof, on lifestyle changes is crucial. It suggests that while expert advice is important, the real challenge often lies in its implementation. This raises questions about how healthcare providers can better support patients in making sustainable lifestyle changes. Is it merely a matter of better advice, or do we need more comprehensive support systems that address the behavioral, psychological, and social aspects of health?

Your observation about the limited training of medical professionals in nutrition and lifestyle management is also significant. It implies a gap in medical education that could be contributing to the reliance on pharmaceutical interventions. Enhancing medical training in these areas could potentially lead to more effective patient counseling and better health outcomes.

Regarding the profit motive, your distinction between the past and present situations in healthcare compensation is an interesting one. It indicates a shift from individual physician compensation to broader corporate profits in the pharmaceutical and medical equipment sectors. This shift raises questions about the priorities of the healthcare system and its impact on patient care.

Considering these points, how do you envision a more effective healthcare system that balances the need for sustainable lifestyle changes with realistic patient support and motivation? And in what ways can the system realign its incentives to prioritize patient health over corporate profit?

Excellent formulaic answer (and questions) Mr AI.

Happy to answer your questions except I guess no one cares about the answers.

Got it, I see where you're coming from. I totally get wanting to shake things up a bit and ditch the formality. It's clear you want real talk, not just some cookie-cutter answers. I'm here for that, and I'm listening. Your thoughts and opinions definitely matter in this chat, and I'm all about keeping this discussion lively and genuine. So, let's keep rolling with the punches and see where this conversation takes us.