You Can Handle the Truth

Some obvious things seem like they don’t need to be researched.   Here are three examples of research that has actually been conducted and published (as reported by Eryn Brown in the Los Angeles Times):

Secondhand smoke in cars is bad for children.

Alcohol increases reaction time and errors during decision-making.

People who live in safe, well-lit neighborhoods are more likely to walk and get exercise.

It may appear to be a monumental waste of time and resources to study the obvious, but then again, it can influence public perceptions and help people personally change what they do.

Here is another example of what I consider to be an obvious finding:  Patients aren’t always honest with their doctors.  A large internet-based survey that involved over 2,000 patients who had received treatment for depression was conducted in Japan.  The survey revealed that 70.2% of responders had lied to their doctor at least once during treatment.  Over half of the patients failed, on purpose, to fully report their symptoms and 69% fibbed about daily activities including work and home life.  Most of us probably have under-reported or avoided full disclosure to our physicians at one point or another.

In assessing reasons why a patient would not be forthcoming about his or her problems or symptoms, the survey revealed that almost one-third lied to their provider because they felt embarrassed to tell the truth.  Almost 37% of respondents did not reveal the full extent of their problems or misled their provider because they felt they would not be taken seriously.

The responsibility of telling the truth does not entirely fall on the patients.  Almost half of the respondents who were not honest reported that they felt it difficult to talk with their doctor.   Many physicians do not have the time or proper bed-side manner to establish a rapport that would foster open communication; but that is a subject for another article.

I can empathize with patients who do not divulge vital information to their providers. I hate seeing the doctor.  It is unsettling to talk about problems or worries of health. The unfortunate consequence of avoiding the truth, however, is that a patient cannot get the proper treatment or support needed.   It's like going into the car dealer and, out of worry of sounding reckless, asking for a slow and safe car despite wanting a convertible race car.  You will leave unsatisfied and without your needs met.

Doctors have ethics.  Your privacy is protected by law.  You should be able to tell doctors anything and have that kept private.  Physicians should also take their patients seriously and treat them with respect and integrity no matter what.  If you have a provider that does not do that, I suggest you stop reading this article immediately and start the process of finding a new provider.

The importance of full disclosure cannot be emphasized enough.  The best outcomes of treatment occur when patients fully disclose, engage in regular communication with their providers and are compliant with treatment.   In the survey, 32% of patients reported quitting treatment for depression without consulting their physician and 45% discontinued medications without consultation.  Research (as if it was needed for this) shows that patients with major depression who do not receive or do not continue proper treatment suffer worse outcomes (ongoing depression, reports of low quality of life, relational problems, job loss, and, worst case scenario, death).

Although we may not have needed a fancy internet survey to tell us that we do not tell our doctors everything, we may as well use the data to our advantage.  If you truly want the best treatment and truly want to pursue improvement, you must be honest.

Let’s be honest anyway; the truth is generally better.  As Gloria Steinem famously quipped, “The truth will set you free, but first it will piss you off."

(Survey data is from “Most Depressed Patients Admit Lying to Their Doctors”, Wendling, P, Clinical Psychiatry News, October 2011.)