Saturday, June 12, 2010

Eight Secrets You Should Tell Your Doctor

It is important to have an open relationship with your primary care physician because the more she knows about your health and lifestyle, the better able she is to diagnose illnesses as they come up.  You wouldn't take your car to a mechanic and not tell him that the brake is sticking.  And a human organism is thousands of times more complicated than a car.  But patients are shy. They are embarrassed. They don't want you to think badly about them.  So they often leave out important information that is critical for the physician to know.  Here are eight secrets you should tell your doctor:


  1. All of the medicines you take, including herbs and over the counter:  It is amazing to me how many times I review a med list and  even when I prompt "is that all?", I find out much later that the patient left out the birth control pill or the herb for prostate.  Everything is important.   
  2.  Smoking, drinking, drugs:  All doctors know to triple the amount a person says they drink.  If you smoke "on weekends"...admit it.  The same with recreational drugs.
  3.  Can't afford your prescriptions:  Studies show that up to 40% of patients cut their pills or don't fill the Rx. because of cost.  Tell your doctor up front. There are many generic equivalents as well as prescription assistance programs that can help.  We all know that prescriptions are wildly expensive and we want to make sure you can afford it.
  4.  How much you really exercise: We all want to exercise more but saying you exercise "regularly", when it is really a walk to the car, makes it hard to come up with a treatment plan that will really work.
  5.  Have sexual dysfunction: For men, sexual dysfunction can signify diabetes, thyroid disorders or atherosclerosis.  Tell your doctor if you can't get it up or if there has been a change in your sexuality.  For women it is even more complicated so open up that discussion.
  6.  Have a change in your bowel movements: Blood in the stool, a change in your regular habits, pain with movements are all things that should be discussed. Doctors are very comfortable talking about body functions.  We do it at the dinner table so don't be shy.
  7.  Extreme stress:  Worried about money? Having marital problems? Have a teenager? Your mental health is as important as your body functions.  Let your doctor know if you are experiencing stress as it can have major impact on your health.
  8.  See another doctor:  One patient recently told me he had "cheated on me" and seen another doctor closer to his home.  I had to laugh at this because he said it like it was a betrayal, but I was glad he felt open enough to tell me.  Coordinating care is important and knowing that tests or prescriptions have been given by another physician is critical information for us to have.
The private nature of medicine shows why it is so important to have a trusted relationship with a physician.  It is also OK to ask that some information be left out of the medical record (chart).  The medical record is not private.  Every time you apply for insurance (life insurance, health insurance, disability, long-term care) you sign a form that allows access to your medical record so protecting it is important.  Again, this is why an open understanding with your treating physician is so important.  But if you have that relationship...go ahead a be open.  It is a partnership.

20 comments:

Tink said...

I love this. Another reason to tell your doctor if you aren't getting your meds for any reason - esp. the $ - they may have samples on hand. I was able to do this with my insulin when my insurance wouldn't cover the amount I needed and I was unemployed. I felt bad about asking for it when I knew there were others that needed it, but then I realized that I needed help, too. My doc was extremely sympathetic, and now also knows to ask about my stress levels.

Really, be candid with your doctor. They can help so much more than you can ever imagine. And if they don't seem to listen - that may be a sign that you need a new one.

Michael Kirsch, M.D. said...

Two points:

(1) Nice post
(2) Gender assumption???
"It is important to have an open relationship with your primary care physician because the more she knows"

Toni Brayer, MD said...

Michael Kirsch: Very funny. The only other way to write it is to say "he" which is a bit of a cliche' since that is how it is written about 100% of the time. I don't think it is proper English to say "they". Any other suggestions?

Michael Kirsch, M.D. said...

No, just poking some fun!

tracy said...

Another excellent post, thanks so much, Dr. Brayer.

Sucks to think that if i am
"absolutely" (hee) honest about the amount of wine i drink, he will s t i l l (hey, another accidental joke...!) TRIPLE it. i knew they teach Medical Students to double the numbers, but triple (sec)....??
Sighs.

tracy said...

"Doh". And here i was, thinking "they" was proper english. That's what a Soc degree will get you!

Sunnydalai said...

Wonderful post and very helpful! Best of all, your personality comes through loud and clear:)

Anonymous said...

"All doctors know to triple the amount a person says they drink."

Wow - talk about fostering mistrust between doctor and patient! Now I know why so many doctors assume symptoms that aren't present when I talk to them. They assume too much.

Want to stay healthy? Eat right, exercise moderately every day - and stay away from doctors!

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This is excellent because if we're confident with our Doctors they can determine if we have a rare disease or something dangerous for us.

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