Why You Need to Be Honest With Your Doctor

Featured Article, Power to the Patient
on August 1, 2013
Why it's important to be honest with your doctor

There’s some serious deception going on in doctors’ offices—half-truths, not-so-innocent omissions, even outright lies. In a 2010 survey, 28 percent of people admit lying to their healthcare providers or at least leaving out key information. And that number could be higher: Over one-fourth of doctors, nurses, pharmacists and dietitians surveyed said half or more of their patients do so.

Whether you’re embarrassed, fear judgment, or don’t want to hear another lecture, being candid when it comes to your health is crucial. “Physician advice is only useful when it is responsive to what the patient is really doing and what her health risks really are,” says Dr. Molly Cooke, president of the American College of Physicians.

If it helps, know that your doctor has heard it all. “Nothing surprises me,” says Dr. Rebecca Starck, chair of the Department of Regional OB/GYN at Cleveland Clinic. And your case won’t be fodder for back-room gossip sessions, either, she says. “We don’t sit back and say ‘Wow, I can’t believe x, y and z.’”

Here are 11 of the most important facts to share with your doc—and why—in case you’re tempted to hold your tongue.

1. Whether you smoke, and how much. 
Being less-than-honest about your smoking habits can seriously handicap any efforts you’re making to quit: Your doctor won’t have the opportunity to share information about proven strategies and new medications to help you stop. Plus, smoking even a few cigarettes a day could compromise the effectiveness of drugs you may be taking. “Any medication that is metabolized by the liver can be affected by cigarette smoking,” says Dr. Kathryn Teng, director of the Center for Personalized Healthcare at the Cleveland Clinic. That includes hormones, cholesterol-lowering drugs, acetaminophen-based products and certain asthma medicines.

2. You have a mysterious growth. 
Sometimes a patient doesn’t call attention to a growth in an intimate spot because she doesn’t think anything is wrong or assumes the doctor will see it. But that mysterious growth could be something as innocuous as a cyst or as serious as a potentially life-threatening cancer, Starck says. “If a patient doesn’t point it out to the doctor, the doctor may not notice it even if she does a thorough exam,” she says.

3. You don’t always take your meds when you should.
Maybe you can’t afford them, hate the side effects, or you’re forgetful. Whatever, the reason, you’ve got to come clean with your doctor. “If you don’t take your pills, I am going to see less of an effect from the drug,” says Dr. Richard A. Stein of the New York University Center for the Prevention of Cardiovascular Disease. As a result, he may increase your dosage, switch drugs or add another one to the mix, boosting your risk of side effects.

4. Your drinking habits. 
“If somebody says, ‘Gosh, I occasionally drink a glass of wine,’ I wouldn’t spend another minute on the subject,” says Cooke. But if you’re actually drinking more than what’s considered moderate—one glass a day for women and two for men—Cooke would discuss the link between excessive alcohol intake and high blood pressure and the empty calories in booze that could contribute to weight gain.

5. You didn’t take all your antibiotics.
Not finishing your antibiotics may cause your symptoms to return and your doctor to think your infection was resistant to the drug. That could lead her to prescribe a second antibiotic that may be more expensive and have more side effects than the first. What’s more, repeat visits to the doctor and new medications cost your health insurer more, and that could translate into higher healthcare costs for you (and everyone) down the road.

6. You use herbal or dietary supplements. 
“Alternative medicines, like conventional medications, can have side effects,” says Cooke. So if a patient complains about say, nausea, and the doctor is in the dark about her use of herbal medications, that could affect diagnosis and treatment. “You may completely miss a simple intervention like, ‘Let’s stop the herbal treatment for two weeks and see if your nausea goes away,’” Cooke says. And some supplements can interact with prescription medications. “Even something as mainstream as Vitamin C can be associated with kidney stones so I’d want to know  if a patient was on it,” she says.

7. How much you are eating and exercising—for real.
If your doctor wants you to lose weight and lower your cholesterol or blood pressure, she’s going to encourage you to make lifestyle changes—become physically active, watch the saturated fat and eat more fruits and vegetables, for instance. If you lead her to believe you’re doing all the right things but your cholesterol and blood pressure levels aren’t budging, then she may put you on a medication to lower them or boost your dose of something you’re already on.

8. How much sun you get.
Your dermatologist can’t assess your skin cancer risk unless she knows your full sun exposure and tanning salon history, says dermatologist Dr. Heidi A. Waldorf of Mt. Sinai Medical Center in New York. If you’ve been to tanning salons in the past, for instance, she would recommmend at least an annual skin cancer screening and may be more likely to biopsy suspicious spots. Plus, she won’t perform certain cosmetic treatments on sun worshippers.

9. You forgot to fast before a medical test.
Fasting before certain tests is essential for accurate results. If you have a bite to eat before a CT scan of your stomach or your colonoscopy, for instance, your doctor may have trouble detecting any abnormalities. You may also experience complications, like vomiting, that could be dangerous in certain situations.