[a1studmuffin]

Your health is ultimately your own responsibility - it's your body. You have free will, and your appetite for risk is yours alone. You can choose to ignore expert advice and refuse to wear a seatbelt, skip your rehabilitation exercises, invest all-in on crypto, or smoke cigarettes. None of this responsibility should fall on the expert if they communicated the risks clearly.

[getnormality]

What you're communicating here, perhaps unintentionally, is that what matters is not results, but blame. If the doctor said what to do but the patient didn't do it, all that matters is the patient is to blame.

You've communicated that by ignoring or dismissing the question of whether better outcomes are possible through other means than demanding that everyone follow doctors' orders and blaming them if they don't.

"Who cares if better outcomes are possible, so long as blame is in the right place"? Is that how we want to approach this?

[recursive]

It's hard to help someone that doesn't want to be helped.

[UltraSane]

The old adage "You can lead a horse to water but you can't make it drink" applies here.

[vacuity]

It may not be the case for statins specifically, but my main concern is side effects. If there was a panacea, I would support giving it to everyone, but lifestyle changes are usually more available, if not easier.

[EasyMark]

Yeah this prickles my hackles too. It took a fairly high dosage of zepbound and many months for me to get to a normal set of eating habits after a couple of decades of bad, but a prediabetes scare surprise on my labs pushed me into the program, but I would not have done it by "white knuckling". I needed some medication to help me along. All these people just saying "calories in and calories out" "just start exercising dude" are making a complex issue into a "simple solution" that almost never works because change takes time; a lot of time that many people don't feel on a deep level that they have to apply to it. So, they just give up after a couple of weeks of "grit" and "will-power". Isn't it like maybe 1-3% succeed over time, while the rest fail when trying to lose significant weight or other health issues that could be resolved with habit only?

[btilly]

If my health is my responsibility, then shouldn't the treatment that I receive be to the standard that I request?

In 2015, https://pubmed.ncbi.nlm.nih.gov/26551272/ showed that medicating all of the way to normal works out better than medicating down to stage 1 hypertension, then insisting on diet and exercise. And yet my request in 2018 to be medicated down to normal blood pressure was refused, because the professional guidelines followed by the experts was to only medicate down to stage 1 hypertension, then get the patient to engage with diet and exercise. The expert standard of care was literally the opposite of what research had shown that they should do.

I agree that experts should not be accountable for my laziness. But can you agree that experts should be accountable for following standard of care guidelines that are in direct conflict with medical research? And (as in my case) refusing the patient's request to be treated in a way that is consistent with what medical research says is optimal?

[mrlongroots]

Maybe 80-90% of people should take doctors at face value, but it is easy and only getting easier to at least access the knowledge to better advocate for your own healthcare (thanks to LLMs), with better outcomes. Of course, this requires doctors that respect your ability to provide useful inputs, which in your case did not happen.

My advice would be to "shop around" for doctors, establish a relationship where you demonstrate openness to what they say, try not to step on their toes unnecessarily, but also provide your own data and arguments. Some of the most "life-changing" interventions in terms of my own healthcare have been due to my own initiative and stubbornness, but I have doctors who humor me and respect my inputs. Credentials/vibes help here I think: in my case "the PhD student from the brand name school across the street who shows up with plots and regressions" is probably a soft signal that indicates that I mean business.

[ac29]

> In 2015, https://pubmed.ncbi.nlm.nih.gov/26551272/ showed that medicating all of the way to normal works out better than medicating down to stage 1 hypertension

Thanks for posting this. While I would generally advise a healthy dose of skepticism for any individual study, this one was very large and seems to be both well designed and executed. While there was a (statistically) significant increase in side effects with more intensive treatments, only about 1% more patients had adverse effects versus the standard treatment group, which seems like a very reasonable risk given the improved outcomes.

I've been trying to get my blood pressure under control recently and was thinking getting down to 12x/8x was good enough, but this has me rethinking that.

[gropo]

You should have bought some illegal street diet and exercise or cholesterol meds or whatever.

[kelseyfrog]

What if you have an intrinsically lower ability to perform temporal discounting?

[nradov]

Is that really something intrinsic and fixed or can you improve it over time with deliberate effort?