My friend told the dr. she doesn’t smoke even though she smokes pot all the time. It made me wonder if the dr. could tell she smokes even if she says no. I’m thinking inhaling smoke a lot, no matter what kind, isn’t good for you and maybe it sounds different when you breath. Then what about a drinker or drug user?
Well, yes and no. It depends on the situation.
Quite often, I have people who come in to my emergency room in a drunken state who swear they have not had any alcohol, and have blood ethanol levels of 50 mMol/L.
I often ask about smoking. When someone says they don’t smoke or drink much, I often multiply the number they give by two or three if they seem at all cagey (and many do).
If you want to fool the doctor, you can to some extent. If you say you don’t smoke and I can’t see any signs you do, I’ll believe you. But you can often tell just by listening to the lungs.
If you have IV scars or tracts, gooseflesh, rhinorrhea, dilated pupils – I’ll probably notice, since I look for these things.
Canniboids can be detected by doing a drug screen, but I’d need a much better reason to order that test than my personal suspicions.
Just out of curiousity what do doctors do when you admit to illegal drugs.
For instance my last two doctors were very thorough and came right out and asked me “Do you use any illegal or recreactional drugs?” I don’t, I don’t even drink.
What would they do if I said “Yeah I drop acid?” Can they report me?
I suspect a certain Mercotan could shed much light on this thread.
We wouldn’t report you. It would be a violation of doctor-patient confidentiality. I have lots of patients who admit to using acid, buying Percocets off the street, doing ecstasy.
I try and persuade people not to use cocaine, to go into methadone programs or stick to “safer” drugs like marijuana (risk reduction) where appropriate.
I concur with Dr_Paprika.
Of course, in my current setting as a prison doc, I am more inclined to be skeptical, and my sensors are set on high for the signs that I’m being lied to.
Even so, I generally give my patients the benefit of the doubt. But I have eyes and ears thruout the prison, in the form of guards who will tell me that patients are on their units, laughing and going to gym, and eating without problems. So when they come to me looking and acting like they can barely walk for their “constant unbearable back pain of months duration”, I tend not to fall for it.
A dissembling patient can get away with a lot. But they won’t fool all the doctors all of the time.
I guess this question would be for Qadgop speaking of doctor-patient confidentiality how does that apply in prison? is it still valid? Or did the prisoner lose that right in being a felon?
I have to add that you’re far better off leveling with us. We won’t be shocked or disappointed - trust me, we’ve seen far worse than you (and if you’re so extreme that we haven’t, lying can lead to bad results for you lickety split, rather than e"ventually, someday").
I may have alternate treatments for what ails you, but if you pull one over on me, how can I provide them? I might diagnose you better if I knew the facts, rather than a fairy tale. Why suffer weeks or months hiding something I’ll have to figure out anyway?
But most of all, I’m there to help. That’s why I feel good at night, not some cranky holier-than-thou complex. Don’t mess that relationship up. I like to think I’m relatively impartial, regardless of how you treat me, but I’m human - and is ‘relatively’ good enough for you?
All in all, I find my patients come clean, once they figure that out – or at least I think they do. Can I be sure? Sometimes - not always, whatever my suspicions. Though I understand that some patients are in complex and difficult circumstances, sometimes of their own making, that they can’t yet see their way out of, I really can’t think of many situations where it would remotely help them to hide it.
Maybe 100% honesty is far too much to even hope for, but 99% is better than 98%, and I’m not the one who is harmed by a lie.
The forms at my doctors office asked about seat belts, how fast do I drive, how many guns in the house et. al.!?!?!?!
I wonder how much information is available to the insurance company if one were to answer all the questions.
A friend of mine told the insurance company (no doctors involved here) that he smoked some pot in HS about 30 years ago and he soon was getting drug abuse and stop smoking stuff in the mail!
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- An aunt who is a nurse said that for smokers (of any kind and regularity) there is a vein on your thumb that usually sticks out a lot more than normal when your blood pressure is taken. Particular drugs tent o cause particular symptoms reflected in one’s physical appearance–it’s just a guess, but after a doctor or nurse has been practicing for 20-30+ years, their guesses tend to be pretty good.
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- Also I have been told that one of the ER “hypochondriac questions” is “Does your hair hurt?”, being as there is basically no known disease or condition which wouldn’t be detectable by simple inspection, and that would make one’s scalp hurt. There are a number of questions like these; some are said to be particular to help detecting schitzophrenics.
- The “guns” one is interesting–apparently a lot of doctors have started to ask about how many guns their patients own, by direction of the AMA official stance on the matter that private ownership of guns should be outlawed and so they will help collect data on them. You are not required to answer any question they ask, and you can also request that they explain how it bears on their assesment of your health. If their explanation is not satisfactory to you, you can say that you feel that they are committing a “boundary violation” which means what they are asking has little or no bearing on their treating your physical condition, and to drop the subject.
- This is excactly why you shouldn’t give a flippant or smart-ass answer: your doctor or insurance company can forward the info you give freely to a psychiatrist, who can recommend you be placed in a mental institution. It’s not real common, but it has happened.
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:dubious: I’d have to question the professionalism of a psychiatrist who recommends instituionalization over a flippant answer.
I’d like to comment on KP’s reply from the point of view of a patient.
I used to take speed in high school to help me concentrate. I had the intelligence, but keeping tuned in to the subject was hard to impossible. That was before people knew much about ADD. Life got much better when I was diagnosed as an adult and started taking Ritalin.
Ditto for weed. I used to use that for stress, and now instead I use Xanax. Safer, less expensive, and does the trick well enough - much like the situation with Ritalin.
Why self-medicate when you don’t have to?
Sadly, it’s happened.
When I was in the Navy, there was a flu virus circulating around the ship. When I get the flu, I KNOW I’m getting the flu. Basically, I have to die to feel better.
I made the mistake of saying something like, “I wish I could hole up and die” during a slow moment. Next thing I know, I’m being evaluated for suicidal behavior. I was sick with the flu, couldn’t get bed rest or anything to help me feel better. Of course I’m not a happy camper!
Robin
Professionals, who work with the general public, often develop a good sense of reading people.
Alcohol and smoke is easy to detect on breath and clothing.
Liars can often be caught changing their stories.
Aside from the ‘does your hair hurt’ test for hypochondriacs, there’s a good test for fake fainters: Take their ‘limp’ hand, hover it over their face, and let go. The hands of those who are truly unconcious will follow the immutable Laws of Physics – the hand drops onto their face. Fakers, OTOH, make their hands falls at an angle to avoid their face.
Peace.
Oh, hell!
Oh, dyslexia!
I thought this thread was entitled ** Do Doctors know when a patient dies?**…
[Emily Litella mode]
Never mind.
[/Emily Litella mode]
Yeah, I think that’s a little easier to detect. 
“Jimmy, WHY aren’t you taking your medicines…? TALK to me!!”
Looking at someone’s fingers can tell you-in some case-whether they smoke, also.
Then we have situations like when I was in high school and everybody thought I smoked, although I never did. The reason was that my parents smoked, heavily (still do) and the smell clung to me.
Went in for a school sports physical with a pushy pediatrician who suddenly started lecturing me on the evils of smokeing and would not believe me when I kept insisting NO, I HAVE NEVER SMOKED!!! Sure, my clothes and hair stank of tobacco - if I go visit my parents for half a day I achieve the same olfactory distinction even now.
Then again, this was the same asshole who tried to force birth control pills on me without my parents’ consent though I was still a minor. When I insisted my parents be brought into the room for such a discussion he told me no, don’t tell them, they don’t have to know you’re taking them!
Well, needless to say we never went back to him.