Can Doctors Tell When Patients Shade the Truth?

June 06, 2013

A recent article in the Wall Street Journal health section caught my attention because it focused on an important aspect of the patient-doctor relationship. The article was about patients who leave out facts or are not entirely accurate in the information they share with their doctor.

TheWSJ article — and life experience — tell us it’s human nature to be less than forthcoming about our diet, how much we exercise, if we’ve quit smoking, or, importantly, whether we’ve taken our medication as directed. Some patients play down symptoms, others exaggerate them.

The reasons for shading the truth are many and varied. Patients, naturally, don’t want to be embarrassed or criticized. Some feel they’ll be judged, some fear disappointing their doctor. Sometimes symptoms are downplayed out of fear of an illness, treatment or even going to the hospital.

So the question arises: Can doctors tell? Can they detect anxiety or notice when a patient avoids eye contact?

While I have no formal training in this area, I have a lot of experience listening and talking to patients. Yes, sometimes we can tell.

The important takeaway here is this: It’s always better to tell your doctor the whole truth, as accurately as possible. To do otherwise can lead to serious health problems stemming from diagnostic inaccuracy or the wrong treatment plan.

For doctors at The Urology Group, candor and openness is critical to providing effective care. That may take some courage. In the prevention of prostate cancer for example, it’s crucial for men to face up to the worries and anxieties attendant to digital rectal exams and the PSA test. Lives can be saved.

That brings us to the final question. Do doctors ever shade?

Let me assure you that trust is sacred in the relationship. As doctors, we strive to be both truthful and compassionate in our messaging. We cannot deceive or withhold the truth, but we don’t need to beat folks over the head with their illnesses, either.

Most patients will instinctively lead us as to how much information they are comfortable receiving about their condition. We try to follow their lead while being truthful at the same time.

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