As toddlers, nothing is off-limits. We are fascinated by the whole world, including our bodies and the things that come out from them.
As we get older, we are socialized to regard many topics as not to be discussed, and this often colors the way we present ourselves to doctors and nurses, sometimes to our detriment.
It is said that 70% of the information a doctor needs to make a diagnosis comes from the history. This assumes the history given is accurate.
One good example is our bowels. While I agree that discussing one’s bowel habits at a dinner party would not be appropriate, the same does not hold true in the doctor’s office. If there has been a change in your frequency or the appearance of your movements, this may indicate disease and so should not be kept secret.
Ditto urination. Increased frequency of urination, loss of bladder control or change in urine color may all need to be addressed, but this will only happen if you tell your doctor about these things.
Your sexual habits may put you at higher risk for certain illnesses and may suggest certain tests be done, but these will only be ordered if the doctor is aware of the need.
Do you drink more than you let on? Do you use injectable drugs? These habits clearly increase your risk of liver disease and other conditions, and it is important that your doctor know about these behaviors.
Just as a Catholic going to confession feels safe in admitting their behaviors to the priest, a patient seeing their doctor should feel safe in discussing topics they would never bring up in any other situation.
Unless your doctor has limited their practice to convents, you will not be telling them anything they have not heard before, so there is no reason to be embarrassed. Knowing these behaviors and habits will get you more effective care than will keeping them secret.
While there is doctor-patient confidentiality, in an era of electronic medical records you may justifiably worry about privacy. If this is a concern, you can ask the doctor specifically not to put what you are telling them in their note. Since, in the U.S., you are entitled to see your medical visit notes, you can verify they have followed your request.
A well-informed doctor will give you better care. Nothing you say will shock them, so be open!
Edward Hoffer MD is Associate Professor of Medicine, part-time, at Harvard.
What Does The Doctor Say?
By Dr. Edward Hoffer