Lie to Your Doctor, Fool Yourself
Experts say lying to your doctor can be hazardous to your health.
By Martin Downs
Reviewed By Michael Smith
How much do you drink? Are you taking your medicine? Do you have risky sex? And if you think your doctor would be displeased with your answers to these questions, would you tell the truth?
Oftentimes people plainly lie to their doctors, omit certain details, or shade the truth to make their behavior seem more acceptable. As the narrator of Denis Johnson's novel Jesus' Son confesses, "It's always been my tendency to lie to doctors, as if good health consisted only of the ability to fool them."
If you're serious about your health, however, honesty is always the best policy.
"If you cannot be honest with your health care provider, you may be doing yourself a grave disservice," says Stephen Goldstone, MD, a professor at Mount Sinai School of Medicine in New York City, and medical director of GayHealth.com.
A Beer ... or Six?
No one wants to admit to having a drinking problem, or even to seem to have a problem. You may lie about how much you drink, even if you drink moderately, for fear of being labeled a lush.
The National Institute on Alcohol Abuse and Alcoholism defines "problem drinking" as:
A standard drink generally is defined as a 12-ounce beer, a 5-ounce glass of wine, or 1.5 ounces of liquor.
If you drink too much, you know you'll get a lecture about cutting down, so you feel like there's no point in being honest about it. But doctors aren't there to scold -- they're there to help.
Many people who imbibe to excess aren't just living it up. They may be self-medicating their insomnia, anxiety, or depression. In such cases, booze isn't a good remedy, and a doctor can find better ways to help whatever is wrong.
There are plenty of other reasons not to lie about your drinking, not the least of which is that alcohol and many medications, including over-the-counter drugs, can be dangerous when mixed. Maybe you've heard the story about the guy who suffered liver failure from taking Tylenol with wine? It's not a myth. His name is Antonio Benedi, and it happened in 1993.
The same thing goes not only for drinking, but also for smoking tobacco and using illicit drugs. Everyone knows that smoking causes cancer, and that you can die from an overdose of heroin, but any chemicals you ingest recreationally might affect you in other ways you haven't thought of.
"You as a patient don't know what's significant," Goldstone says. "You don't know what your health care provider needs to know, and it's best to be honest."
Talking About S-E-X
"The hardest thing for anyone to talk about is sexual practices," Goldstone says.
Nevertheless, if you're reluctant to speak openly about sex, the subject may never come up in time to avert a health crisis.
The American Social Health Association estimates that 15 million people in the U.S. get a sexually transmitted disease (STD) each year. One of the most common is the human papillomavirus (HPV), which at least 80% of all women get by age 50, according to the CDC. Certain strains of HPV can cause mutations in cells of the cervix, possibly leading to cervical cancer. That's why sexually active women are urged to get regular Pap smears.
Less well known is the fact that the anal canal can be infected with HPV, which may lead to anal cancer. Some doctors argue that gay and bisexual men should have routine anal Pap smears, but that's assuming only gay and bisexual men have anal sex.
"There are many men and women who have anal sex who are not gay," Goldstone says.
What's more, doctors shouldn't assume that married people have no risk for STDs. "There are women who are married, and men who are married, who have sex outside their relationship," Goldstone says. "We cannot make assumptions about patients."
Don't be afraid of being judged when asked about your sex life. "We're used to asking, and if you're going to ask, you'd better be ready for what you get back," says Michael Fleming, MD, president of the American Academy of Family Physicians, who has a family practice in Shreveport, La.
From the Taboo to the Mundane
"Sensitive issues that you may not want to disclose to your physician can be really run-of-the-mill issues," Goldstone says.
For chronic conditions such as high blood pressure and cholesterol, it's thought that only 50% of patients take prescribed medications correctly, if at all. If you don't take your medicine, you may be afraid the doctor will get mad at you, so you lie and say you've never missed a dose.
Doctors may dearly wish that patients would follow their instructions exactly, but they also understand that there are reasons why the patients don't. Perhaps the side effects are disagreeable, or the drugs are too expensive, for example.
These kinds of problems can be worked out. For bad side effects, you might be able to switch to another medication or try a different kind of treatment altogether. Sometimes there are cheaper alternatives to expensive brand-name drugs.
You may have also told some whoppers about how much you exercise, whether you have given up donuts, how often you floss, and so on. Remember that you really have nothing to gain if you lie. Pretending to be healthy doesn't make it so.
Doctors need to know the truth so they can have a clear picture of your health, but it's tough to admit certain things to a stranger. "It takes a huge amount of comfort on the part of the patient with the physician to be able to speak honestly," Goldstone says.
Furthermore, doctors who don't know you may not know what to ask. That's why Fleming says it's important to have a personal physician or a family doctor who you see regularly, and it's crucial that you feel comfortable talking to him or her.
"Someone who I've known for years, and know their family, it's not difficult for me to ask those questions," Fleming says.
Goldstone agrees that you should try to establish a rapport with a healthcare provider you like and trust, adding that, "It doesn't have to be a physician. Many people get excellent care from nurse-practitioners or from physicians-assistants."
Many don't have that kind of relationship, however, which may explain some of the hesitance to tell all. "In a closed-door room with someone they trust, they tend to be more honest than you would imagine," Fleming says.
Published April 26, 2004.
SOURCES: Michael Fleming, MD, president, American Academy of Family Physicians. Stephen Goldstone, MD, assistant clinical professor of surgery, Mt. Sinai School of Medicine, New York; medical director, GayHealth.com. American Social Health Association web site. CDC web site. American Cancer Society web site. WebMD Medical News, "Gay Men Should Be Checked for Anal Cancer, Experts Say," May 2000, Enoch, M. American Family Physician, February 2002; vol 65: pp 441-448.Drugs and Therapy Perspectives, 1999; vol 13: pp 11-12. Emory University School of Law web site, "Benedi v. McNeil-P.P.C., Inc." Oct. 26, 1995. United States Court of Appeals, for the Fourth Circuit; No. 94-2596 (CA-94-345-A).
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