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Care Manager’s Rules for Doctor Visits

By , 11:31 pm on

“Liar, liar, pants on fire.”  Remember that childhood taunt? Did you know 77% of doctors think 1 in 4 of their patients lie to them?  And, according to a 2009 survey, 28% of patients admit lying to doctors about everything from taking alternative medications to what they actually eat.  What are we (the patients) thinking? Why would we lie to a doctor, our doctor?  The doctor is the person we need to help us, who we’re paying to help us.Turns out, we lie for a lot of reasonable and unreasonable motives:

  • To please the doctor
  • To play down symptoms in fear of a diagnosis
  • To play up symptoms to secure handicapped parking permits or other controlled substances
  • In fear of disappointing the doctor
  • In fear our medical records will be communicated to employers, insurance companies, or legal authorities
  • To project the right image to the doctor (I’m an exerciser.)
  • Because we disagree with the doctor’s philosophy (Eating red meat is good/bad for people.)
  • We do not have enough time with the doctor to be comfortable enough to address sensitive issues.  (Some doctors consider 12-15 minutes per patient is an effective amount of time to spend with each patient.)

It would be wonderful if doctors could just look in our ears and see we have nerve damage occurring because we sit all day, or memory problems due entirely to stress,or depression, or we drink too much, or that we’re so depressed we can no longer take care of ourselves or in the case of older adults, we’re afraid of falling.  But they can’t.

Older people often have serious conditions which need honest discussions between doctor and patient. Our approach can work for you or the older adult in your life.

Go prepared

  • Know symptoms (fever, lumps, bumps, pain, mysterious weight gain or loss, too much or too little sleep)
  • Know the frequency of symptoms
  • Be ready to explain what you done to address the symptoms (took this over-the- counter medication)

Take a list of all medications

  • Or all the medications in their originally labeled containers
  • Include absolutely everything you put in or on your body: prescription, OTC alternative, and homeopathic medications, supplements, creams and lotions, vitamins, eye and eardrops, and suppositories.

Have patient wear glasses and hearing aids, so communication ability is at its peak.

List allergies

  • Food
  • Mediations
  • Environmental (pets, pollen)

Mention events or situation changes which affect you

  • “I just lost my sister 2 weeks ago.” (grief)
  • “My granddaughter moved in with me. She’s a toddler.” (stress)

When talking with doctors

  • Be honest
  • List the 3-4 most important concerns
  • Stick to the point

Ask questions about

  1. Tests: purpose, specifics, dangers, and when and what results can be expected?
  2. Diagnosis: what caused the condition, is it permanent, what are treatment options, how to manage conditions, what changes to life can be expected, and where can I get more information?
  3. Medication: what are common side effects, which ones are important, how long will it take to be effective, when to take and how, what if a dose is missed, less expensive options, and details on refills?

Remember, the communication process with your doctor should be a collaborative effort, so ask questions as needed.  Take notes and ask if there is written or recorded version of the information available, such as a DVD on the diagnosis or treatment. The doctor’s staff is also there for your help—ask questions of the nurse orphysician’s assistant. Find out if you can call or email the doctor with questions. Pharmacists are a great resource for medication questions.

If you are reluctant to talk to your doctor about especially sensitive subjects, consider this: problems with memory loss, depression, sexual function, and incontinence are not normal signs of aging.  The NIH recommends using brochures and booklets to introduce sticky subjects to your doctor.  This is a great idea since it lets the print speak for you and shows the doctor the source of your information.  A doctor worth relying on will treat your concerns seriously.  Seek advice elsewhere if your doctor brushes your concerns aside, especially if you have expressed your feelings clearly and honestly.

Honesty really is the best policy, even with your doctor. Honest.

(This article was inspired by an article in the WSJ: “I Don’t Smoke, Doc’ and Other Patient Lies.” From Feb 2013.Other sources include the National Institute of Health (NIH).)

Lee Nyberg serves seniors through her company,  Home Care Assistance is North America’s premier provider of in-home senior care.  Our mission is to change the way the world ages. We provide older adults with exceptional care that enables them to live happier, healthier lives at home. Our services are distinguished by the caliber of our caregivers, the responsiveness of our staff and our expertise in live-In care. We embrace a positive, balanced approach to aging centered on the evolving needs of older adults. For more information visit our website:

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