You know the drill. Your doctor asks, “How are you?” and that’s your cue to explain that new pain you’re wrestling with or that weird rash you’ve recently noticed. But be honest—do you bare all the facts when talking to your doctor? If you’re like most people, probably not.
Shocking research: When more than 4,500 adults were surveyed, 60% to 80% admitted to omissions, distortions and outright lies when talking to their doctors about topics such as how often they exercise, whether they take dietary supplements and how much alcohol they drink, according to research published in JAMA Network Open.
Why the cover-up? There are a variety of reasons why patients aren’t completely honest with their doctors. Among the most common…
Shame (such as not wanting to reveal things they may consider socially unacceptable)…Embarrassment (including a reluctance to admit they didn’t take their medications because they couldn’t afford them)…A desire to be liked (wanting to appear to be a “good patient,” they may say they’ve given up smoking, for example, and replaced KFC with kale when that’s not true)…and Fear of bad news (failing to mention worrisome symptoms because they are afraid the information might point to a serious illness).
A Bigger Problem
There also can be larger communication issues at play that may interfere with honest dialogue—even if that is the patient’s goal—due to today’s strained health-care system with shorter doctor visits, electronic record-keeping and overburdened medical personnel.
For one thing, doctors generally dominate the conversation. Even when patients are invited to voice their concerns, research shows that doctors interrupt them within 11 seconds. This isn’t simple rudeness—doctors are trained to zero in on diagnosis.
If you start by complaining of a pain in your shoulder, for example, your doctor wants to quickly figure out the source of the pain. But if you wanted to bring something else to your doctor’s attention, this may be left unsaid.
Sobering finding: In a recent study published in Journal of General Internal Medicine, patients’ agendas—what mattered to them—got sufficient attention during only one-third of doctor visits.
Listening also can be a problem in which both doctors and patients fall short. Nervous, rushed and upset by a troubling diagnosis or news about your condition, you may miss much of what you are told. Meanwhile, omissions in your story may occur if your doctor is distracted by the computer on which he/she is entering notes…or is preoccupied with unraveling an earlier symptom.
Truth or Consequences
With all these inherent traps in doctor-patient communications, the likely result is overlooked symptoms, misdiagnoses and missed opportunities for the most effective medical intervention.
To avoid such consequences…
• Make good communication your top priority. It’s the part of your doctor visit that deserves the most time and energy. If this happens, all the other pieces, such as the physical exam, blood tests and X-rays, will fall into place.
• Bring a list of all your questions and concerns. But don’t expect your doctor to address a dozen symptoms. Instead, show the doctor your list and ask him to pick out what’s most important. Helpful: If there’s an item that’s especially important to you, let the doctor know by saying, “I want to be sure we get to X.”
• Don’t censor yourself. Don’t be ashamed to bring up whatever matters to you—even if you’re not sure whether it’s medically important.
• Ask a family member or close friend to be a second listener and take notes. If you’re alone at the appointment and can’t take notes, ask your doctor if it’s OK to record the conversation on your smartphone.
• Be sure the doctor is listening. If he’s not, say, tactfully, “Could you please stop looking at the computer for a minute while I get my story out? I’ll be brief.”
• Confirm how to stay in touch. Whether it’s a patient portal, e-mail or number to call, find out how to ask additional questions or request clarifications on anything you don’t understand.
• Don’t stick with a doctor with whom you’re unable to speak freely. If you don’t feel able to get your story heard, think seriously about changing doctors.
Also: You’ll be less likely to lie, fudge or skip over things with a doctor you trust and feel comfortable with.