Doctors say lying puts patients' health at risk

Can lead to costly diagnostics and unneeded referrals

Monday, January 22, 2007
By CARLA K. JOHNSON
The Associated Press
CHICAGO - There's an open secret in medicine: Patients lie.
They lie about how much they smoke and whether they're taking their medicine. They minimize how much they drink and overstate how much they exercise. They feign symptoms to get appointments quicker and ask doctors to hide the truth from insurance companies.
"Doctors have a rule of thumb. Whatever the patient says they're drinking, multiply it by three," said Dr. Bruce Rowe, a family doctor in suburban Milwaukee. "If they say two drinks a day, assume they have six."
Hippocrates, the father of medicine, is said to have warned his students around 400 B.C. that patients often dissemble when they say they've taken their medicine. TV's fictional Dr. Gregory House repeats the same message to his crack team: "Everybody lies."
But lying can lead to expensive diagnostic procedures and unneeded referrals to specialists. It also can have disastrous results.
"I definitely learned my lesson. I could have ended up in a coma," said Michael Levine, a 28-year-old financial adviser in Los Angeles, who lied to a specialist he saw for a wrist injury. Misguided pride, he said, kept him from mentioning the Xanax he was taking for anxiety. He didn't think the doctor needed to know.
"He wasn't my regular doctor. He was treating my wrist," Levine explained.
The doctor prescribed the pain reliever Vicodin and Levine took it on top of Xanax. The next few days vanished in a cloud of grogginess. Levine slept through ringing phones and alarms and woke up exhausted. His wrist pain was easing, but he could barely function. Eventually, he stopped the Vicodin, returned to the doctor and, under questioning, confessed.
"The doctor said, 'Why didn't you tell me? I never would have prescribed you that,' " said Levine, who now realizes how easily he could have overdosed and died. "For the future, I will always 'fess up.' "
Why do patients lie? The examination room itself is an environment that discourages honesty, said Los Angeles psychiatrist Dr. Charles Sophy.
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