GG, a 35-year old lady, consulted a doctor on account of certain complaints. During her evaluation, she was asked if her blood pressure had always been high. Due to the fear of being tagged, ‘hypertensive,’ she answered, ‘no.’ Not convinced, the doctor probed further. She maintained her position. Her blood pressure that day was 160/100mmHg. She was counseled on what to do and investigations to have conducted. She never returned.
Five years later, GG had stroke. Her sister told the doctor that GG was informed eight years earlier of an elevated blood pressure…
XY, a 23-year old man, complained at a clinic of difficulty with breathing and cough. He had experienced these complaints repeatedly. He read it up online and learnt that Asthma could be a cause. He hated to be called an asthmatic patient. His doctor asked about previous history of recurrent difficulty with breathing, catarrh, and/or cough. He affirmed that he had always been fine. He was informed that he probably had Asthma. He got better with the first aid treatment given but ignored further counsel.
Eight months later, he had to excuse himself from an oral interview for a dream job. He began to cough uncontrollably in the boardroom when the chairman’s perfume irritated his airway…
PJ, a 30-year old lady, complained of lower abdominal pain while urinating. She was otherwise fine. She was asked for the date of her last menstrual period but she could not remember. She was further asked about any history of unprotected intercourse in the previous weeks. She declared not to have had any form of intercourse in a month prior to her complaint.
The doctor recommended a pregnancy test amongst other tests. She tested pregnancy positive. She could have been given a medication that would harm the unborn baby….
The above are a few scenarios of how patients ignorantly but intentionally mislead their doctors. The questions asked during the period of consultation are very necessary to take a decision at diagnosis and treatment. Any false information is dangerous. Both parties are affected. The doctor feels like a ‘bad’ physician because he or she had made a mistake despite being innocent. The patient is even more affected. He or she may even die.
In some cases, some patients want to hurry the doctor up to just administer his or her treatment so that they can leave the hospital. The hospital is not a grocery store where the time spent is predictable. In other cases, some persons feel their secrets are about to be uncovered just because they were ill and had to come to the hospital. They concoct information to suite themselves and yet expect to get well. They feel the doctor should use his or her initiative to make them healthy irrespective of their uncooperative attitude at providing necessary information.
In some traditional settings, the woman refuses to state the number of pregnancies and children she has. It is believed that you do not count the number of pregnancies. During medical consultation, the number of pregnancies, especially, if some complications occurred, is very important in the management of the woman. The absolute truth helps everyone.
How can a patient be encouraged to be transparent? There is no doubt that we all have a right to our private lives. However, such rights are relinquished when one’s chance of getting better depends on the accuracy, reproducibility, and reliability of the information given. The following are tips that would encourage clients to feel free to give information without fear of ‘victimization or stigmatization.’
• Develop a healthy relationship with medical personnel: This makes you not just a client but an ‘’official friend’’ of the personnel involved. This approach protects the client always.
• Stick to one or two medical personnel where possible: Switching from one hospital or doctor to another without a cogent reason increases the number of times ‘uncomfortable’ questions would be asked.
• If possible, consult another medical personnel after you must have gotten a referral from your personal physician.
• If you have reservations about the services of your personal physician, politely let him or her know about it. You have a right to be treated well.
• Keep strictly to appointments: Some hospitals do not assign doctors to patients. This means that any doctor can see any patient at any time in such settings. However, when patients keep appointments as recommended by a particular physician, there is a high likelihood that he or she would be seen always by that physician. This keeps the client’s information safe in the hands of one doctor. No medical personnel has the time to be looking into hospital folders for information which has no professional relevance.
• Understand that the doctor had sworn an oath of secrecy: At graduation, every doctor is made to swear an oath to keep confidential every information obtained from a patient. Therefore, patients need not fear to tell the truth always.
You shall know the truth and the truth will set you free…
Dr Ademola Orolu is a Consultant Family Physician. He holds the Fellowship of The West African College of Physicians. He is also an Associate Fellow of The National Postgraduate Medical College of Nigeria. He is in active clinical practice. He is a writer, a patient advocate, and has a passion for health education. He is the Medical Director/Chief Executive Officer of Nathaniel Health Consulting (a family hospital), Matogun, Ogun State. He is the editor-in-chief of The Family Doctors. He can be contacted via firstname.lastname@example.org