The nurse asked me if I could get on the office scale before my appointment. She wanted to record my weight. I told her “not today.” Sometimes I say, “I feel a bit weak today, and my weight is the same as it was six months ago.” I Just did not want to get on that scale since it is a challenge and there is only one grab bar for me to hold. Since I saw my neurologist every six months, I felt the next visit would show my true weight. I told them I was about the same as my last visit.
In all honesty, I usually do not feel strong enough to get on a scale. With my MS-weakened legs, I just didn’t want to go through the ordeal of getting on that floor scale. My weight was pretty accurate, although sometime over a period of four years, I lost eight pounds! But in matters of new symptoms, pain, or side effects from medications, I tell my doctor the truth.
I asked my doctor if patients always told him the truth about their bodies. He shared that, “Sometimes I feel like a trial lawyer because I have to pin my patients down and ask them directly. Basically, I ask my patient to tell the truth. Also, I have been in depositions with lawyers, and I just tell them what they tell me. If they said they are not drinking, for example, I need to take their blood to liver enzymes to see if there is elevation of liver enzymes. Patients on narcotics, I test them for narcotics therapy, etc. Tests don’t lie.”
He added that often a wife or family member calls him and informs him that the patient is not telling the truth about their pain or dementia. “The call from family tells me other medical facts that the patient never mentioned during their office visit with me,” he said.
Many of us are not completely truthful with our doctors, and there are statistics to back that up. A recent national opinion telephone survey of 2,000 patients discovered 28 percent said they “sometimes lie to their healthcare professional or omit facts about their health.” When patients get sick, they expect their doctor to make them well. They demand the best care, the latest drugs, and the most advanced diagnostics available—and they seek nothing less than a total recovery. Oddly, though, it’s often the patients themselves who sabotage their own medical outcomes.
A surprising number of patients withhold information or outright lie to their doctors for fear of being judged, an aversion to being lectured, or because they wish to present themselves in a positive light. Others do it because they want something from their doctor—like pain medication or a diagnosis that enables them to collect disability. Unfortunately, such deceit forces physicians to order unnecessary and increasingly invasive tests to diagnose the patient’s problem. Worse, it ups the odds that physicians might prescribe a medication that would react negatively with a drug the patient is already (secretly) taking.
According to surveys conducted by FIERCEhealthcare.com, 23% of people admitted they have lied to their doctors. So what are people lying about? The survey of 500 people found:
• 46% lied about smoking.
• 43% lied about exercise.
• 38% lied about drinking.
• 29% lied about their sexual partners.
That doesn’t add up to 100% because some people said they lied about multiple subjects. On the upside, most people (77% of those surveyed) are honest with their doctors.
Why do patients lie? Some 75% of respondents cited embarrassment as the reason. Another 31% said they lie to avoid discrimination, and 22% said they lie because they don’t think their doctor will take them seriously if they tell the truth. Those that lied to avoid discrimination were overwhelmingly female (80% female, 20% male).
It’s hard for doctors to tell how often patients lie, Clark Madsen, MD, a family physician, told TermLife2Go. “Doctors don’t have some sort of lie detector and aren’t trained like the FBI,” said Madsen, who suspects he gets lied to in about 30% to 40% of patient visits. Most of the time, patients lie to keep the visit moving, thinking “sure, I’ll do that,” or “no, I don’t have that problem,” said Madsen.
Sometimes, patients just tell doctors what they think their physician wants to hear, he added. For example, they will say they exercise more than they do. But other times, patients try to conceal information, and the lies can be more serious. “I have caught many people telling me stories that don’t make sense or denying actions they have taken. This usually happens when they have an agenda and want the doctor to do something specific for them. If they have a problem and want a specific treatment, they will sometimes tell you they have taken other treatments or are allergic to certain medicines to force you to pick the one they want,” he said.
The survey found there are some gender differences when it comes to lies patients tell. More men lied to doctors about alcohol consumption than women (50% versus 32%). On the other hand, women were more likely to lie about sexual partners (33% versus 21%). Madsen said gender differences could be the result of cultural norms for men and women. Patients either consciously or unconsciously try to meet those norms.
And there are differences based on age. Patients 35 and older are more likely to lie about their exercise habits than younger patients. Patients 35 and younger are more likely to lie about smoking. The age group most likely to lie about sexual partners are those 35 to 45.
Most patients are honest, but that honesty isn’t always comfortable. In fact, almost half of survey respondents said they feel uncomfortable talking to their doctors about their sexual activities. On the other hand, 34% said they were comfortable talking with their doctor about anything.
So, why do we withhold health informant from our healthcare provider? There are a number of reasons. We might be embarrassed talking about constipation, bladder problems, hearing loss, or aches and pains. We might be too proud to admit we are experiencing some physical losses that show we are not perfect. It also might mean that if we have a symptom, the doctor will want to follow up with a few medical tests. We don’t want to be bothered with the inconvenience of more time at the doctor’s office or the expense of more copays and new medicines. So, we withhold some medical facts about what is happening to us, and the doctor does not give us any medical advice or medicines since she does not know what is going on.
Other times, patients tell their doctors that they have pain and often exaggerate the extent that it’s bothering them. It might be back pain, shoulder pain, or anything. We have all seen stories in the media about patients who receive doctor’s orders about their condition and are awarded disability compensation or orders that they cannot work in certain jobs that require lifting or standing. Sometimes we apply for permanent disability. I recently saw a person on permanent disability for his back problems hauling two large bags of mulch to his yard.
I used to watch the TV show House, a medical drama starring Hugh Laurie as Dr. House. House was a cantankerous person but a brilliant diagnostician. His bedside manner was rough and often rude—but he could diagnose every obscure ailment before the hourlong show ended. Despite his brash interpersonal manners with his fellow medical staff and patients, he spoke the truth to them. One of his classic lines dealt with patient honesty with their physicians. Dr. House simply said, “Everybody lies.”
But we really shouldn’t. The truth is much better for our overall health.
Honestly.
Sister Karen Zielinski is the Director of Canticle Studio. Canticle Studio is a part of the Sisters of St. Francis of Sylvania, OH’s overall advancement effort and has a mission of being a creative center where artists generate works, products, and services in harmony with the mission of the Sisters St. Francis. She can be reached at kzielins@sistersosf.org or 419-824-3543.
