As a doctor, I often notice the strange faces of family members next to patients after they answer my questions. From their expressions of surprise, sarcasm, or joking, I knew that the patient might not be telling the truth.
Lied to the doctor? | Oriental IC
for example–
Doctor: “Are you still smoking?”
Patient: “Almost none, maybe one or two.”
And the patient’s daughter gave feedback afterwards, adding a zero after one or two.
Another example–
Doctor: “Are you taking the two prescribed medicines on time?”
Patient: “Well, I ate them all on time.”
After a while, the pharmacy called to say that the patient did not take one of the medicines, because he had read the instruction manual and was worried about side effects, so he never took it at all.
And for example——
I once had a patient who underwent lower extremity artery bypass grafting. Every time I had a re-examination, I asked him if he had walked and exercised as required. He always said that he walked every day, and it was no problem to walk one or two kilometers each time.
And every time he left, his wife would come back and tell me that he hardly ever went out every day.
— Lie to the doctor? ! You might think that lying to a doctor is not something the average person would do. After all, it’s about your own health. Who has such a big heart that he can lie to a doctor?
But in fact, there are not a few people who deliberately conceal information about diagnosis and treatment from doctors. This is not only a question of “honesty and dishonesty”, but also reflects the blind spot in communication between patients and doctors in the process of seeing a doctor.
When talking to a doctor,
What do you need to communicate?
Many people may think that going to the hospital to see a doctor is equivalent to doing an examination, and patients and doctors have very little time to communicate face-to-face. But this period of time that has been compressed beyond compression is actually a very important and irreplaceable process in the clinical diagnosis and treatment process.
The process of face-to-face communication between patients and doctors is very important | pixabay
There are two important stages of communication: the inquiry of information about disease symptoms before a diagnosis is made, and the communication of the condition and the explanation of the diagnosis and treatment plan after the diagnosis is made.
Before Diagnosis: Honest Communication Helps Accurate Diagnosis
Maybe everyone knows that the information related to symptoms is very important, such as how uncomfortable, when it started, how severe it is, whether there are any regular characteristics of the attack, are there any particularly relevant triggers, and so on. In addition, there is a lot of information that you may think is irrelevant , such as have you had any diseases before, have you had any surgery, what job do you do, how you eat recently, whether your weight has changed, and whether you have a daily exercise. Gas and stool, do you smoke and drink, are you satisfied with XXOO life, where did you go to play recently, are you particularly stressed and stressed, do you exercise regularly, what medicine are you taking recently, what diseases have your family members suffered from? ,wait.
The doctor is very worried, but this is not talking to you. These information are useful clues for disease diagnosis . For example, eating, drinking, and defecation can fully reflect a person’s gastrointestinal function, sexual life history suggests possible sources of infectious diseases, and smoking habits usually indicate more serious arteriosclerosis or respiratory problems.
Smoking behavior will obviously be criticized by doctors, so many people choose to conceal or underreport the amount, but this is likely to affect the doctor’s judgment | Oriental IC
When faced with these questions involving all aspects of life, will you answer truthfully?
If some key information is deliberately concealed, it may lead to misdiagnosis and missed diagnosis by doctors, and they may not be able to make accurate judgments on the severity of the disease, and may even make inappropriate treatment arrangements. For example, for a patient who has smoked heavily for a long time, we usually do not arrange general anesthesia for endotracheal intubation if he has not quit smoking, otherwise the risk of postoperative respiratory complications will increase.
After understanding the condition and relevant information, the doctor can purposely arrange physical examination, laboratory, and imaging examinations, and finally make a disease diagnosis and formulate a treatment plan.
Post-diagnosis: Feedback and questions to help treatment go smoothly
At this time, the doctor needs to explain the condition to the patient in plain language. For example, what kind of problem is this, how did it form, what are the possible reasons, and what is the current level; what kind of treatment methods do we currently have, such as what medicine to take, how to take it, how long to take it, and what problems should be paid attention to when taking medicine; Or, what kind of surgery is needed, what surgical options are available, when is the right time to do it, what are the risks of the surgery, what are the alternatives if you don’t have the surgery, what are the possible complications of the surgery, and what is the recovery like after surgery? ; or without taking medicine or surgery, what problems should be paid attention to in life, how to continue to observe changes in symptoms, what needs to be checked in the hospital again, and so on.
After the diagnosis, the doctor needs to explain the condition to the patient | Pixabay
During this communication phase, the doctor usually preaches for a long time without asking questions. However, if the doctor speaks too obscurely and you don’t understand, if the doctor speaks too fast and you don’t remember, or if you disagree with the doctor’s diagnosis and treatment plan, will you give your opinion truthfully?
Many patients may choose not to express their true thoughts out of the original intention of avoiding conflicts. We have found untapped packs of pills hidden by patients on the ward because the patient didn’t think the drug was right but didn’t want to challenge the doctor during the hospital stay. In this case, doctors and nurses’ observation and evaluation of the patient’s clinical condition changes are all wrong.
Why do patients lie?
Because I don’t want to be taught by the doctor
The communication between doctors and patients is a process that has extremely high requirements for the authenticity and effectiveness of information but is time-limited. It almost requires doctors and patients to establish mutual trust and start barrier-free communication immediately after meeting. In this short period of time, the doctor’s talking style, the patient’s psychological factors, the patient’s existing understanding of the disease, the mutual impression and trust between the patient and the doctor, or some special situations, all have a great influence on the disease. Efficiency of communication between them.
For example, the patient did not understand the doctor’s words but often did not ask further because of embarrassment; it was difficult for the patient to confess some details to a doctor who did not like it at the first meeting; a strict doctor could easily make the patient feel intimidated, and could not Telling the facts that may cause the doctor to blame; most patients will not tell the truth to the doctor about the fact that patients did not follow the doctor’s advice to take medicine, quit smoking, and limit alcohol; most girls who come with their parents deny their sexual life history, and so on.
Will you tell the doctor about the fact that you did not follow the doctor’s advice? |
Although “honesty” is so important and involves medical safety and the personal health of patients, it is actually a long-standing and very common phenomenon for patients to conceal facts from doctors or even lie. Many doctors have the habit of doubling the number of cigarettes provided by patients and halving the time of exercise, which is the result of being familiar with this fact.
A study of more than 4,000 people published in the United States in 2019 found that more than half of the patients concealed different types of information from doctors when they saw a doctor, and the information that patients most often did not tell their doctors was neither “I haven’t Quit smoking”, “I’m still drinking heavily”, not “I didn’t take my medicine on time”, but “I disagree with your treatment plan”, followed by not understanding the doctor’s treatment advice, and then Failure to truthfully report unhealthy living habits and failure to take medicine as prescribed by the doctor. The main reason for concealing the facts from doctors is “do not want to be blamed and taught by doctors” , followed by “don’t want to hear the possible consequences of your bad behavior”, “sorry”, “don’t want doctors to feel that you are difficult to deal with patient”, and “do not want to take up more of the doctor’s time”. The study also found that patients who were younger, female, had lower self-esteem, and those with chronic diseases were more likely to withhold information from their doctors.
Not wanting to be blamed is the main reason for patients to conceal the truth | Pixabay
It can be seen that the most important communication blind spot between doctors and patients is actually that patients do not agree with the doctor’s advice or do not understand the doctor’s instructions, but because they do not want to be lectured by the doctor or feel embarrassed, they do not give back their opinions truthfully, and the doctors also Most do not receive this. This communication blind spot will obviously greatly affect the efficiency of clinical diagnosis and treatment. In addition, patients will not admit their bad life behaviors because they don’t want to be lectured by doctors. The poorer the health status of the patients, the easier it is to conceal some information, and this group is precisely the ones most in need of high-quality medical services.
Reduce communication blind spots,
Doctors and patients need to change
From a doctor’s point of view, the so-called adequate communication is not only enough to “explain clearly and clearly”, but also to actively understand the feedback and opinions of patients. If time permits, you should ask a few more questions, “Do you understand”, “Do you need me to repeat it again”, “Is there anything I don’t understand”, “Are there any questions”, “Do you have any questions about this treatment plan?” Any opinion?”
In addition, rich forms of information transmission can also help doctors make up for the limitations of face-to-face communication , such as providing patient education documents that patients can take away, read and save, including introduction of disease knowledge and specific treatment guidance; Information on the website of the materials; providing channels for patients to consult and give feedback later if they have questions, and so on.
Doctors can deliver information in richer forms | Pixabay
From the patient’s point of view, it is still necessary to answer the questions raised by the doctor as frankly as possible , and not to conceal key information, so as to avoid the adverse consequences of misdiagnosis and missed diagnosis. Regarding the treatment suggestions given by the doctor, boldly ask your own questions , and ask the doctor to repeat the key information that you did not understand. Lives are at stake, so don’t be shy.
Author: Zhai Mengyao
Edit: odette
references
[1]Levy AG, Scherer AM, Zikmund-Fisher BJ, Larkin K, Barnes GD, Fagerlin A. Prevalence of and Factors Associated With Patient Nondisclosure of Medically Relevant Information to Clinicians. JAMA Netw Open. 2018;1(7):e185293 .doi:10.1001/jamanetworkopen.2018.5293
an AI
Generally speaking, human beings will lie for their own benefit, why would anyone want to suffer and lie about their illness?
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