The Fat Doctor Podcast When Healthcare Becomes Compliance Theater
Nov 19, 2025
A critique of how diabetes care has shifted into administrative theater with goal forms and confidence scales. A fictional patient’s journey reveals medication side effects, intolerances, and abandoned treatments. The episode examines infantilizing clinic practices, shifted responsibility onto patients, and how stigma and poor administration drive people away from care.
AI Snips
Chapters
Transcript
Episode notes
Cascading Medication Failures
- Asher Larmie tells Cosmo's fictional medication journey from metformin to multiple intolerable or ineffective drugs.
- The story illustrates how treatments and side effects (diarrhea, frequent urination, vomiting) pile up before effective control is achieved.
Nurse Marie And Sulfonylureas
- Asher recounts nurse Marie teaching that diabetes is 'easy to treat' and historical use of gliclazide (a sulfonylurea).
- He explains sulfonylureas work well but fell out of favor largely because they cause weight gain.
Pre-Appointment Goal Forms Infantilize Patients
- Referral paperwork asks patients to 'think about what results mean to you' and set goals before meeting clinicians.
- Asher argues these forms infantilize patients and mix important medical checks with moralising items like 'avoid sugary foods.'