DocSwiner's Superwoman Complex Blog

After taking some time off from writing, I was asked to comment on the importance of being honest with your doctor. This can be approached from many different angles.

The simplest route is to apply the “proof’s in the pudding” explanation. This means that if testing is done, I’ll eventually discover what’s going on after the results return. In reference to this issue and my adult patients, it means there’s no use in hiding the fact that you were once told you had high blood sugar, high cholesterol or drink alcohol a little too regularly. This is easily picked up on routine screening labs when you see your doctor. Why not be forthcoming in the beginning?

In reference to my adolescent and teenage patients, it’s useless to hide or lie about the fact that you may be sexually active, smoke cigarettes or tried illegal substances because this can be discovered in blood or urine.

However, don’t get me wrong; this is a much more important issue that just getting caught in a lie by your doctor. It speaks to an issue of trust, or lack thereof. A patient is supposed to feel comfortable with his provider enough to share intimate details, even when it may be sensitive. The matter of trust can be life or death. If a patient does not have great rapport with his provider, then that provider is not the right one.

I’ve unfortunately had more than one occasion with teen patients whom I thought I had a close relationship with that lied to me about being sexually active or involved with illegal substances. In two cases I can recall, I was either told a teen patient was not having sex or she just had her menstrual cycle, so pregnancy was not a concern. However, at the very next visit, we found out she was either pregnant or had a sexually transmitted disease.

Cases like these can be avoided if you are honest with your doctor from the beginning. We could have discussed abstinence, birth control or STD prevention. We, as your doctors, are there to protect you from harm. It’s very disappointing when instances like these occur, because I talk openly and frankly about health prevention, STD prevention and other health problems that can occur from bad decisions until I’m blue in the face.

For my adults, the more transparent you are with your doctor, the healthier you’ll ultimately be. Ask that embarrassing question you’ve always wanted to ask. Just like in school, “there’s no dumb question.”

For my teens again, if there’s an issue you want to share with your doctor, it’s ideal, of course, to first discuss it with your parents. However, if you’re too ashamed or nervous to talk to them, or a more detailed answer is needed, we can politely ask Mom or Dad if it’s OK to have a private conversation with your provider so that it’s more comfortable for you. Your medical questions are held as confidential information unless in extreme or fatal situations. If Mom or Dad says no, we can all have an open conversation together. The most important thing is to have the conversation one way or another.

Dr. C. Nicole Swiner works at Durham Family Medicine, where she treats newborns to elderly patients. She and her colleagues are accepting new patients and can be found at www.durhamfamilymedicine.net.