Health and Hypocrisy: Should We All “Practice What We Preach?”

Do outside appearances imply knowledge? Must one “look the part” to “play the part?”

I have asked myself both of these questions recently, after having witnessed some back-and-forth on twitter between health professionals.

From what I can remember, the exchange went something like this. Dietician #1 sends out a tweet where she either solicited some sort of nutrition advice, or tweeted about how one or more dietary recommendations might be misguided (I think she was down-playing the low-carbohydrate diet, but I may be wrong). In response to this, Dietician #2 quoted the tweet, and added some disparaging mark about how Dietician #1 is overweight, can’t even follow her own advice, and thus should not be taken seriously. This unwound into a frenzy of Tweets both in support of Dietician #1 as well as more incipient remarks about how, indeed, Dietician #1 was more or less restricted in her input on the topic.

Essentially, Dietician #1 was ousted from her title as a licensed health professional because she was overweight. Her opinion (and expertise) was invalidated simply due to her appearance.

I began to ask myself the question. It it necessary for someone in any profession to “walk the walk” if they are to dispense similar advice to patients, clients, even friends and family? Does a personal trainer have to work out and be >10% body fat? Does the owner of a vegan restaurant need to abstain from meat? Does a doctor need to take pristine care of his body and exercise regularly, avoid smoking cigarette, and swallow the same metaphorical and literal pills he dispenses to his own patients?

We could list these situations ad infinitum. Add any profession “x” and decide whether or not an actor in profession x, to be successful or reputable at their job, must do exactly for themselves what their job title entails in the “work sphere”. I am going to call this “work expertise-life habit symmetry”.

The answer to the above question, whether or not this “work expertise-life habit symmetry” should be a requirement for any academic or business professional is clearly no. One doesn’t NEED to follow their own advice in order for their advice to have a positive affect on the receiver. There are numerous successful doctors who smoke, plenty of overweight personal trainers, and perhaps that one guy who works at the local vegan restaurant who returns home to eat an 8oz ribeye for dinner. “Walking the walk” is neither necessary nor sufficient to be successful in any profession. One can gain the knowledge of how to properly care for sick individuals, then immediately disregard the knowledge in one’s own life, so long as that the two spheres — work and personal life — are separate.

The question now becomes, SHOULD this asymmetry exist; whereby it becomes more a problem of morality and ethics than professional capability. There is a name for those who dispense facts and advice, only to turn around and do the opposite behind close doors.

Hypocrites.

hypocrite [hip-uh-krit]

noun

1. a person who pretends to have virtues, moral or religious beliefs, principles, etc., that he or she does not actually possess, especially a person whose actions belie stated beliefs.

2. a person who feigns some desirable or publicly approved attitude, especially one whose private life, opinions, or statements belie his or her public statements.

Is hypocrisy in medicine or healthcare O.K? An argument in favor of hypocrisy may include that stipulation that, so long as a doctor follows the “Hippocratic Oath” of “first, do no harm,” he or she can indulge in whatever bacchanal they so choose…outside the clinic at least.

(An interesting note here; Hippocrates, the Greek physician, and “hypocrite”, while homonyms, are unrelated in their etymology. But, I’m glad I could fit both into the same story).

However, this leaves some ethical qualms to be discussed. The “anti-hypocrisy” arguement is two-pronged.

If a healthcare professional is failing to “practice what they preach”, we should begin to question whether or not what they preach is actually what they believe. The medical knowledge learned in training may turn out to be something that our seemingly hypocritical doctor never bought into, but nonetheless is “required” to allocate to his patients. To advise one diet and eat another — wouldn’t this suggest that the “advised” diet, perhaps, isn’t one our prescriber deems optimal? Maybe this is a form of sub-concious hypocrisy; someone just doing what they’ve been taught and not bothering to disrupt the system. “Ill just take care of myself.”

If we do some mental rearrangement, hypocrisy in medicine and healthcare, i.e. not “practicing what you preach” does, in a way, violate the Hippocratic oath. Assuming that the healthcare professional is dispensing the advice deemed to be the most beneficial to health, then by not following this advice, they are putting themselves at risk. Failing to keep oneself in the highest physical and mental status IS harming the patient; they aren’t receiving the best care that they possibly could. A doctor in ill health, it might be said, can’t possibly provide his patients with the best possible care, for he himself isn’t functioning at his peak

While doing harm to oneself isn’t necessarily equal to doing direct harm to someone you care for, it can clearly be suggested that those relying on your expertise deserve the best version of you.

Looking part isn’t a prerequisite for knowledge, we have established that. However, it stands to reason that while we shouldn’t discount someone who doesn’t practice what they preach, we should at least question their motives, their knowledge, and possibly their intent.

I have caught myself multiple times throughout the past month committing this logical fallacy. I see someone in scrubs smoking a cigarette and immediately mark them as careless, as a hypocrite.

However, I must acknowledge that I am unaware of the complexity of anyone else’s life, all of the factors involved in their career choice or their habits. What is going on inside the complex meshwork of neurons of any one person is beyond me…probably even beyond them.

Sometimes, we must take the doctrine of “first, do no harm” and decide, that, if followed, might just be sufficient. If we can all agree on this precedent, in medicine, if not in life as a whole, I think we will all get along just fine.