The Tip Off

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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.

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44 thoughts on “The Tip Off

  1. I suffer more from embarrassment with the doctor, and hate going especially about ‘personal stuff’. Still, I seem to have a good GP at the moment, and if I can get to see her, I’m quite comfortable, which is probably half the battle.

    Liked by 2 people

  2. Having now gotten that snarky little comment out there, I would like to add that some things are hard to discuss with non-family members, even medical personnel. That’s why I waited so long to see my doctor for my ulcerative colitis. I even hesitated to tell him the nasty little details (like bleeding through my clothes at night), until I started crying in the exam room and then just blurted everything out.

    Liked by 2 people

  3. There’s a term, I don’t remember what it is called, that describes the importance for Dr. ‘s to pay attention to the last thing mentioned, as he/she is on the way out the door. That is apparently when patients talk about the real reason they came, their most important, maybe embarrassing concerns ?

    Liked by 1 person

  4. Never lie to my dr, but I omit at the dentist. I don’t understand why dentists need a sexual history. I just leave it blank and tell mine I was a slutty slut and ask how much they need to know. They say, “I don’t.” But there it is on the form. Pshaw. Whatever.

    Liked by 2 people

  5. I agree!!! My department gets a health history for surgical patients and we try to tell them they need to be really honest because of how drugs and other things can react with anesthesia. I get it too. I wish patients knew that our only concern was getting them through surgery safely!

    Liked by 1 person

  6. I know its irrational, but I always feel like I’m failing the test at the doctors office. If my blood pressure is too high, I failed. If my thyroid number is up, I failed. Everything is a test. And I’m always aware of the failures.

    My doctor is kind and supportive and non-judgemental. But I still get that feeling.

    Liked by 3 people

  7. I don’t lie to my doctors anymore, but I did when I was in my 20s. Now, I enjoy filling out the forms and giving lots of information, writing in the columns…problem is they don’t give me enough time, and sometimes I don’t remember stuff, especially stuff from my 20s.

    Liked by 2 people

  8. I lie partly because I don’t want to feel judged and as much as any professional says they won’t judge – it is rare to find one who really doesn’t. And you learn to read their facial expressions,body language, tone, and turn of phrase to figure out which is which. As often as I am judged, that isn’t the biggest reason why I don’t tell the truth – after all I’m a big boy now and not as concerned about others’ perceptions. What I do care about is the power that those others have to make unwanted changes in my life, despite and over my objections.

    For instance, I went to see a psychiatrist voluntarily to help with depression brought on by serious health issues It took a great deal of effort to get an appointment and so I swore to myself that being totally honest was the only way to proceed for the best outcome. I asked at least 4 times if our conversations were private and was assured they were. He asked if I drank alcohol and I told him I did and was concerned about it. He then told me he was informing the DMV and they would pull my licence and I couldn’t drive anymore. I was furious and told him I never drank and drove, just drank at home – and he said it didn’t matter. I should never have told him I drank.

    Or customs. The officers will tell you when crossing the border that what drugs you use elsewhere (for example) has no impact , as long as you are not carrying when crossing. If you believe them and give the slightest hint that you use at any time,they will search until they find some reason to bar your crossing. Guaranteed. They pride themselves on their judgement and their job is literally described as assuming guilt until innocence is proven.

    Or social services. At one point when I had cancer i was so down and out that I had sold all my possessions to pay bills and could not work because of treatments. I was forced to go to welfare to eat. I had one small room where I boarded and it took over 90% of my welfare check. Then I had to spend weeks in hospital when there were complications in treatment (colon blockage). When I had my next regular meeting with welfare I made the mistake of telling them i had been hospitalized. They said I would have to repay the welfare I received while hospitalized because I was being fed by the state and I was double-dipping. Meanwhile what petty possessions I had – like an old laptop, writings,books, etc would be thrown out to the street in the garbage to clear a room I could no longer pay for because I made the mistake of telling my worker the truth.

    The list goes on Victo. It is always better to withhold the truth unless you are 100% certain what will be done with the information. Like a good lawyer will never ask a question in court unless they know the answer (many defenses have been sandbagged by innocent questions on the stand), so too the average person is vulnerable to unfair and even unethical treatment when the truth is known – after all knowledge is power and I have learned not to give away power to those who do not have by best interests at heart. 😀

    Liked by 1 person

    • I hear you. I was floored to receive a subpoena one day not only calling for my records but also requiring that I appear in court to testify against a patient of mine who was involved in a child custody proceeding. And I had no choice but to do it. And THEN they had the gall to send me a check for my time. You are correct that there is no such thing as privacy. I am more careful what I put into patient records now. You have no idea who is writing what when or who will have access to it later.

      Liked by 1 person

      • Absolutely Victo. I was safety manger for a trucking company for a while and I was very careful what I put in driver’s records, entering as little as was legal. I had a disagreement with ownership and I went back to driving and they brought in a new safety manager. He began entering everything into the files and it built up until one day we had a knock down drag out yelling match. He was entering stupid stuff like if a driver made an addition mistake on his log book. Previously,if there was no intent to deceive, i just sent the logs back and told the driver to correct them and be moire careful. Unless the problem persisted, that was it. The issue was that the files could be abused to fire some one who had committed no violations – just made mistakes that affected no one, as we all occasionally did. The safety manger insisted that the files were confidential and he was the only one who could see them. I very clearly informed him that the law said the files were the property of the company, not him. And that anyone of authority from Head Office could call at any time and have the files sent to them.He had a company car and did a lot of miles checking and visiting sites. I asked how he would feel if I wrote him up every time I saw his car with a burnt headlight or a tail light out. Anyone not a driver reading a file on the safety manager full of entries of evidence of unsafe driving, would infer he was a bad manager. We never did resolve that issue.

        Liked by 1 person

  9. Reminds me of my grandmother. She faked her hearing test in hopes she would get a more powerful hearing aid. But my wife ratted on her. Good thing, too, otherwise she would have gotten a device that could have deafened her. Not smart to lie to your doctor.

    Liked by 1 person

  10. Oh, this one got me. I actually belly laughed. I would be your favorite patient in the whole wide world. Let me tell you why…I write everything down..Literally. I just interviewed a new doctor..Yes, I really do interview any doctor that I see and there are a plethora of reasons. I wrote a three page list of everything that was going on with my body, autoimmune diseases, list of prescriptions, dosages, what I’m allergic which is all narcotics but morphine btw. The last crew I interviewed was so flustered over this, it was comical. I didn’t go back though..the doctor failed my test.

    Liked by 1 person

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