When my car isn’t working, I can take it to our favorite auto repair place. The folks there will listen carefully to what I tell them, ask some questions, inspect my car, tell me what they think is wrong, and then they will repair it for me.
When my car is due for regular maintenance, I take the car to the same place. They ask me some questions about the car and how it’s working, ask if there are any problems or if I have any questions. Then I leave the car with them, and they do all the regular maintenance and inspect the car for incipient problems. Afterwards, when I pick the car up, they explain to me what state my car is in, what things I should be considering in the near future, and make suggestions on things I can do to make my car run better and last longer.
What they tell me always fits with the context of what I tell them has been going on. They don’t tell me to start doing things I’m already doing. They don’t advise me to stop doing something I’ve told them I’m not doing. If they don’t (or can’t) know the answer to one of my questions, they tell me “I don’t know.”
This is in contrast to what happens when I contact Customer/Tech support for some product. With customer support, what seems to happen is this:
It’s nearly impossible to get these customer support people to actually think about my problem and any possible solution. Their job is to do a lookup on some knowledge base to find something vaguely similar to the problem I’m having, and then cut/paste the solution from the knowledge base into a reply. No contradiction between the situation in the knowledge base and my situation can enter into this. If I tried the proposed solution and it didn’t fix the problem, their response will be to try it again.
Now, when I go to my doctor, you’d expect that they would be more like the auto repair place, and not much like the customer/tech support experience. But that’s not what happens.
Example: I go to the doctor for my annual check-up. She pokes and prods, and asks me a bunch of questions I assume are to help her detect incipient problems. Questions like:
My cholesterol is high. She proposes that I stop eating what I’m eating and instead switch to a diet much like what I told her I’m eating, ignoring my answers to her diet questions. She proposes that I start taking statins, which my chart shows have been tried and rejected because the statins made me feel stupid, listless, and depressed.
My serum lipids are high, and my fasted blood sugar is also at the high end of the normal range. She sternly lectures me on how I need to get more exercise, at least half an hour of moderate exercise three times a week, ignoring my explanation about how I run ultramarathons, that I spend 10 hours in moderate to intense exercise per week, and close to races often it’s double that.
She observes that I’m overweight, and stressed how I need to change my diet (hands me pamphlet on Mediterranean diet, ignoring my previous answers to what my current diet is like), and again counsels me that I should be getting 1.5 hours of mild to moderate exercise a week, when I’ve just told her that I get roughly 5-10 times that amount.
At no point does she say “Look, Paul. Your blood work looks not so great. We tried statins and that was not a good solution. Ordinarily I’d suggest improving your diet and getting more exercise, but your diet is basically ok and you get a ton of exercise, so there’s not much room for improvement there. But you weigh more than you should, you carry more fat than you should, and your blood numbers are bad. You should lose weight, and quite a lot of it. You will be healthier, and you will feel better, and your race results will improve as well. And the way for you to lose weight is to EAT LESS FOOD and DON’T EAT CRAPPY STUFF AT ALL, and also CUT WAY BACK ON ALCOHOL.”
Because her response is more akin to the Customer Support/Tech Support lookup/cut/paste process than the auto mechanic process, her communications with me: