Making confessions to your doctor

By Dr Tomlin Paul

Your doctor, pastor and counsellor are persons to whom you should be able to tell anything and it stays right there. In solving a patient's problem, a doctor has to get all kinds of information and put it together with what is found on examination or from doing particular tests. Remember that what you tell your doctor sets the base for proper diagnosis and treatment.

By the age of 50, you should have a family doctor to whom you can tell any and everything. In talking with my patients over the years, I have heard lots of stories about the twists and turns of life. I have also realised that they don't always tell me some important things. Every once in a while, I have to put down my pen and just listen to a true confession. Doc, I really don't take these tablets

Lifestyle advice

It was quite some time after seeing this patient with high blood pressure and giving lifestyle advice and changing medication doses that I got this one day. Folding her arms and looking down with a more serious look on her face, she says "Doc, I really have to tell you this."

Turning and responding attentively to her signal, she mutters, "Doc I really don't take the tablets." Aha! It was a breakthrough moment for us. I finally found the piece of the puzzle that was missing. She had never said that before when I asked, and would never bring her pill bottles to the office so I could check.

Okay, let me tell you what really happened

A doctor can always treat you for your symptoms. But when we hear the background, it makes more sense and the prescription becomes more focused and likely to work. When it comes to sexually transmitted infections, which by the way can still be a problem over 50, then full disclosure is of great benefit.

After seeing this patient, not the same one with high blood pressure, I write the prescription and we are all set. As he gets up to leave he says, "By the way doc ...". Oh no, I am thinking this is the notorious detour that precedes the exit. "What if I had had sex with someone else like two days before this discharge started? Do you think ...". Okay, here comes a new set of information that starts the process rolling all over again.

You have the right to remain silent

At the end of the day, you make that decision about how much to tell your doctor. You can do as little as pointing out the rash on your face and asking for a prescription. Not the best way to do things. Or you can come in, sit down and bare your soul.

That extreme is not always necessary, but be prepared to give what is relevant. Confidentiality is a vital part of the work of a doctor and so your secrets are safe. If you are not taking your medication, don't follow the diet, still having those extra drinks, hardly exercise, had an interesting night out on the town, or have some secret habit that could be affecting your health, then come in and put it on the table. Remember that, at 50 and over, the amnesty on your health history is still in place.

Dr Tomlin Paul is a family physician at Health Plus Associates in Kingston; email: yourhealth@gleanerjm.com.