Thanks for your comment, Sasha.

When it comes to behavior change it turns out that different people want different things from their doctors, and what works well for one patient might not work at all for another. (And I do want to emphasize that we're not talking about acute situations--no one wants their doctor to see them bleeding and ask if it's ok to offer a treatment recommendation.) I imagine that, the first time a doctor might check with you before raising the topic of your diet or weight or smoking or stress level, you would reply similarly to what you've said here--and I would hope that your doctor would respect your wishes from that point forward by simply telling you whatever he sees or thinks. For many patients, though, the prospect of have their doctor give them information they already know or tell them to change things they've already been struggling to change--without any understanding or awareness of their history and experience with those behaviors--is quite off-putting. And the best way for the doctor to find out who is who, and create an effective doctor-patient relationship, is to ask.

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