'Is pooping your pants worse than high cholesterol?'

Physician Scott Jensen, MD, thinks we’re asking the wrong clinical questions—and missing what actually matters to patients.

In a recent Instagram Reel, he shares the story of an 87-year-old man who was afraid to leave the house—not because of chest pain or fall risk, but because he might lose control of his bowels in public. The man had been on a statin for 20 years. And while the medication may have once made sense, Jensen questioned whether it was still worth the trade-off.

When Dr. Jensen searched “what drugs cause fecal incontinence,” he noticed something troubling. “The first article I found never even mentioned statins,” he said. “Then I found numerous articles from highly regarded academic centers across the world identifying that yes, statin drugs can cause fecal incontinence.”

He points out that a male patient at 87 has a 50/50 statistical chance of living another decade—and that at that stage of life, goals need to shift. “I don’t care what his cholesterol is anymore,” Jensen said. “I want him to have the freedom to go visit his buddies at a restaurant or a golf course or watch a grandkid. I don’t want him nervous or tweaking out because he might poop his pants.”

For Dr. Jensen, this isn’t about rejecting clinical guidelines. It’s about recognizing when those guidelines stop serving the person in front of you. “If we’re not willing to do this as physicians,” he said, “shame on us.”