Doctor, My Nose Keeps Growing Longer and Longer
Written by Michael Richardson
“How often do you exercise?” the doctor asks.
“About 3 times a week,” the patient responds, ignoring the little voice in the back of his head.
It’s probably more like once a week when he really thinks about it. But at least he avoided a lecture, right?
Sure he may’ve avoided a lecture. But lying to the doctor is also a great way to avoid good health care. Business people make decisions based on accurate numbers, pilots take off with a plan based on quality weather reports and firemen respond to fires based on 911 calls. Good communication is crucial to excellence in whatever endeavor you undertake, and health is no different.
Yet Americans lie to doctors.
Surveys from the Cleveland Clinic and WebMD show that millions of Americans either blatantly lie or distort the truth to their doctors, essentially saying, “Let me make it harder for you to help me.”
They lie about smoking, diet, exercise, adherence to medication, sexual activity and more for a number of reasons:
- Desire to minimize/avoid treatment.
- Desire to get treatment/medications.
- Fear of monetary costs.
- Desire to avoid conflict/have doctor be pleased.
- Sometimes medical histories can include some embarrassing, even shameful things.
- Provider seems rushed, patient doesn’t want to be a burden.
All these reasons to lie are understandable. But the consequences can be serious. Say a man lies about taking his blood pressure medication. The doctor thinks the medication isn’t working, and so he changes the medication or ups the dosage. Now the man’s health is in jeopardy when he does decide to take the medication.
Perhaps we lie because we fear confrontation with the doctor, a confrontation that in reality might be nothing more than a conversation. Lies often come because we wrongly estimate a doctor’s response.
“We aren’t here to render moral judgments,” says cardiologist Dr. Amy Tucker, associate professor of internal medicine at the University of Virginia Health System, to thedailybeast.com. “So the half-truths really aren’t necessary.”
But doctors still expect half-truths. Dr. Don Bigelow, a Salt Lake City dentist, says that many patients are embarrassed that they aren’t faithful to their good habits and fear a lecture. So he fights lies by not giving lectures.
“I think it eases their mind,” he says. “We can tell if they have been brushing and flossing on a regular basis just through the examination, so we don’t need to harp on them about it. In my office, our gentle reminder comes by way of giving them a new toothbrush and some floss when they leave the office…enough said right there.”
But, Dr. Bigelow adds, lying about changes in medication, medical history, or illegal drug use is on a different level than lying about flossing. Patient health and safety is of paramount importance, he says, and more serious lies can compromise this safety.
The System Made Me Do It
Patient lies only explain part of the problem, according to John Palmieri, MD, of Massachusetts General Hospital and author of an article exploring lies in doctor-patient relationships. A typical seven minute doctor visit, he says, isn’t long enough for complete openness. “Full disclosure of truth is generally not possible in most situations,” he says. “Some items will be glossed over, or ignored altogether. Such omissions compromise the exchange, aside from the more blatant misrepresentations.”
He says the important question that needs answering today is how to create an environment that maximizes openness.
However, don’t let the excuse “I ran out of time” keep you from mentioning a symptom to your doctor, or from answering questions fully. In the end, we should be fighting for the doctor’s understanding, not attempting to cloud it.
Why You Shouldn’t Lie to the Doctor
- Once a doctor knows you’ve lied (and remember the doctor is probably adept at recognizing lies), he must account for the possibility of future lies. Care can’t be as exact and the relationship with your doctor, which is important, suffers.
- Lying to your doctor can lead to seriously damaging medication combinations. Say you lie about taking a certain supplement because you’re embarrassed about taking it. The doctor may prescribe a medication that causes harm when combined with that supplement.
- You waste money. The doctor is trying to monitor your health, and you are projecting a false image. It’s like wearing gloves during a visit to a palm-reader.
- You might end up getting unnecessary treatment. This can lead to both side-effects and more wasted money.
- You might develop a preventable disease or health condition.