Thursday, January 23, 2014


Patients lie. Constantly. It's frustrating enough to make a diagnosis without half the things the patient says being freaking lies. Or better yet, they intentionally omit things.

Sometimes it's due to embarrassment. Like I had one patient who didn't want to admit to me that his stroke symptoms occurred while he was having sex with his wife. That's understandable, I guess.

We assume everyone is lying. No matter what they tell us, we always get a urine tox. We always add few drinks to what the patients say their daily EtOH consumption is. Even if a woman claims she hasn't had sex in a year, we do a pregnancy test. I've heard the whole logic of starting pap smears on woman at age 21 regardless of sexual activity is that if a woman is 21 and says she's never had sex, she's probably lying.

It's sad that it's gotten to the point where if a patient asks for an excuse to stay out from work or a few vicodin, my radar goes up immediately... even if they very clearly need what they are asking for.

For example, a while ago, a quadriplegic patient asked me to fill out a disability form for him (for a few weeks) because he had fractured his leg and couldn't transfer into his car anymore to drive to work while in the cast, my automatic thought was, "Is he trying to sucker me into signing a disability form?" That's really and truly sad that I've been conditioned to think that way. It's not good to be a pushover, but I wish I weren't that skeptical.


  1. You're not alone. It was actually easier for my wife to get a temporary tag from the DMV for her broken femur than it was to get a reserved spot at work. Apparently the DMV tag alone doesn't qualify you, nor does a doctor's note. You also have to get a special form you fill out that is looked over by their "reserved spot specialists" or whoever the hell they really are before you can qualify for a spot near the door.

    It's because so many people try to scam them for the spots. It makes life difficult for those in real need and it makes those with the power to fulfill the need automatically suspicious.

  2. Is it really skepticism if that intuition is correct the majority of the time? I prefer "common sense."

  3. It's too bad this is the case. For one thing, my physicians' assumptions that I lie, when I don't, are part of the reason why it took so long for me to finally be diagnosed with my rare disease.

    I would also point out that many doctors lie, a LOT, especially when they have a patient like me with a complex condition that they do not understand and don't have the guts to simply admit that they are in over their heads. There is no shame in that, and as a patient I would have appreciated that honesty. No one can possibly know everything.

  4. As a virgin in her mid-20s who has tired of doctors not believing me, I try to at least pretend to believe my patients until it's obvious they've lied or there is evidence to the contrary. However, if I feel a patient may be untruthful about a question that could significantly affect their care in some way, I try to explain to them why it's particularly important that they answer that question truthfully. I feel like a lot of the lying because of shame or embarrassment (not so much the lying for personal gain) ceases when doctors take the time to mention confidentiality and actually ask/listen patiently and non-judgmentally.

  5. It's very sad to hear that doctors believe we patients lie. Most don't. Most are truly looking for help, and if what he/she says to the doc sounds crazy or made just might not be.

    I have fibromyalgia. I had NO clue what the hell that was, and had been repeatedly told I was just trying to get pain meds or that I was crazy.

    Thank God I found a doctor who not only understood what was going on, but explained it to me. I cried from relief...and I've stuck with her for 15 years - partially because of that.