I think the doctors just stop caring at a certain point and appease them. They know the hams aren't going to do anything to correct the issue so why bother? But that's why my doctor is awesome. There's no hams that go to him cause he shames the fuck out of everyone. Smoke, drink too much? He has it written in your file and will bring it up every time he sees you whether you stopped or cut down and will tell you how you're destroying your body.