Why you should never lie to your doctor

Patients lying — from half-truths and deceptions to bold, blatant lies— is surprisingly common and can be hard to detect in today’s harried medical practices.  Common lies include everything from medication adherence, diet, and exercise regimen, to sexual history, to taking alternative medicines.  Some patients play down symptoms out of fear of a diagnosis or hospitalization.  Others play up symptoms to obtain something such as a handicapped parking permit or a controlled substance.  According to a 2004 online survey of 1,500 respondents, men were two times more likely to get caught lying as women.  In a 2009 survey, 28% of patients admit sometimes lying to their health care provider or omitting information.  Patients aged 25 to 34 were more likely to lie than older patients.

Case 1: AJ, a 23-year-old Filipina, insisted that she was following my instructions to the letter on her daily regimen for treating her melasma.  She also swore she was 100 percent avoiding sunlight and all other sources of ultraviolet light, including infrared light sources, too.  On her third visit though, her husband arrived 30 minutes ahead of her and we had a short chat on how AJ was doing with her treatment program.  Her husband told me that AJ was riding daily with him on a motorcycle with all her facial skin exposed under the sun.

Case 2: Then there’s Gigi, also with melasma, but still taking her oral contraceptive pill for fear of having another child even after she was informed that it was the primary trigger of her pigmentation problem.

Case 3: A Chinese couple consulted me for a rash that appeared on the husband’s genital area.  The husband maintained that he had the rash after he started using a certain wash one month ago.  Just looking at his rash, I concluded that he does have a sexually transmitted disease.  So I asked him if he had sexual contact with another girl.  The wife retorted, swearing to the high heavens, that her husband was clean and did not have any sexual partner other than her.  The husband also denied to death that he was having an extramarital affair.  I then requested the husband to do a Herpes Simplex I and II IgG and IgM.  Voila! Results were positive so I asked to talk to the husband alone and that was when he admitted having sex with another girl several times.   He then told me not to tell his wife about it so I said to him to explain it himself to his wife.  They never came back after that.

Case 3:  Mario, a 30-year-old bank manager, visited me and I diagnosed him to have neurodermatitis, specifically lichen simplex chronicus.  Since his skin was quite thick at the time of his first visit, I gave him an injection and then asked him to apply and orally take some medicines.  After three weeks, his dermatitis was totally gone, but only to recur after two months.  This time, he came with his wife.  I asked him, “Did you scratch or pick on that same spot again?”  Mario denied any form of manipulation.  So I asked again, “Are you sure you did not scratch it?” A 100-percent sure, was his reply.  Then the wife blurted out, “Doctor, he does not scratch it anymore; in fact, he always cleans it with a toothbrush everytime he takes a bath.”

Case 4:  Luisa, mother of four, brought her seven-month-old baby who appeared bloated.  The baby was itchy and red so she brought a cream from a Chinese store and started to apply it on her baby since she was three months old.  It brought great relief, but after just a few days, the itching would come back.  Since the baby appeared to be cushingoid (bloated and hairy), I can deduce that the mother was applying something really bad.  I asked Luisa, “Did you apply a cream, lotion, or ointment to your baby?”  She replied, “No, Doctor, I did not apply anything of that sort.” I repeated my question three more times: “Did you apply anything at all, like oil or alcohol or anything else?  No was her repeated reply.  Then when I was starting to write a prescription, she saw this tiny box on top of an antique display on my table and she suddenly remembered the cream from the Chinese store that she applied every now and then for almost four months now.  So, I told her that this very dangerous cream was a favorite of patients to relieve their itch.  I also told her that I was displaying it to disseminate information, that it is no ordinary cream and that I had several patients who used it and developed severe complications because of its abuse.

Case 5:  A 34-year-old patient who smokes and drinks (a lot) was being treated for his severe case of plaque psoriasis.  From the start of his treatment, I already forewarned him of the bad effects of cigarette and alcohol on his skin condition and told him that once I started him on oral medication, he had to stop smoking and drinking.  Well, he did promise to give them up.  Oral medication was then started, but after three months, his psoriasis went crazy.  It not only flared up, multiple, generalized abscesses also appeared.

Case 6: These last two cases were the worst lies of them all.   My team was preparing for a liposuction and tummy tuck procedure.  My nurse and anesthesiologist asked my patient if she had false teeth.  The patient denied, so we proceeded to insert the tube, and suddenly, her teeth moved.  Another worst case of lying involved the patient who was instructed not to eat for at least nine hours before surgery.  We almost lost her.  We were all panicking because of a flat line on our monitor and everybody in the OR was freaking out, wondering what went wrong.  Luckily, she survived.  I talked to her companion who told me they passed by Jollibee to eat breakfast before proceeding to the hospital.  Three people asked her prior to surgery if she ate anything and she said she didn’t.

Some patients lie out of embarrassment or fear of disappointing their doctors.  Others worry about electronic medical records or information being communicated to employers, insurance companies or the authorities.

Doctors say omitting important information or lying can lead to wrong treatment, medicine or even diagnosis.

Moral lesson:  Never, never lie to your doctor because you put yourself at risk, compromise your treatment, and jeopardize others, too!

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For questions or inquiries, call 09174976261, 09998834802 or 263-4094; email gc_beltran@yahoo.com.