"Hello Jane, How are you today?" a greeting that I have said over and over in our office. Some patient's will tell me about the birth of their new Grandchild. Other's about the trip they have been planning, but for the most part, "If I was doing good, I wouldn't be here" is the response I hear most often. Look, I know going to see your Doctor is not high up there on the list of fun things to do, but it's necessary at times. More times than not we see patients make a positive shift for a period of time and then BOOM out of nowhere they slip a few steps back. We change things up, they slip back again.The reason these patient's are not always "doing good" and having set backs might be because of the information that they're NOT sharing with their providers. When asked, patients stated they withhold important information because either it was a sensitive topic or sharing made them feel uncomfortable in some way. How can this be right?
For the most part, Patients that are looking for providers get stuck in the cycle of no choices. Here is what I mean. If you need a PCP, asking a close friend or family member for a suggestion occurs more times than not. This can go one of two ways. One: They tell you how great their PCP is, how they helped so and so solve their chronic problem. Two: They express dislike for who they have but continue going out of convenience or the inability to "fire" their Doctor. Yes, you read that right, FIRE! We will get back to that in a minute. Say you are lucky enough to have option one. You call the office of Dr.So and So, who at this time is not seeing new Patients, but be assured that Dr.Smith in our office is just as good. You feel put on the spot. You may be desperate for care. So, you agree to now be a Patient of Dr.Smith.
Most people don't go through the interviewing process for who they see. You, as the Patient, have the right to make sure the person overseeing your care is the right fit for you. As I tell our Patients all the time: The only person who is the best advocate for you, is you. Take the time to research the Doctors beliefs. Are they by the book? Would they consider alternative methods of care? Would they work well with other members of your health care team. Even if you currently have a PCP it is not to late to ask investigate how they value the personally aspect of your working relationship. If you are not being listened too,rushed out of the office, ignored in anyway-FIRE them! Find someone else who will care for you the way you deserve. There are so many amazing Providers that will be the right fit for you. Now let's get back to the little white lies we tell our providers.
Not being completely honest to your provider is problematic because withholding relevant information could lead to dangerous outcomes. As more and more people choose to be seen by way of Urgent Care, Emergency Room or a pop up clinic in town the harder it is to track the medical history of a person. Your PCP may not be aware that you were seen a month ago in Urgent Care, where you were prescribed a pain killer for the skiing accident you had. He or she then sees you in there office for a rash that is itchy and red. The nurse comes in, asks you if anything has changed since the last time you were seen, you answer "No" because really, it was just a twisted ankle that isn't bothering you that much anymore. Plus, you had already seen a Doctor for that. The Doctor comes in, does an examine on the rash you came in for and prescribes antihistamine pill for you to take. Follow up if the rash persists. Seems harmless right? Wrong! The combination of pain killers and antihistamines start slowing down your breathing and the combined effects lead to life-threatening respiratory depression. This happens in Doctors office and clinics all the time.
Let's go back to the WHY factor. The VA Salt Lake City Health System, who conducted a study asking Patients why they struggle to be fully honest with their providers found multiple reasons. Let's look at a few.
-Innate power dynamic that occurs within the Doctor-Patient relationship: 32% of Patients reported that they didn't follow through with what was recommended due to not understanding the clinicians' instructions. Responding by saying they felt rushed and didn't feel they had time to ask further questions. Even saying that the medical jargon used made them more confused and didn't KNOW what questions to ask. People don't want to look stupid. It's hard to admit not understanding in that power dynamic. This can be life threatening if a medication is not taken properly or mixed with something else.
-How often are you exercising? I was not shocked to learn that 25% respondents were not honest about their eating or exercise habits. The reason being though is where I feel Practitioners need to look within them and change how they address patients. Patient's admitted they are not honest about what they're eating, drinking or their exercise routine(or lack thereof) so they wont be lectured by their Provider.
-Omitting symptoms: When Patients who are already on a number of prescriptions have new symptoms that arise they aren't quick to say anything. The study showed fear of rising prescription cost is holding honesty back in some patients. Having your Doctor suggest an additional blood pressure medication on top of the four your already taking is stressing out our older generations. Cost are rising, more and more patients are finding themselves cutting back on their medication or trying to find a way to get them cheaper. This is extremely risky.
Better communication is needed on both sides of this equation. Above I have laid out the struggles of the medical world. Here at Back To Life, we have similar struggles as well. Alternative Care Providers need the same, if not more, information as your PCP does. Everything that goes into, onto or around her body has a consequence. The more information we all have, the better you will feel. In 2020 make a deal with yourself that you will share all aspects of your health to your Providers, not Facebook.The results will blow you away.