I often get patients who expect me to blame them. Sometimes it's not really volitional - guilt is a common emotion. But other times it's a learned behavior. They don't feel like they're really "going to the doctor" if someone doesn't wag their finger at them and call them BAD BAD BAD for not "living healthy." If you're expecting moralizing, I'm not gonna. I don't think you're a bad person for not following physicians' guidelines. Most of the time, PHYSICIANS don't follow physicians' guidelines.
The author of Talking To Your Doctor and Making Sense of Medicine blogs about the books, shared decision making, doctor-patient communication, and the redeemable imperfections of healthcare.