Doctors and Patients - A simple question: How often do you lie?

In My Humble Opinion
1

OK - maybe not so simple, but I’m curious how either side of the doctor/patient relationship behaves regarding, shall we say, “full disclosure”. I would ask that we limit the discussion to adults for this thread, as children are a distinct and quite different subset, medically speaking. I don’t want to get into the whole vaccination thing and similar topics at the moment. Thanks.

Docs: How often do you expect to be lied to during routine examinations, such as physicals, well-check visits, etc.? By lying, I mean the typical responses to those pesky questions like “are you following the diet we discussed”, or “have you cut down or eliminated alcohol”, or “how often are you exercising?”

On the flip side, how often (if ever) do you play down someone’s condition, or try to modify behavior without dire warnings (e.g. “if you don’t stop eating/drinking this way, you’ll be diabetic within the year” vs. “you really need to eat better”)?

Patients: How much do you “spin” your answers to your primary care doc? C’mon, I know you want the best care, but do you/have you ever “tweaked” your responses so that you didn’t disappoint your doctor? Please be honest. This is sorta like the “how often do you floss?” question that dental hygienists routinely ask. They know, of course, who is lying and who is not. A lot of questions by doctors can be very uncomfortable to talk about, but are crucial to diagnosis, treatment, and your health in general. Who honestly wants to reveal how many times they really eat out at McD’s or Pizza Hut? How many brewskis they really had last weekend? Or every day? The last time they got off the couch and took a three-mile walk?

My answers? I’ve lied, routinely, and so have some of the docs I’ve seen. I’m getting much better about the honesty thing as I age. It ain’t easy, but I’m a lot more comfortable talking with my PCP these days - I’ve been seeing him for almost a decade, and we have a decent “working relationship” - he doesn’t preach, and I try real hard not to deceive.
Your thoughts?

2

I’m happy to report that my doctor really seems to accept me the way I am, and therefore I feel that I can be honest with him about my vices. He does suggest things, but never makes me feel judged or looked down on if I choose not to follow his advice. He uses “alternative” medicine in addition to traditional, and I’m not really down with the woo-woo, so his niceness and good attitude towards me are what really keep me with him. If he did display intolerance of my lifestyle choices, I’d be out of there in a second, but he doesn’t, and I don’t lie to him.

3

[Jon Lovitz]Er, I have never, ever lied to anyone about anything. Not once. Yeah, that’s the ticket. [/Jon Lovitz]

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He works for me. I pay for his advice. If he breathes a word about our conversation, I have him before a review board and make his life hell.

Why would I lie to him? What would I have to gain??

5

My doctor (or more often, my physician assistant) can’t do his job without accurate information, so it wouldn’t make much sense to lie to him. I can’t imagine taking my car in to the shop and lying to the technician about unholy screeching I’m hearing in the undercarriage, and it’s the same principle. If I had that little interest in an proper diagnosis, I’d just stay home where I can turn the heat up while I sit around in my underwear.

I certainly hope he’d be as honest with me. There wouldn’t be any reason for him not to, as far as I can see. I doubt it would hurt his feelings or his pocketbook if I got offended because he told me I was fat and never came to see him again.

6

I tell my dentist the truth about brushing and flossing. I never flossed till I was 30-something and still only do it 3-4 times a week. We laugh that I’ll get the daily flossing habit the day before I die. With my doctors…diet, exercise, drinking habits…they get the truth, with one omission. Illegal stuff gets left out, as I have no faith in ‘doctor-patient confidentiality’, especially in light of some court cases I’ve heard about in recent years.

7

So…I’m a doctor.

I expect to get lied to about alcohol, cigarettes and drugs and embarrassing personal problems. I expect to be told the truth about most other things.

I don’t usually do scare tactics. I ask if they smoke, if they do, I say “well, you need to stop for your health’s sake, we can help with patches, gum etc if you want it”.

If they drink too much I say so, and suggest they cut down or stop completely and say that if they have trouble doing that on their own, they can get some help and that their own GP is best placed to help them with that.

One exception: I expect most diabetics to lie to me about every aspect of the management of their condition. It’s sad, but there you go.

It’s not unusual to see blood sugar diaries filled in with perfect numbers, all in the same pen, all bearing no relation to the patient’s actual condition or their blood results. We have people who say thay check their sugar daily, but can’t remember any results, people who haven’t touched anything sweet in six months and who say they exercise daily but who have gained 12 lbs and have an HBA1C reading of 11%, and people who check their feet daily and wear only suitable footwear who have somehow neglected to find the massive ulcer or abscess on their sole.

I’m afraid those patients get a speech, along the lines of:
“This is not my disease, it is your disease. If it remains out of control like this you could lose your feet, your eyesight, your kidneys or suffer a massive heart attack or stroke. There is only so much we can do with medication, the diet and lifestyle choices are your responsibility. You know what you have to do and you know what is at stake. I can’t force you to do anything you don’t want to do, I can only offer you support to make the right choices. You need to make some tough decisions about how you want to live your life and I will make sure we give you help to keep you as healthy as possible”.

9 time out of 10 it makes no difference, but I feel I have to say it.

8

Diabetic since 1980, and I tell the absolute truth. I grew up with a very memorable couple of years in my early teens of watching a family friend getting shorter from teh bottom up as they chopped off bits and pieces of his feet and legs. Very sobering.

My feet are in fantastic condition except for the pseudogout - but i have prescription orthotics, and do physeotherapy to correct for the gait that most of a year of broken foot and 4 successive serious flares gave me. I take my meds religously, examine my feet morning and night, and even track my BP even though I dont have BP or cholesterol issues.

I have lost 62 lbs in just under a year, and unfortunately because of the pseudogout had to stop exercising [my daily 20 minute walk ended up becoming a slow 40 minute gimp on crutches or with a cane, then devolved to my podiatrist telling me to stop walking and to think about getting a wheelchair now so i can still do short walks like to the bathroom and back in the house for 5 years longer…] but since I now am the proud possessor of FMLA documentation forcing work to let me telecommute, and the house is now getting renovated with ramp and grab bars, and I am going to be able to swim 3-5 days a week before logging in to work <squeee> so I am looking forward to losing another kids equivalent in weight this coming year.

my a1c is steadily in the 6 range which takes hard work, and playing with meds [1k mg 2x day metformin and 10 mcg byetta 2x day] to find the best mix for me. As friends, coworkers and family can attest, I am fairly anal about my diet, and even though the indocin/colchicine I do for the pseudo gout has fairly drastic effects, I work around them to reduce flares and still maintain my diabetes regimin.

I can not understand anybody who lies to a doctor … it is seriously counterproductive. I have great relationships with my GP, endocrinologist, opthemologist, podiatrist and dentist. I want to keep all my body parts as long as I can. I am so freaking thrilled to finally be out of the clutches of military medical practice and into civillian practice, the last 3 years have been fantastic at solving pretty much all the issues that the navy considered all in my head. [hell, it took them 7 years to admit that i was diabetic and finally put me into the control program…] that I value a doctor that listens and asks questions instead of figuring that I am looking for attention because my husband is out to sea and I feel lonely…

9

I can recall one instance of memorable lying to a doctor. I had an “omfg-is-he-hot” neurology resident who was seeing me for a year; he’d do the workup then go consult with the attending physician, who then would come see me in the room.

The first time the resident saw me, he was going through his series of examinations, and one was using that little light-up hand-held instrument to look into each of my eyes. So he turned off the lights, walked up very close to me, and pressed into my right shoulder with his shoulder as he leaned in for a good look at my right eye. Then again on the left side. I’m sitting there going meep and trying to keep my breathing rate smooth. Immediately he turns on the lights and takes my heart rate and blood pressure. :smack: Now my blood pressure tends to stay low no matter what’s going on, so that was OK, but my heart rate was up, and he commented on that.

I really believe in trying to be frank with your doctors but just could not bring myself to explain what I suspected was the major contributing factor. (“Well Doctor, you’re hot as hell and having you that close got my hormones all a flutter.”) Instead, I mentioned a minor but more chronic one, which was not exercising/having poor physical conditioning.

I don’t know if he believed me, but I did notice that at future visits he’d switched the order of those examinations. Maybe he realized that a lot of his patients had increased heart rate/BP and why that might be the case? :smiley:

10

I don’t lie to my medical professionals. What would be the point?

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I have to agree with irishgirl, many diabetics lie. IANAD but an RN and I’d have to say that all of my home care pt’s who are diabetic do lie. I have the advantage of being in their homes and actually seeing what foods they have. So when they tell me they have no idea why their sugar is 300 and that they are following their diet, I realize that most of it is denial. So it’s not malicious lying but more of a mental block.

Also, many effects from diabetes take years to develop so people have the attitude of “I have time to change”.

12

As my MIL gets older, we’re taking an increasing role in assisting with her doctor relationships. She lies to all of them all the time. And is perpetually disappointed with the care & clinical outcomes she gets.

Damn if I understand it. Drives me nuts. We are trying to counsel her, and to slip the docs the real facts, but that puts them in a tough spot too.

My attitude is simple: what Purgatory Creek said.
On a loosely related note, my wife is a business lawyer. Acts as in-house council for many small and a few mid-sized businesses. She gets lied to by top management all the time. They come in with a problem, carefully select which half of the facts to tell, then expect useful advice. And this isn’t in cases where internal politics are primary & the advice seeker is just trying to use the advice as a stick to beat another insider.

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Thank you all for the responses so far - a mix; about what I expected. I do understand the folks who ask “Why would I lie?”, but of the people I’ve asked personally, it seems quite a few do. A lot of them simply do not trust the integrity of the patient/doc relationship. Not the doctors themselves necessarily, but rather the records. I’ve been told that they (the patient) simply does not want certain information in their “permanent” medical record. Some have expressed concern that a future employer may require a complete physical as a condition of employment, and that a medical release might be buried in their somewhere. I see that as a valid concern; one I share, in fact. Or that a private investigator could gain access by legitimate legal means somehow. I should clarify that I’m quite open with my current doc, but it took a long time for me to get to this point. The doc/patient relationship is very intimate, and sometimes it takes awhile to nurture that relationship.

Thanks again for taking the time to share your opinions.