A while ago I was asked to write a column about why patients lie to their doctors. That got me to thinking about what I have learned in the past thirty-seven years since I started my career as a primary care physician, or PCP. Since I write my columns well in advance of the date they will run, this was the first chance I had to answer that question.
It is said that the best way to learn something is to actually do it, and I have learned much over the years. The keystone to good medical care is communication. Consider, if you will, a bicycle wheel. Medical communication is akin to that wheel. At the hub is the PCP. Specialists are located along the rim and tire. The spokes of the wheel represent the two-way communication between the patient’s specialists and PCP. This communication, in whatever form it may take, is vital to the health of the patient. The patient is riding the bicycle, causing the wheel to spin. If there is no communication between the PCP and specialists, the wheel breaks and the patient falls off.
All too often, it has been my experience that many specialists do not communicate with the PCP. When I refer a patient to a specialist, I make it a point to reach out to him or her to explain the reason for the referral. When this happens, the odds of my hearing back from the specialist are good. However, patients frequently go to specialists on their own. When they do, I rarely hear from that specialist. It is not uncommon for a patient to tell me during a visit that he/she was hospitalized or had surgery, a heart attack, etc. without me ever being made aware of it. The patient may be on medications that are completely different from what I thought they were on because the specialist changed them and didn’t inform me. This creates a dangerous situation for the patient because, in case of an emergency, an ER or hospital is more likely to reach out to the patient’s PCP, not a specialist. If that happens and the PCP is unaware of the patient’s current medical state, a disaster may ensue.
Likewise, proper and accurate communication between the doctor and patient is also vital. I don’t believe that patients willfully lie to their doctor, but they may alter or leave out details out of embarrassment. For example, if you drink six beers a day, don’t say you only drink on weekends. This may mislead the doctor and cause an incorrect diagnosis. In addition, the doctor must ensure that the patient fully understands the doctor’s directions. Sometimes, a follow-up call to the patient helps to ensure that the patient is fully aware of what had been discussed.
Primary care medicine is a very fulfilling career choice but is not easy. Keeping current with a patient’s ongoing medical situation can be challenging. Be sure that your PCP is fully aware of any changes in your medical condition and is involved with your treatment choices. After all, it is your health that is at stake.
By Peter Galvin, MDBLOG COMMENTS POWERED BY DISQUS