The 40 Secrets Your Doctor Won't Tell You
"Give it to me straight doc," goes the old quote, "How long do I have to live?" That question might be harder to answer than you think. Doctors aren't always honest with patients—not because they're bad people, but because they are people, and no one can be honest all of the time (are you?). Sometimes they tell white lies. Sometimes they withhold information. Sometimes they keep their personal details, well, personal.
If they let you know their every thought, you might trust them less.
Curious about what's really going on inside doctors' minds, Eat This, Not That! Health asked the country's top professionals to reveal 40 secrets they'd never normally tell you. Read on for the ultimate brain X-ray.
They Know When You're Lying
"You'd be surprised at how frequently patients come to the ER and decide not to tell us important details pertaining to their case," says Dr. Rachel Shively, MD, an Emergency Medicine physician and Toxicologist practicing in New York. "Plus we can tell when you're lying. With lying, it is usually because they are embarrassed or nervous that we won't give them the same care if they are upfront about things they do that might be disadvantageous to their health—such as drug use or not being compliant with their medications. Which is totally not true—we certainly don't judge—but is sad. Things like what you took, or the mechanism of your injury, are important things to tell us."
They Don't Love It When You Exaggerate
"Sometimes people will lie about the severity of their symptoms or add symptoms because they think—or have been told—that doctors won't take them seriously unless they have '10 out 10' pain," says Dr. Shively. "This is also unfounded but with them I always wonder what happened to them in prior medical experiences that made them think that way and also why that seems to be a pervasive thought in certain communities. Same goes for threatening to sue if you don't get what you want."
They May Not Tell You About Their Dark Past
"Consider complications they have had with procedures they do," says Dr. Thomas Horowitz of CHA Hollywood Presbyterian Medical Center in Los Angeles. "Ask if they: a) have withdrawn from a medical staff to avoid an inquiry, b) have had any accusations or board actions, and/or c) have had to give up any privileges at a facility."
They Don't Know Everything
"Ninety-nine of the 100 things doctors won't share with their patients are what we don't know!" says Jack J Springer, MD, an Assistant Professor of Emergency Medicine at the Zucker School of Medicine at Hofstra-Northwell. "For example, as an emergency physician, my primary role is to stabilize seriously ill patients and reverse their condition, if possible; next is to rule out, within reason, the presence of any life or limb threatening, or organ threatening injury/illness; and lastly to decrease pain as much as is reasonable." He continues: "Many people come to ER expecting definitive answers and so are disappointed. But if you arrive with a benign rash, we will most often not be able to give a precise cause for the rash—and for the vast majority of time it won't make any negative difference."
The First Appointment of the Day is Best
"The earlier in the day that you schedule your appointment—especially if you are the first to be seen that day—the better the treatment you will receive," says chiropractor Brandon Meade, DC. "Many times, by the end of the day, doctors—especially chiropractors—are mentally and, in the case of a chiropractor, physically exhausted and they may not be as focused as they are in the beginning of the shift."
If You're Doomed, They May Not Say So
"Our culture has a general desire to 'fight' disease," says Dr. Springer. "There are times, in my opinion, that patients should be told that a fight is futile. That the cost of continuing a course of therapies and poking and probing and hospitalizations is only stealing quality from the little life they have left. Many doctors, especially oncologists, are hesitant to give to patients their 'permission' to let go. There is withholding of a description of the emotional and physical costs of 'battling' when there is little likelihood of success. Doctors should take the lead in changing our cultural views around death, allowing it to be discussed everyday with comfort and acceptance."
Some Make Their Decision in 18 Seconds
"Perhaps the number one secret that doctors do not share with patients is that their training has provided little insight into the cause of illness. Statistically, within 18 seconds of a doctor entering a treatment room to see a patient, he knows what drug he is going to prescribe for whatever you have complained about," says Dr. Michael E. Platt, MD. "For example, if the complaint is insomnia, a hypnotic will be prescribed. If you have low back pain and fatigue, the doctor might prescribe Lyrica suspecting that you might have fibromyalgia." In order to get a more considered diagnosis, make sure you tell your doctor, in detail, everything you are experiencing, and ask what to expect from the medications prescribed.
Antibiotics Are Not Always the Answer
"Most colds, coughs, fevers, ear infections, conjunctivitis, sinus 'infections,' bronchitis, and 'flu'-like illnesses are caused by viruses which must run their course and no amount of antibiotics will be of benefit, and may cause harm in the form of side effects and bacterial resistance," says Dr. Springer.
Some Treatments Not Covered by Insurance May be Cheaper
"A doctor won't typically offer a treatment that might be more convenient because it's not covered by insurance," says Dean C. Mitchell, MD, Clinical Assistant Professor at Touro College of Osteopathic Medicine. "I do a lot of special treatments for nutrition and allergy, and I treat hundreds of patients with sublingual allergy drops which are safer, more convenient and as effective as allergy injections. But since many insurances don't cover the drops doctors don't even offer it to their patients. I think patients have to be their own best advocate and push their doctor to give them all the treatment options, even those not covered by insurance. Also, surprisingly, sometimes these treatments—like the allergy drops—are less expensive and save time and money in travel."
They Won't Guess
"Doctors are not speculators," says Dr. Springer. "We use the best evidence available to make a diagnosis and treat illness. Don't ask your doctor to guess."
They Won't Tell You You're Exercising the Wrong Way
"A lot of people begin an exercise program by duplicating an exercise they saw someone do at the gym," states Dr. Allen Conrad, owner of Montgomery County Chiropractic Center. "Not only may that exercise not help you achieve your goals, but also it may not be safe for someone who is a beginner. Exercising is an important part of good health, but discuss with your doctor what type of program is appropriate for you. The key is identifying your specific goals, like weight loss or muscle gain, and develop a workout plan that targets those specific goals. Just because someone at the gym was doing it doesn't mean it's right for you."
They Get Frustrated If You're Not There For the Right Reasons
"I don't work in a clinic, so I don't deal with cancellations, but occasionally we do get people who are opiate-seeking or seeking to be admitted to the hospital for social reasons. Those people are frustrating as they inappropriately use resources causing people with legitimate concerns longer wait times—plus they can become violent with medical staff which is clearly unsafe for everyone," says Dr. Shively. "But, usually, they have unfortunate reasons for doing so—like homelessness and mental illness—so we try to have compassion about it."
They Don't Have Time to Explain the "Why"
"What I know to be true is that there is so much doctors don't share with their patients, because most doctors don't have enough time with their patients. One thing doctors don't share due to this time limitation, it's the 'why' of the therapies and medications that they prescribe," says Lisa Paladino MS RN CNM IBCLC, a nurse practitioner for women's health care.
They Likely Don't Know Much About Nutrition
"Nutrition is key to all wellness. Unfortunately, most doctors aren't learning too much about nutrition in school," says Paladino. "Those who have further knowledge are too pressed for time to bring up the topic and give detailed information to their patients."
They May Redirect You
"I treat patients with complex pain syndromes," says Eric D. Grahling, MD, owner/director of Comprehensive Pain Management of Central Connecticut. "Their pain is usually multifactorial—not one simple reason for their pain. Patients often are fixated on findings on MRIs which are frequently clinically not significant (meaning not the cause of any of their issues). We redirect the patient and explain to them that we treat the whole person, not just their MRI picture unlike a lot of providers. Such redirection helps them pursue a more holistic view of their being and condition and usually leads to better outcomes."
They May Refuse to Operate
"As an elective cosmetic surgeon, I don't operate on all patients that see me for a consultation," says Dr. Christopher Zoumalan MD, FACS, a Beverly Hills Oculoplastic surgeon. "Just because a patient wants a procedure doesn't necessarily mean they are a good candidate or would benefit from the procedure. Ultimately, I use my judgment and clinical exam findings to determine if I can truly help the patient."
They Want You To Bring a Family Member For Surgeries
"If you're having a surgical procedure performed, try to bring your caretaker or family member that will be caring for you after the surgery to your preoperative appointment," says Dr. Zoumalan. "In my practice, which is primarily an elective cosmetic surgery practice, we encourage our patients to bring their caretaker with them for their preoperative appointment. In cases of an elective cosmetic surgery, you're spending your money and your time to get an elective procedure by a skilled surgeon, so it's important for you to have the best post operative care as possible to ensure optimal healing."
They Don't Understand Your Insurance Plan, So You Better
"Even as a board-certified physician and a graduate of multiple years of medical school and residency, I don't understand insurance plans well and neither do my patients," says Inessa Fishman, MD, a Facial Plastic and Reconstructive Surgeon at Aviva Plastic Surgery & Aesthetics. "I find that patients often think that having insurance means all their treatments are 'covered in full'; this is certainly not the case for many people. Many of my patients do not understand concepts like copays and deductibles, and do not know the details of these as they pertain to their individual health insurance plans. This isn't a secret per se, but I do think that understanding one's health insurance plan—and preparing for a specialist visit by finding out which treatments are covered and which are not—would lead to a more effective and less frustrating experience for a patient at the doctor's office."
They Won't Answer 'What Would You Do?'
"Doctors often don't feel comfortable sharing their personal decisions with their patients," says Dr. Alyssa Dweck, MS MD FACOG and Scientific Advisory Board Member for Tru Niagen. "Oftentimes, doing so might blur the lines between a personal and professional relationship and create a feeling of vulnerability. Take, for example, a birth control method, hormone replacement therapy for menopause symptoms or undergoing surgery such as hysterectomy—these decisions are fraught with multiple variables which influence a person's decision including medical, cultural, financial and even religious. In these more complex and thought provoking cases, one provider really cannot say 'what he/she would do.'"
That said, Dr. Dweck can recommend the Mediterranean diet, an exercise regimen combining cardio and weight training and a vitamin B3 water soluble. "While these recommendations are personal," she says, "they are general enough as to not cross that fine line between doctor and patient or friend."
They Never Share Their Personal Opinions
"I tend to withhold personal opinions with patients," says Dr. Erica Steele, DNM ND CFMP BCND of Holistic Family Practice. "A patient may be on the fence about huge topics such as immunizations, abortion, etc., and my job is to be a biased objective healthcare perspective simply weighing the pros and cons for various healthcare scenarios. It is not my job to place blame, judgement, or sway my patients in any direction. Ultimately, I respect a person's right to choose their own healthcare decisions therefore will only provide the facts as I see them, nothing more."
They Don't Talk About Religion
"I withhold my religious/spiritual beliefs," says Steele. "I treat in Virginia, a Bible Belt state, and am often asked questions about my religious beliefs. Although I think it is very important to have a provider you can trust, I also think that sometimes it is rather invasive to be asked personal questions regarding your spiritual beliefs. Although I have a strong spiritual background, I often do not feel my healthcare practice is often the place to express those views, especially when I am fearful of saying the wrong thing or the right thing."
They Won't Share Their Age
"I am young, and I also look younger than I am, however I am extremely intelligent—remember Doogie Howser?" says Dr. Steele. "I tend to blow people away with my knowledge and insight, but also look very young which leaves people curious. I am often asked my age and become reluctant to answer as I become concerned that my opinion will not be taken as seriously as my twenty-year counter parts. Although age may be a factor in some things, cutting healthcare knowledge is found in the younger healthcare teams."
They May Not Disclose all Potential Treatment Options
"Doctors often withhold, or fail to disclose, all the potential treatment options available to their cancer patients," says Dr. Beatriz Amendola of the Innovative Cancer Institute. "Sometimes it's intentional because a certain option may not be offered by their practice, hospital or group and they don't want to see that patient go elsewhere. Sometimes it's unintentional due to lack of education on alternative treatments. The speed of change in the medical field is daunting. So, it's understandable for a doctor to not know everything, after all we are human too. If we do know all the options, it is our duty not to withhold the information—and I follow that."
They Neglect to Mention How to Prepare Your Home
"Support pillows, drinking straws, pickup tools, and a medical grade shower chair are all examples of products that can help a patient feel safer and more comfortable after surgery," says Dr. Paul Parker, a board-certified plastic surgeon and author based in Paramus, NJ. "It's also a great idea to go through your home before a procedure and pull out anything that you use regularly—having everything conveniently placed within arm's length will help you avoid unnecessary reaching and bending. These simple and intentional preparation steps could help you avoid injury and potentially reduce your recovery time."
They'll Tell You the Shortest Possible Recovery Time—Not the Longest
"This is unrealistic for many average patients," says Dr. Parker. "You should do your own research to confirm, reading about recovery time ranges from trusted online sources. You can also ask your doctor or nurse for the outside range as well as effects that might linger. It's better to know ahead of time if you are likely to need more time to recover."
Yes, If Push Comes to Shove, They May Use Leeches
"If all else fails, we will use leeches. In my first book, In Stitches, I described a situation with a patient whose nipples were having major problems with blood supply after a breast lift operation," says Dr. Anthony Youn, M.D., F.A.C.S. "When this happens, the nipple can literally turn blue, then purple, then black. Once it's black it's dead and the nipple eventually sloughs off. How did we save the nipple? Leeches. Leech therapy, as medieval as it sounds, is still being used in major medical centers as a last ditch savior for plastic surgeons. They act like a temporary attachable vein, removing the overloaded venous blood and saving the nipple."
July is a Potentially Dangerous Month
"Your chances of being subjected to a medical error is higher in July than any other month," says Dr. Youn. "July 1st is the day when all the new interns begin working in the hospitals, and the outgoing interns take new roles as residents. Studies have shown that at academic medical centers, the rate of medical errors is higher in July, probably because of it."
Plastic Surgery is the Wild West of Medicine
"Plastic surgery is the only field of medicine where doctors, such as ob-gyns, emergency room physicians, and family medicine docs, ditch their chosen profession to masquerade as another one," says Dr. Youn. " Because they don't have to deal with insurance companies and managed care, these doctors take weekend courses in cosmetic treatments and surgeries in order to make some extra money. It's truly a buyer beware market. It's no surprise that there is a very successful TV show called Botched."
Medical Students and Residents Might Practice Suturing on You While You Sleep
"It happens in all teaching hospitals," says Dr. Youn. "Doctors need to learn how to suture, and sewing a pig's foot on your kitchen table will only go so far. While the thought of a medical student or resident learning how to suture by suturing your incision may be concerning, fret not. Good surgeons make sure the closure is as good, if not better, than he or she would do themselves."
Not All Doctors are the Best
"There is a joke amongst physicians: What do you call the person ranked dead last in medical school? 'Doctor,'" says Dr. Youn. "Yes, although you need to be an outstanding student to get into medical school and to finish, someone has to be ranked dead last. And as long as he or she passes the tests, then that person gets to be called 'Dr.' just like the rest of us."
They Won't Give You a Medical Degree
"In the age of Google, patients have access to more than enough information in regards to their health but often do not know how to apply that information. Due to time constraints, we are not also able to answer every question posed and every detail of their case," says Dr. Steele. "The withholds are not done in malice but rather in timing and attention. Every minute detail does not always need to be explained, especially when it relates to practical applications. It is impossible to boilerplate 30-40 years of poor health habits in a neat and clean one or two paragraphs. Some patients it seems want a medical degree in their appointments and become so distracted with the quest for knowledge they forget their main focus is on the practical application of healing."
Treatment is Not Always the Answer
"Sometimes, what doctors and hospitals don't tell you, is that after the fact treatment is really not the answer," says Dr. Tarek Hassanein of the Southern California Liver Centers. "This is the same as a politician who wants to cut the ribbon on a new bridge. Sure, the press is great, and it's nice to have your name on something new and shiny—but, had the bridge been maintained regularly, then the massive (and expensive) work would be unnecessary. We focus on preventative care—screenings, lifestyle changes, and careful monitoring all come together to create the best version of that person's health."
They Might Have Dealt With Your Illness Before
"Your doctor may not tell you that they are dealing or have previously dealt with the illness you may have," says Dr. Nofisat Almaroof, Board Certified Family Medicine Physician. "Most doctors are trained to show a certain degree of empathy, but sometimes they may secretly want to invoke sympathy by telling a shared experience. A lot of physicians may hold back for fear of seeming too forward and possibly diminishing professional boundaries, especially if the illness carries stigma or embarrassment."
This May Be Their First Time
"Doctors can withhold that it may very well be the first time they are doing a certain treatment or procedure," says Dr. Almaroof. "This applies similarly to procedures that haven't been performed in a long time, or procedures being performed for the first time without supervision. Doctors want their patients to feel comfortable and trust their abilities. While residency training is rigorous and comprehensive, post-residency many doctors may have a healthy nervousness about performing a certain treatment despite their weighted title of attending physician. Even though they may not disclose how many times they have performed a certain procedure, it is always the doctor's ethical responsibility to make sure they are fully competent and safe."
They Won't Give You a Definite Diagnosis
"Another thing a doctor shouldn't tell you is a definite diagnosis, even when they suspect a 'bad' one, until a final diagnosis can be made," says Dr. Springer. "Say your CT scan in ER shows a mass in your lung which the doctor knows is likely cancer. He or she can't tell you the diagnosis because it requires a tissue biopsy or other advanced diagnostic test not available in the ER. So you will be told 'the truth' that 'we just don't know yet.'"
They Sometimes "Polish" Your Chart With Unneeded Tests
"Whether a test is needed to confirm a suspected diagnosis or is just defensive medicine, doctors waste many health care dollars in the belief that it gives them legal protection," says Dr. Horowitz. "It is important to ask what is really needed rather than just 'polishing' the patient's chart."
They Sometimes Recommend You to Their Pals
"Wonder whether the specialist is someone the doctor would see or is just a friend that is in that specialty," says Dr. Horowitz. "The same can be said for other health vendors as well. Different facilities have different equipment. The local MRI might be half as strong as the newer units."
They May Just Be Following Protocol
"Treatment of disease should be personalized," believes Dr. Horowitz. "The physician may be following guidelines based on insurer protocol rather than unique need of that patient."
They Might Not Be Thinking of Your Costs
"Cost of diagnostic tests and medications vary a great deal," says Dr. Horowitz. "Doctors often will not spend time discussing the most cost-effective option. Many services can be negotiated but it must be done prior to the test or procedure." And, he adds: "They might have financial ties to companies. It is important to ask, 'Why this or why here?'"
They Think About You After You Leave
"I suspect most patients don't realize how much time we spend thinking about them after they've left the office," says Jordan Glicksman, an otolaryngologist, head and neck surgeon, rhinologist & skull base surgeon. "Most patients we see have routine problems, but when something is more complicated or unusual then the visit doesn't really end for the doctor when the patient leaves. At the end of the day or between patients we often do some research or consult with our colleagues for advice with unusual situations to ensure we provide our patients with the best possible care." For more secrets revealed—and to live a happier and healthier life—don't miss these essential 70 Things You Should Never Do For Your Health.