The more honest you are with your doctor, the more likely it is that you’ll receive proper treatment, but the more vulnerable you’ll be to the kind of harsh, often unhealthy judgment usually reserved for your mother—except now she has a medical degree, or is in a position to make important decisions about your health based on how many drinks you may or may not have consumed.
Plenty of articles will tell you why you should always be honest with your doctor, but few health care professionals are willing to publicly entertain the idea that sometimes patients lie to them for reasons that go far beyond the fear of being judged.
While you shouldn’t lie to your doctor if you expect them to solve your problems (particularly if you’re dealing with serious medical conditions), the reality is that there are times when keeping parts of your medical history secret could be wiser than laying it all on the line.
When it’s the difference between insurance and no insurance
Though the Affordable Care Act keeps health insurance companies from denying coverage for pre-existing conditions, the same rules don’t apply to other types of policies, like life insurance. Copping to smoking weed (even with a legal medical card), taking other drugs and suffering from mental health problems might count as “being honest with your doctor,” but it also could lead to flat denial of coverage (should anyone from the insurance company look at your medical records) or, at the very least, higher premiums.
When they assume you’re lying anyway
According to a doctor at UCLA’s medical school, some physicians will mentally double whatever you report drinking on a weekly basis. This means full-blown honesty would make a nightly drinker look like a raging alcoholic.
When exposing your darkest secrets really doesn’t help
Lying to your therapist is a very bad idea — let’s just put that up front. But it may not be worth it to be as honest as you are with your therapist about your depression, addiction issues or proclivity for unprotected sex as with the podiatrist. No one needs a lecture or a bunch of nosey questions from someone who’s being paid to deal with athlete’s foot, because this isn’t an episode of House — your foot fungus and mental illness aren’t related.
When arbitrary rules prevent you from receiving (or avoiding) treatments, tests or services
Say you’re in your late 30s and you and your partner are having trouble conceiving. The fertility clinic will only start conducting tests if you’ve been trying for three years. Your partner had a miscarriage two years ago, and you were only physically able to start trying again last year. If you wait, you might miss your chance to have children altogether. Would it be understandable to lie here? In instances like this — and others, like a drug trial for Truvada that only admits people who have had unprotected sex with three partners (and you’ve had two) or an exorbitantly expensive ambulance ride—absolutely.
When a doctor’s dismissal of your personal experience actually prevents care
Perhaps the most common reason people lie to their doctors is a lack of good faith. Ask 10 people whether they’ve ever had a doctor not believe them when they reported an illness — half of those people will likely have more than one story, anything from pain to a simple, persistent cough that you know for sure is bronchitis because you’ve had it 500 times. In a culture that stresses masculinity at all costs, men often keep issues to themselves to maintain their sense of dignity; when women express their own pain, they are often measured on the inaccurate baseline set by men and ruled overly dramatic, or that they’re faking it (to say nothing of what transgender people experience at the hands of the health care system).
Again, keeping information from your doctors isn’t a habit one should indulge often, but there’s a difference between honesty for the sake of proper care and honesty in the face of a healthcare system that regularly privileges corporate interests over the welfare of individual patients. Before you walk into a doctor’s office, make sure you know which one you’re dealing with.
Devon Maloney is a L.A.-based writer. She previously wrote about the possibility that science might one day be able to erase your terrible ex from your memory.