It's one of the first lessons medical students learn as doctors in training: Patients lie. If they say they have one drink a day, it's probably two. The same is true for cigarettes and drugs.
"That's what they tell us: You should double what they tell you," says Stephanie Haridopolos, M.D., a board-certified family practitioner in Melbourne, Fla.
She tells Newsmax Health that patients may not be honest with their doctors for a variety of reasons, ranging from embarrassment to fear.
"I think it's more common than we think and I have seen it many times in my practice," says Dr. Haridopolos, vice president of the Brevard County Medical Society. “Usually it's fear, or they want their physician to see them in a positive light. That's a big issue for a lot of patients: They want your approval."
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Common lies involve diet and exercise habits, sexual problems, alternative treatments, and drug use. Some patients won’t mention some symptoms because they are afraid of being diagnosed with a serious condition or that it may affect their health insurance. Still others may lie to gain something, such as a handicapped parking permit or a painkiller.
A recent Cleveland Clinic/General Electric Co. poll found more than quarter of 2,000 patients surveyed admitted they lie to their doctors. Among the 1,200 doctors polled, 28 percent said at least half their patients have told them lies, while 77 percent estimated one in four patients weren’t honest with them.
But the issue isn't just a question of honesty. It's critical for patients to tell their doctors the truth about their lifestyles, health-related habits, and other matters. Without knowing the truth, doctors can’t provide quality care for their patients.
Case in point: Dr. Haridopolos recalls a patient who was too embarrassed to tell her that she’d been experiencing rectal bleeding — until she was diagnosed with colorectal cancer.
"That is really something you have to tell your doctor about because colorectal cancer can be treated if caught early," she notes. "That's why it's important for patients to trust you so they will tell you the truth."
With that in mind, here's a list of common issues patients may lie to their doctors about — and why.
Memory loss: Fear that memory lapses are a sign of Alzheimer's disease may keep some patients from discussing such issues with their physicians, but such conditions are best treated if caught early. "I find that this is very common, particularly with patients who are getting older," Dr. Haridopolos says. "There is a fear of loss of independence. I have had patients say everything is fine, but then I'll get a family member come in and say they're forgetting names or not paying their bills."
Troubling symptoms: Fear of a serious disease keeps some patients silent about unexplained pain, bleeding, or other symptoms. "A lot of people are just so scared of having something wrong with them, so they won't tell you they have something going on they're worried about," she says. "Like with rectal bleeding; it might be a hemorrhoid, but it could also be colorectal cancer."
Sexual or embarrassing issues: Erectile dysfunction, impotence, sexual problems, and other uncomfortable issues can be difficult for some patients to bring up. "If you don't feel comfortable with your doctor, you're not going to tell your doctor about erectile dysfunction, bleeding, or incontinence issues," Dr. Haridopolos notes. "But those could be a sign of a much bigger disease, like heart disease or cancer. And if you’re not telling your doctor, your doctor can’t help you get treatment."
OTC, alternative treatments: Many patients take over-the-counter drugs or use alternative medicines, but don't tell their doctors because they believe they are safe or their physician won’t approve. "You always have to ask about over-the-counter medications, because they may not know an herbal substance may interact with their drugs," she explains.
Diet, exercise habits: Some patients overestimate their exercise levels and healthy-foods consumption. Even obese patients may not be honest about their weight. "Sometimes they refuse to even get on the scale! " Dr. Haridopolos says. "It is hard sometimes to bring that topic up, but it’s important to discuss. Weight loss is going to cure diabetes and hypertension, so that is really the answer."
Drinking, smoking, drugs: Patients with obvious signs of heavy drinking, smoking, or drug use may minimize those issues. "Sometimes people will say they’re not drinking at all, but their wives or husbands will tell you there’s a problem," she adds. Some patients even engage in "doctor shopping" — visiting many physicians to get prescriptions for painkillers and other risky narcotics. Dr. Haridopolos is a member of a Florida task force on prescription drug abuse and advocated for the creation of a statewide database allowing doctors to see if patients are doctor shopping or getting scripts that might negatively interact with other medications they are taking. Most states in the country have similar database programs.
"I always do the 60-second online check to be sure the patient hasn’t gotten prescriptions from other doctors," she says. "I have indeed caught people telling me untruths about that, but it was a way I could open a communication channel, so we could try to get them into treatment or rehab."
This issue underscores the connection between a strong doctor-patient relationship and a person’s overall health, she explains. "Making your patient feel comfortable with the first minute or two minutes is really crucial," she explains. "Because the more you know your patients, the better you can care for them."
The bottom line: Not telling your doctor the truth can put your health, and even your life, at risk.
"They’re shortchanging themselves, if they’re not being completely honest with their doctor," Dr. Haridopolos says.
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