Are you putting yourself at risk?

“Risk?”  Yes, patients place themselves at risk daily by lying about their medical history with their doctors.  And what is a lie you ask?

Definition in Oxford Advanced Learner's Dictionary

Lie

Syllabification: lie

Pronunciation: /lī/

noun

1. An intentionally false statement,

1.1 Used with reference to a situation involving deception or founded on a mistaken impression,

1.2 (Of a thing) present a false impression; be deceptive.

As a physician, we are concerned with our patients’ health, wellbeing, and recovery.  But I am watching a large body of our patients, both young and old, head towards a path of lying about their medical history. 

·         According to a 2009 survey, conducted by General Electric Co,of more than 2,000 patients and 1,200 care providers, 28% of patients admitted to occasionally lying or not sharing information with their health care provider.

·         A WebMD survey in 2004 found that 38 percent of patients lied or “stretched the truth” about following their doctor’s orders, while 32 percent lied about their diet or how much they exercised. Another 22 percent lied about smoking, 17 percent lied about sex, 16 percent lied about their intake of alcohol, and 12 percent lied about recreational drug use.

·         Younger patients — aged 25 to 34 — are more likely to lie about recreational drug use, sexual history, and smoking than patients who are 55 or older, while men are significantly more likely to lie about how much they drink than women, according to the survey.

·         A nonprofit California HealthCare Foundation in 2005 found that one in eight patients engaged in behavior presenting a potential risk to their health, to protect their personal privacy. That includes avoiding their regular doctor, asking their doctor to fudge a diagnosis, paying for a test because they didn’t want to submit an insurance claim, or avoiding a test altogether. 

As physicians, we have to get to the core reason for the lie, and there are several.  The most commonly cited excuses are:

1. Patients feel embarrassed or fear that they will disappoint their doctor.
2. Patients report their self-diagnosis as fact.
3. Patients' concern about electronic medical records or that employers, insurance companies, or some other authority will learn about their condition.
4. Patients worry that they will be judged by their physician.

To this end, we must address these issues and resolve them.  As your physician, I am concerned for your safety.  I worry about:

• ·         prescribing a wrong medication
• ·         causing damage to your kidneys or liver
• ·         missing key information from your past
• ·         have poor  surgery/treatment outcomes
• ·     not healing you

So let’s work together to improve your time with me, your other doctors, and your health by coming to your appointments with an open mind and your honest anxieties.

Start by being prepared, and so will we. Take a photo of your medication list and medical history with your phone and store it. Send it to a friend or family member you trust, who can get the information to us if we need it quickly.  We will make sure to keep this process simple and efficient.

Be open about your past and your ideas regarding your medical history.  Please remember, if you are taking a medication, it is because there is a problem; list that problem. Your primary care doctor did not place you on medication for hypertension prophylactically. You have hypertension that is controlled by high blood pressure medication.  

The internet is fabulous.  Reading articles on the internet does not mean you can diagnosis yourself.  It does mean you should bring these topics up with your physician to discuss.  It is refreshing when a patient beings in the literature and we schedule an appointment to review these concerns.

Do not lie about your past. This can kill you.  Early in my practice, I had a wound care patient I was treating. The wounds would come and go; different injuries resulted in new appointments. It wasn’t until she was admitted to the hospital that I realized the depth of her lies. She was an alcoholic with severe cirrhosis of the liver. On all of her history forms she failed to divulge that information to me and several other physicians; her gastroenterologist and cardiologist where the only physicians that knew.  She could have died from taking an anti-inflammatory that I prescribed her during one of her “falls”.

Dear Patients,

When asked how I live my life, quote Stephen Grellet,

“I shall pass through this world but once. Any good therefore that I can do or any kindness that I can show to any human being, let me do it now. Let me not defer or neglect it, for I shall not pass this way again.”

Dr. Jenneffer Pulapaka, DPM