Trust me, I’m a doctor

Family history. Medications you take. Relationship status. Those forms you fill out before your doctor’s appointment are full of questions because your responses help your doctor understand your health risks, history and needs.

 And just like it’s important to fill out your paperwork honestly, it’s crucial for patients to be upfront with their physicians during their checkups.

A recent study published in the JAMA Network Open journal found that approximately 80% of patients aren’t truthful with their doctors. Jamila Mainor, MD, a family physician with Baptist Primary Care, says she sometimes has patients who hesitate to tell her the whole truth during their appointments.

“It’s hard to tell exactly how common it is, but it does happen. Sometimes we can’t tell initially, but on follow-up, it becomes more obvious and we try to figure out why,” she said.

In her own experience, Dr. Mainor has found that patients have the most difficulty opening up about sensitive subjects like sex and substance abuse.

“Definitely involving sexual health questions or concerns, a lot of patients may feel uncomfortable verbalizing what they’re experiencing, like if the patient is concerned they may have a sexually transmitted disease,” Dr. Mainor said.  “Also, they can be uncomfortable about their alcohol use or drug use, currently or in the past. It could have been 20 years ago and now they’re doing very well but we still need to know about it.”

What’s the harm if you’re not honest?

“If we don’t have all the information, it’s difficult to draw an accurate conclusion about the health concern they’re having. Their condition could potentially get worse if they delay sharing an important piece of the puzzle,” said Dr. Mainor. “For example, I do have some patients who aren’t honest about taking their medications, say for diabetes, and I would be concerned because their sugars are high. I ask them, ‘Are you having any side effects from the medication? Is it too expensive? Has someone in your family had a negative experience with this medication?’ Asking them about some possible barriers usually helps them open up. Getting to the root of what’s causing them not to be as compliant or honest with me helps us address it and move forward.”

Dr. Mainor explained that if a patient stops taking their medication but doesn’t share this information with his or her doctor, the physician may think the medication isn’t working and prescribe a stronger dose. Then on a day the patient does take their medication, it could cause a negative outcome, such as more side effects than usual.

Study participants said their top reasons for not being truthful with their doctors included not wanting to feel judged, not wanting to be lectured, not wanting something potentially damaging to appear on their medical record, and not wanting to take up their doctor’s time.

“I completely understand that — I wouldn’t want to be lectured either!” said Dr. Mainor. “For patients who feel they may be judged about their behaviors, especially if they are high-risk behaviors, I want them to feel comfortable sharing details they may not even share with their family, so if there is an issue, we can address it together. My job is to gather all the information I can and give them all the information I have, so together we can solve the problem. And a lot of that information we gather comes from the patient.”

Is your health information really private?

When it comes to concerns about medical records, Dr. Mainor assures her patients that patient privacy laws protect them from people, like employers or nosy family members, from accessing their records.

“Their medical record is only used for medical purposes. But it’s important to get all the information so another provider who treats them can access all the necessary information about the person. It could prevent them from accidentally doing that patient harm,” she said.

But even if you’re not ready to be completely honest, going to the doctor is always better than avoiding it altogether.

“It’s in a patient’s best interest to be open and honest about their health history, family history, medications, and any high-risk behaviors,” said Dr. Mainor. “But without all of that, the doctor will still do his or her best. You can build up to that, just like with any relationship and for some people that’s how it is with a doctor-patient relationship. Over time we want to build that relationship so they can open up.” said Dr. Mainor.

To find a primary care doctor who supports you and whom you can trust, call 202-4YOU to schedule an appointment with a Baptist Primary Care physician.

Study: jamanetwork.com