I have two things that keep rattling around in my mind. First, a negative review of a new client we’ll be starting with tomorrow: a patient complained that their doctors were judgmental.

Then, since I have been listening to How Not to Die while driving and while doing chores today, I am also thinking about how avoidable and reversible so many health issues are. If we will eat right and exercise, quit smoking or using other drugs, manage stress well and sleep… we are far less likely to end up with any of the degenerative diseases Americans usually die from.

So would it be judgmental for a doctor to tell us to quit eating bacon cheeseburgers? To take up strength and cardio training? To drink less beer and more water? To give up risky sex and take up good sleep hygiene?

Or would it be the right and responsible thing to do, as opposed to handing out prescriptions and accepting excuses?

Of course, I have no idea what kind of judgement the reviewer had experienced. But the book’s author claims that doctors don’t tell patients to change their diets or to exercise because mostly people won’t. They’d rather have pills.

That seems very wimpy. But if you know that you’ll have patients going online and saying that you’re judgmental, is it better to touch lightly on lifestyle choices and then move firmly on to statins and such? Maybe so.

I think I’d rather have a judgmental doctor, though.