Dearlilyjune also asked: Do you know when a patient is lying to you? How?
There is truth. Like, how a man treats his mother is how he will treat you.
And then there is the truth.
I won’t claim to know 100% of the time if someone is telling me the truth but after a few years of doing this job, you figure out pretty quickly that there are usually tells.
Eye contact. I really like looking someone in the eye. In person. Especially if I know that person well. The direction of gaze, blinks, pupillary dilation, hands on or near the face, arms crossed, deviations from that person’s norm…. There is a whole science devoted to this.
If you cannot have eye contact, voice sometimes gives it away.
If your gut tells you something isn’t right, it probably isn’t.
There are certain things, though, that physicians just assume are being lied about. For instance, the number of sexual partners. Condom use. Drug use history. Alcohol consumption beyond a certain point. How faithful you are at taking your meds.
There are active deceits, which are easier to catch, and then there are lies of omission.
Most of what patients lie about doesn’t really matter because I am going to figure it out regardless. Your lab numbers suck? Busted. I am gonna know you haven’t been taking your cholesterol or diabetes medication. Abusing prescription narcotics? Yeah, soon you won’t be able to control it and your addiction will have you telling stories that don’t make sense.
Sometimes, though, it does matter. Certain illegal drugs should not combined with certain medications. Knowing your lifestyle can help diagnose issues and manage risk factors. I could go on further, but that would be boring….
I did have a new patient once decide he was going to test how good of a doctor I was by not telling me about his multiple myeloma, kidney failure, and diabetes. I about had a cow when I saw those results, thinking I was diagnosing a man I had just met with all of these terrible things at once.
Everyone knows they shouldn’t lie to their doctor but we all still do it…. Why?
Fear of judgement.
I completely get it. You don’t know who you are baring your soul to until it is too late. Still. Honesty is the best policy when it comes to your health.