I have had doctors ask if I have any firearms in my home and instead of lying I
tell them that is none of their business. My PCP told me that they are required,
by the government, to ask that question. I once answered that I had high
blood pressure, that was totally controlled by medication. For the next ten
years I received a notification, from the State of Utah, and form that I had to
take to my doctor and have him certify that I was healthy enough to have a
drivers license. My blood pressure during that time never exceeded 120/70 and I
was able to stop the medication and it still stayed in a normal range, but I
still had to submit the form and pay the insurance co-pay to have my doctor
verify that it was normal and allow me to have a drivers license for one more
year. I will never answer that question in renewing my drivers license again.
It is not dishonest to withhold information that is none of their business and
not relevant to your visit. The privacy concerns mentioned by several other
commenters are legitimate, especially because records are now kept
electronically, and more and more frequently they are passed from doctor to
doctor, hospital to hospital, to insurance companies, and sometimes even to
researchers and government agencies. The records never go away and are forever
at risk of public disclosure by hackers or inappropriate access by curious
friends / acquaintances who happen to work in the healthcare industry. Even a
trip to the dentist to have your teeth cleaned or a trip to a chiropractor to
have your back aligned starts with filling out a detailed "history" form
about completely unrelated things. They think you owe them your entire physical,
mental, and emotional history, and it all goes into their computer where you
have no guarantee it will be safe, secure, or private.
I would guess most people don't because they are ashamed of sharing some
info., they are afraid it will be used against them by the doctor, their
insurance companies, or others which is the case many times. Or, they do not
trust or feel comfortable enough with the Dr. to share more personal or
concerning info. We have a family friend that had a bad year due to a couple of
significant deaths in their family. They did share with their family Dr. they
were struggling that year with some mild depression from these events. For the
next 5 years it showed up as a red flag on their medical records they were
suffering from active depression when it was that particular year right after
the deaths they were struggling. After this happened they swore they would never
share anything personal with the Dr. other than what they had to share with
@Thomas Thompson:I'm married to doc, and I can assure you that
this is a real problem even when the doc tries his or her best to come across as
understanding and non-judgmental. When it comes to diet, exercise, smoking,
alcohol, recreational drugs, medication compliance, domestic violence,
psychological problems or sexual activities, patients are often very reluctant
to tell the whole story. It feels like an invasion of their privacy.Doctors even refer to the "doorknob syndrome." Oftentimes a patient
has come in for an express purpose (an STD test, for example) but still has a
hard time bringing up the topic. It's not until the doctor's hand
touches the doorknob to leave the exam room that some patients can work up the
nerve to ask the crucial question.You're right that it's a
little illogical, but hey, that's just human nature.
As to withholding information, consider medical records can be subpoenaed in
future legal proceedings, or some other third party review. The government
sometimes proposes or requires certain questions such as “have you fallen
in the last year”. Positive responses to some questions or volunteering
unsolicited information can trigger unsolicited intrusions into your life. Also, given that some medical personnel are speaking English as a
second language. Their comprehension of slang and phrases might incorrectly
communicate a problem or be misinterpreted and become part of the record. And,
last but not least, I feel my doctors are excellent, but on a very tight
schedule and have no time for chit-chat that may, or may not reveal some
“hidden” health issue.
Hmm.Maybe doctors need to look to themselves as to why this
happens.A recent study from the Journal of General Internal Medicine
suggests that doctors only listen 11 seconds to a patient.If this is
true, then the problem is not with the patient at all, but rather with the
doctor not listening.I've seen this over and over again. I
solve it by asking lots of questions of the doctor to engage him/her.I get it, doctors are very busy and have to see many patients in a day and it
can be tiring and tedious. Doctors are human despite what we patients sometimes
would like to believe.But in this case I would submit that the
doctor should listen more and ask lots of questions to gain the patients trust.
That just might help to solve the problem identified by this survey.
I know all of those reasons are true. One reason not mentioned in the article is
that sometimes (and I have been one) the person isn’t aware that a symptom
pertains to a specific problem. For example, they think a symptom is actually
normal or that it’s related to something entirely different, something
they aren’t seeing the doctor for that day.I also know that
there are patients who are somewhat intimidated by the doctor, but they will
share it with the medical assistant or nurse. Sometimes that has to do with the
doctor’s personality or communication style. Sometimes it’s a
language barrier (I’ve had two doctors with accents that were so heavy I
struggled to understand them, so I sometimes left things out so I wouldn’t
have to try to discuss it). But there are times where the patient is intimidated
by the doctor’s medical degree, which in their mind equals smart, and the
patient doesn’t want to sound dumb. These patients are more comfortable
talking with someone they perceive as being more like them.
This was an interesting read. At first I thought to myself “I don’t
do that, I don’t withhold or lie.” But then I realized I’m
always stuck with certain Q’s a doc asks, like “how often do you
exercise?” (Uh....)Perhaps docs could reframe the Q’s.
Make them easier to be open. I’ve had many docs who are overweight
themselves...or don’t appear to be in peak physical shape. If the doc
begins his Q’s by tapping his bowling ball belly and then said “how
much do YOU exercise?”...wink/wink, maybe more people would open up.
Although it’s probably hard for a doc to be open about his own habits. Basically we’re all protecting ourselves from judgment. And that
has consequences, but it’s definitely human nature.
I feel sorry for doctors.
I find the conclusion reached by these researchers to be dubious. People go to
doctors to be healed of their maladies and thus, they do not expect to receive a
lecture from him or her about "morality." That's in the realm of
religion, and most every doctor I've ever seen recognizes that.