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I've shadowed a doctor who had a patient write letters to him complaining about how he approached her weight issue. She came in to the Orthopedic surgeon I was following, complaining of back and shoulder pain.
She wasn't interested in physical therapy, so he simply said the best way to help ease her pain was to stop smoking and lose her excess weight. I was there for the appointment in question, and I saw the letter she wrote. While she was angry about a number of other things (time spent waiting, short visit length with the doctor, my presence in the examination room - which I might add he asked her if it was okay that I was in the room - the list went on) she spent the most significant portion of her time bitching about him only reccomending weight loss.
The point of the story is, tact or no tact, some people simply get upset over things that they shouldn't. As a future doctor, I know that my duty will be to promote the health of my patients, and while I'd like to think that each time I'll do so as tactfully as possible, I think I know that I'm not going to allow dancing around the issue to interfere with my duty as a physician. If this really was a patient he had seen over and over again, I believe that he was simply trying to emphasize the overall importance of his point.
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