Gary McClain, PhD, is a therapist, patient advocate, and writer who specializes in helping clients—as well as their family members and professional caregivers—deal with the emotional impact of chronic and life-threatening illnesses.
Megan had an appointment with her doctor to go over her progress in the treatment of her chronic condition. After examining her, he asked her a few questions, including the one she dreaded:
“How have you been feeling?”
Megan hesitated for a moment, and then answered. “Fine.”
“Great,” her doctor responded. “We’ll keep an eye on your lab results. But as long as you’re doing everything we agreed on and taking your medications every day, I don’t see why you shouldn’t be seeing improvement in how you feel day to day.” And then, he added: “Glad to know you’re feeling better. I guess we’re on the right track.”
Later that day, Megan thought about her doctor’s questions and how she had answered. And she felt pretty guilty. The truth was that she wasn’t feeling very well. She was having some good days and some bad days. She wasn’t getting the symptom relief her doctor had said she should receive from her new regimen. She was also experiencing a couple of new symptoms that she wasn’t sure were related or not.
So why hadn’t Megan had a talk with her doctor about her symptoms? First, it seemed like he had worked so hard to come up with her current regimen, after some setbacks along the way, and she didn’t want to disappoint him. He’s been so concerned about her.
But there was more to it than that. Megan didn’t want to go through another change in medication. And she was worried about what her symptoms might mean. “Is my condition changing for the worst?” she had asked herself. “Or is something else going on?”
Megan knew it was best to be honest with her doctor. But instead, she had decided not to initiate this conversation. “Let me just wait awhile longer,” she had finally told herself. “I don’t feel all that bad. So maybe the symptoms will go away. And I don’t want to get all dramatic about this and sound an alarm when there’s really nothing to worry about.”
Megan did a pretty good job of talking herself out of reporting her symptoms, right?
Now, what about you? Have you ever felt like Megan and withheld information from your doctor? Maybe conveniently forget to mention something? Let your doctor think you were feeling fine when you weren’t? Or just plain told an untruth?
If you have, you’re in good company. So there’s no need to get down on yourself. But still, if you are withholding information, you may be placing your health at risk, not to mention making it harder for your doctor to do his/her job.
So the next time you have the urge to hold back on letting your doctor know everything that’s going on with you, here’s what you can do instead:
Remember that your doctor is a professional. It’s great to have a friendly relationship with your doctor. But if you are concerned about protecting your doctor’s feelings in some way, or avoiding making your doctor angry, then you are more likely to hold back on information he/she needs to know. As much as you may have positive feelings for your doctor, he/she is still a professional. And look at it this way: Being honest with another person is one of the ways in which we show respect.
And you can’t read minds anyway. As much as you may think you know your doctor, chances are you aren’t able to read his/her mind. Guessing at how your doctor might react is a waste of your time, and it wastes your doctor’s time as well. This is time that could be well spent talking about what’s going on with you and deciding on any next steps that may be needed.
Don’t worry about being high-maintenance. One of the main reasons my clients tell me they withhold information from their physicians is that they don’t want to be labeled as a high-maintenance patient or, worse yet, as a hypochondriac. Again, enough with the mind reading! Your doctor’s job is to take care of your health. If your doctor thinks you are overreacting to a symptom, they will tell you. You can agree or disagree.
Keep in mind that lack of information leads to stress. When we don’t have enough information, our minds have a way of filling in the information gaps by creating stories. And often those stories are really worst-case scenarios of what could happen. Scary stores lead to stress. And give you another reason to avoid learning the truth. You can do something about that gap in information, and avoid the stories your mind creates, by giving your doctor the full, up-to-the-minute report.
Remember that relationships are based on honesty. Teaming up with your physician requires an exchange of information. All of it. Being upfront about whatever you’re experiencing strengthens your relationship with your doctor. You help yourself by doing what you can to help your doctor do his/her job effectively.
Just say it. As hard as it is, the best way to talk about something uncomfortable with your doctor is to dive in without doing a lot of hemming and hawing. In the first place, your doctor doesn’t have time to listen to you give a long apology or your own evaluation of whether you think your symptoms are a big deal or not before you communicate the facts. Let you doctor make that call. It’s as easy as: “Look, I need to mention a couple of things to you. Over the last couple of weeks, I’ve been feeling ______.” And then provide the symptoms, how often, when, and the severity. You might want to write them down on a note card. The facts. No explanations, no apologies.
Also come clean about your lifestyle and any other medications. Patients aren’t only known to withhold symptoms from their physician. They also avoid talking about lifestyle concerns, such as not eating healthy, not exercising, smoking, etc., as well as medications they may be using that they suspect their physician may not approve of. Or they may be too embarrassed to admit that they haven’t always followed the doctor’s treatment regimen. Remember that your doctor is not there to judge you. But he/she is there to help you to stay healthy. The more they know, the better.
Bottom line: Withholding information from your doctor can be downright dangerous. And place your health, and your life, at risk. Withholding can also result in testing and treatment that could have been avoided if your doctor had all the facts.
So back to you. It’s better to know than not to know. Be upfront with your doctor. Err on the side of too much information rather than not enough. After all, it’s your health we’re talking about. So talk!