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How to Be Honest With Your Doctor About Your Many, Many Vices

Yes, that includes the risky stripper sex you had in South Beach

Walking into your annual check-up with your primary care physician can be a weirdly nerve-wracking event, because you know that, since your last visit, you haven’t followed much of their medical advice at all. In fact, you’ve done your level best to utterly violate it: They advised you to get more exercise, eat healthier, drink less and always avoid casual, unprotected sex. Instead, you remained mostly in the prone position, outdid Morgan Spurlock’s Super Size Me stunt diet, replaced your bodily fluids with booze and generally behaved like an animal with a dick where its brain should be.

That’s why, even on our best days, we tend to fudge our answers. Units of alcohol per week: Ohh, maybe three? Drug use: Never! Exercise: Loads, yeah, just… loads.

But how honest with our doctors should we really be?

“Deadly honest,” says primary care physician Dr. Marc Leavey. “You may not realize it, but treatment decisions are based on what the patient discloses. A physician’s evaluation is based on full and complete knowledge of what’s going on with the patient. Without that knowledge, the diagnostic plan, and subsequent treatments, may be flawed.”

Which, yeah, we kinda all know this, really. So what makes us feel compelled to lie so frequently in such situations?

“For me, it comes down to social stigma,” says Richard Garcia, a 46-year-old supermarket general manager from North Bergen, N.J. “I’m embarrassed to say how much I really drink — what if he tries to peg me as an alcoholic? Second, I always feel that if he finds something wrong with me, he’ll link it directly to my alcohol use. Then, in turn, when I’d have to explain to family and friends that I have an ailment, they’d also connect it to drinking.”

According to Leavey, however, this type of elusiveness can backfire on you drastically. “Leaving out the fact that you drink more than a glass of wine a week, when it’s more like several a day, can cause the doctor to order a raft of unneeded and possibly uncomfortable testing,” he says. “An accurate history may be all that was needed.”

Social stigmas aren’t the only things that might deter us from coming clean with doctors about our not-so-healthy lifestyles: There are also the potential legal ramifications. “I never admit to my doctor about smoking weed, even after I’ve been to L.A. or Denver where it’s legal,” laughs 38-year-old Tara Singletary, a division coordinator from Neptune, N.J. “It’s illegal in this state, and I don’t want to be judged. But I have no problem discussing it with anyone else — family, friends, etc.”

Of course, we don’t only lie to our doctors to hide our vices — sometimes we lie to feed them. John Walcott, a 38-year-old food safety director from Westchester County, N.Y., says he use to feign illnesses to get his doctor to help supply his habit. “I always lied to doctors to get drugs. I exaggerated conditions like pain and anxiety, and in turn, the doctor would prescribe me something: Percocet, Xanax, Valium.”

Leavey insists that lying about any kind of drug use is one of the biggest no-nos. “Interactions with prescription drugs can be a pejorative factor with what you’re taking, both legal and illicit products,” he says. “So, you should inform us about even something prescribed by another physician that you don’t want to talk about [think plastic surgery or erectile problems].”

No matter the reasons we choose not to shoot straight with our physicians, it’s obvious we’re doing ourselves a huge disservice. But when the truth feels embarrassing or awkward, what’s the best approach? Leavey admits it’s a tough question, but says it’s important to let the candor forth anyway. “It’s kind of like when your mother asked who broke the vase. Part of being an adult is learning to face the truth, no matter how embarrassing. Just as one needs to be honest with one’s spouse, one needs to be able to suck it up and gather the strength to be honest with your doctor.”

And don’t worry about straddling the line between needless oversharing and telling them the stuff they need for our better health. “Let the doctor be the judge of that,” Leavey advises. “He or she knows what’s important, and what really doesn’t matter, while you most likely don’t. The thing that may most concern you might be viewed as trivial by the doctor, and something you feel is insignificant may be the key to the problem. So feel free to put yourself in brain dump mode, take it easy, and let the physician guide the process.”