Do you binge?

Once a year, the government of Canada would like you to see your family doctor for a preventative health visit. In fact, they would like it so much that they will give your family doc a bonus for filling out the "annual health check" forms.

This is good for many reasons.

1. The annual health check asks the same questions of everyone. It standardizes things so you get the same level of care, regardless of who your doctor is.
2. It creates a framework that can be compared from year to year so you can monitor chronic conditions.
3. Your family doc needs a donut fund so that every day (and not just Friday) has a desk-donut.

The drawback is this: The annual health check asks the same questions of everyone.

My 80 year old patients laugh when I ask them about their libido & recent sexual partners. (Or more disturbingly, they TELL ME DETAILS.)
My 20 year old patients look horrified as I ask them about chest pain, urinary incontinence, haemorrhoids & erectile dysfunction. (But again, there's always one...)

Honestly, the questions that bother me the most are related to drinking.

I feel totally confident saying to my 45 year old patients, "You need to have a maximum of two alcoholic drinks per day and at least one alcohol-free day per week."

But when a 29 year old says, "I don't drink regularly, often go up to a month without drinking, but then I drink 5-10 drinks in one night", I pause.

This is, clearly, unhealthy binge drinking.
This is also my exact answer.

I don't know anyone in my peer group who doesn't drink like this. The days of a drink before dinner and a nightcap before bed are gone. People in my age group (scientific polling of my friends, n= 20) have big nights, pub nights, dinner parties, etc where alcohol is consumed in mass quantities, but they don't drink between occasions.

As a result, I don't know what to say to my patients. I cop out. I read them the spiel of 1-2 max. I suggest that they alternate water with their alcoholic beverages. I vigorously counsel them against drunk driving, unprotected sex, walking alone, and risk-taking behaviours. I give them fistfuls of condoms and test them for STI's & liver damage. I try to explain why they should stop. But I can't tell them to stop without being hypocritical.

As a result, I do not go for my annual health check. Which means that somewhere in Toronto, there's a doctor without a desk-donut, all because I am a hypocrite. But everyone else is doing it...