We trust that our doctors are always being truthful with us, yet that isn't always the case. Perhaps they lie to try and spare us some pain, or perhaps to cover their own mistakes, or even worse, for their own personal gain.
Not In The Best Interest Of The Patients.
“In some countries, even if you know the patient is brain dead and keeping them on the ventilator is not worth it, if the family chooses to remove the patient of the ventilator some insurance claims will not accept it as a natural cause of death and will refuse to pay. Doctors know this and they never reveal it. Many doctors are associated to large corporations which invest in hospitals and research. They just go with the company’s motto of keeping the best interest of the company instead of the patients.”
Give Him Hope.
“During the war in Rhodesia, now Zimbabwe, a 7-year-old boy was brought in to the hospital where I was part of the surgical team on-call. He had been attacked 6 hours previously with a machete on the left side of his abdomen. It was a perfect anatomical dissection. His spleen and left kidney were hanging out and his stomach was bloated from paralytic ileus. He asked me if he was going to die. As far as I was concerned, there was no ways he would survive, given the blood loss, the delay in bringing him in from the rural areas, and of course the extreme nature of the injuries. I lied: ‘No, of course not. You’re going to be fine.’ He looked relieved.
He was taken to surgery and one week later he was running around the ward, playing with the other kids, as though nothing had happened. I’m convinced to this day, that had I told him what I really was thinking, he would have given up all hope and died.”
Timing Is Everything.
“A colleague of mine was riddled with cancer. It was only discovered after he had keeled over while playing tennis. The doctor told him he had six months to live. In actual fact he died in less than three weeks. His wife and the doctor had colluded in the lie. Apparently the not dishonorable motive for the lie was the wife’s love and desire to cause her husband less anxiety and stress. I have mixed feelings about this. My colleague was an academic and was working on a paper that was important to him; had he had correct information about his prospects he might’ve made an effort to finish the paper for his legacy. Also, he might’ve wanted to contact a few more friends in the short time left instead of putting it off for what was a bit too long. Maybe he even might’ve wanted to change his will. If I had been in his shoes, I would certainly have wanted to know what my prognosis was.”
He’d Probably Like To Know That…
“Three years ago, a doctor put a stethoscope on my heart and said, ‘You have a murmur.’ It was a few days before a major surgery so they sent me to cardiology for an echo. The result was undetermined because the technician failed to get a clear picture of the heart. None of this particularly bothered me; I had a murmur at birth that I grew out of by age 12. Heart problems are rampant in the family, yet we survive to a normal lifespan (80-90). I went through with the surgery without incident.
Two months later I returned to my home, far from the hospital, and saw my PCP for follow-up. I told him the hospital found a murmur, and referenced the family history of good outcomes with annual monitoring and sometimes beta blockers. My doctor listened and said he didn’t hear a murmur. Knowing that hearing the murmur may have been random chance, the stress of surgery, or a mistake, I thought little more of it as I focused on recovery from the surgery.
For the next three years, I told the various dentists, ER docs, surgeons and nurses that I had no heart problems. Never checked the box on the form(s). Meanwhile, I saw my PCP about every three months or so. Each time, he’d ask to listen to my heart. I’d say, ‘Sure, you hear anything?’ ‘No, there is no murmur.’ Okey dokey. So I believed him. Even though I had a funny feeling about his answer—nothing specific, just a gut sensation not to trust him. It made no sense though. Why would he lie about that?
This year I was discharged from a hospital and received the usual handful of educational materials and a discharge summary. I read the summary and it had no surprises. Then I lost it. So, I contacted my PCP and asked for a copy. He sent it.
That discharge summary was quite different than mine. The doctor’s copy included information about the longstanding tricuspid regurgitation from a valve problem. This matters because heart damage, specifically, the tricuspid regurgitation, can be a result of another disease process I’m being tested for. I would never have known to disclose this pertinent info to the specialist if I hadn’t seen the doctor’s copy of the discharge summary.
Moral of the story: Doctors keep two files—one is the truth in their professional judgment, while the Patient Copy is the bs they feed patients to get them out the door.
I haven’t brought this to my PCP’s attention yet. I thought perhaps the murmur was hard to hear and maybe only picked up on with hospital equipment. However, in a recent discharge another doctor I’ve never met before was giving me a once over before I left. After she listened to the heart, I asked if she heard a murmur. She said yes, and noted that it’s quite prominent and easily heard. I asked why she didn’t tell me. The response was: ‘We often don’t tell patients about conditions we can’t fix.'”
Medical Discrimination.
“My wife is a male-to-female transsexual, and there have been several instances in which doctors misdiagnosed her or openly accused her of being ‘drug seeking.’ She has been clean and sober for 25 years. After she was assaulted by a co-worker, a doctor told her she had bursitis, refused to do a physical exam, and referred her to physical therapy. The physical therapist took one look at her shoulders and said that one jutted out at such an angle that he was afraid to do any PT. She got a second opinion. It was a torn rotator cuff.
She got spinal surgery after a car wreck. Her neck, shoulder, and back continued to pain her. The spinal surgeon said nothing was wrong, so she got a second opinion. Turns out the vertebrae fusion was botched and the vertebrae never fused.
On more than one occasion, she has been prescribed medications that caused dangerous interactions. We now check all meds.
When she goes to the ER, we regularly see practically all the ER staff troop through to stare at her. Once, two staff members made derogatory comments about her in Spanish, which she understands.
She is now terrified to see doctors, not knowing whether she will be misdiagnosed, yelled at, humiliated, or prescribed dangerous treatments.
This is not an isolated case. A survey found that 19% of transgendered or non-gender conforming patients are refused medical care, 28% are harassed, and 2% are physically assaulted by medical staff. These numbers are much higher if the trans person is a person of color. An African-American transwoman named Tyra Hunter died after a car accident because she was refused medical care by EMS technicians and ER doctors.
Now I see many states enacting ‘religious freedom laws’ to allow businesses to refuse service to LGBT on religious grounds. I wonder if this will legalize the medical discrimination that already takes place.”
A Blatant Lie.
“When I trained in medicine in Germany the medical students were told to tell a patient that they had ‘chronic inflammation’ instead of the true diagnosis of ‘cancer.’ This was a blatant lie. I don’t know whether this is still practiced today.”
When Lies Ruin Your Life.
“Sadly I can confirm that’s a big fat YES from personal experience!
A surgeon lied to me and my family as I came out of my hazy post-op anesthesia last July…why? I’m afraid I may never get the honest truth out of him but best guess it was to cover his own a–!
Back in 2008 I was grateful for his honesty when he confirmed he’d never actually performed the surgery I needed to repair a hole in the base of my skull that was allowing my brain to put pressure on my left superior canal. It was then a recent discovery and pretty rare. He gave it his best shot and rectified a lot of my symptoms but 90% deafened me in the process and left me with mega loud tinnitus. Hey ho!
When symptoms returned in 2014, what to do… go see the guy who fixed me last time….right?
Well I did just that.
CT confirmed I was now bilateral (holes in both sides of my skull base) BUT clever surgeon thinks that his original repair has failed – pointing to a blob on the screen showing my scan. He performed no other proper tests on me.
Ok so what’s the plan – well he refused to touch my right side in case he deafened me completely BUT insisted that I needed the left side re-repairing before he’d even consider the right side and even then only if he didn’t make my left side a dead ear!
That was it… no other options or suggestions… nothing else to do but operate on my left side again. Ok do it!
On awakening Doc said he’d changed things a bit as he couldn’t access the original repair due to excessive scar tissue – so he’d decided to OBLITERATE my superior canal! Don’t worry the effects would be just the same as plugging and resurfacing but this time there was no way it could ever break loose again as it was GONE! Within a week I just knew something was drastically wrong.
Told Doc – give it more time.
1 month saw Doc – too soon to tell.
3 month saw Doc – still too soon to tell but agreed if I felt so bad now things had definitely not gone to plan.
Emailed Doc begging for another scan to see what was so wrong – another scan won’t tell him anything, just give it more time!
Month 4 crisis point – every symptom I’d ever had was fully back with a vengeance. Autophony, oscillopsia, tinnitus worsened, hearing eyes scraping in their sockets, hearing everything going on in my body, permanent heartbeat pounding in my left ear, insomnia….the works! It’s like being trapped in a waking nightmare with no respite…EVER!
My work was suffering as I couldn’t drive to see my clients and couldn’t focus on anything. I was so depressed and panicking all of the time I attempted suicide by shooting myself in the temple with an air rifle point blank! Resulting in neurosurgery and another week in hospital. Thankfully no major lasting damage done.
So I made a formal complaint. Here’s where more lies start to flow from the Doc and the hospital. They replied saying that while operating in July he found the original repair was actually still intact (not inaccessible) so he decided his best course was to obliterate. Something that was never discussed or consented to. While they acknowledged their standard of care was substandard they felt the Doc had acted in my best interest!
Whereas in the real world any sane person would have thought ‘ok so the hole is still sealed so the symptoms must be coming from the big right side hole I saw on the scan – let’s not do anything else today and rearrange to repair the right side at a later date.’ Following this momentous cock up the Doc refuses to see me again and referred me to his colleague.
A visit to a new hospital in a different city revealed even more bad news. Straight away they showed that YES I had a large hole on the right BUT on the left the superior canal had been obliterated – AND the Lateral and Posterior canals were screwed as well as the saccule and utricle! All confirmed with MRI/CT scans. (Turns out the other hospital didn’t even have the equipment needed to test properly!) In fact the new team confirmed that they would not have operated on me without me undergoing all of the new tests.
So now I’ve lost my well paid employment, my car, my motorcycle, my independence, my sanity – basically my life as I knew it has also been OBLITERATED.
Lies upon lies have been confirmed in writing from the hospital and we’re now embarking on a malpractice legal case against the Doc. The only problem being that anyone who actually knows about the correct surgical procedure will know the Doc in question – and my god do these guys know how to cover for each other by banding together as it’s such a small select community.”
“Can’t Cover Up For Him.”
“My mother had cancer but had undergone radiation and chemotherapy. Five years later, she was doing very well and she wanted to go off the medication. Her doctor said he would like to do a Laproscopic Procedure. He explained to her that he would make a small incision and put a lighted scope in her and have a look around. It would just be day surgery and then she could go home. She scheduled the procedure and didn’t want anyone to go with her, because she knew that the cancer was gone.
The morning of her ‘procedure,’ I got this really funny feeling that something had gone wrong with my mother, so I went to the hospital to see. When I asked what room my mother was in, they told me but said that her surgery was delayed, so she wasn’t down’ yet. They were sure she would be down any minute. I went to her room to wait. After an hour, I went back to the desk and asked about her again. They called upstairs and then told me that there had been a ‘slight’ problem with the surgery, but she was in recovery now. Her doctor was coming down to talk with me. It took more than another hour for him to come down. He came in acting all chirpy and said that it was really a good thing they had scheduled her surgery for today, because when he went in to look, he ‘discovered’ that there was a tear in her colon. It might have killed her if he hadn’t ‘caught that’ in time. Some of the contents of her colon had gotten into her abdomen and they would have to watch carefully to make sure that she didn’t start to have infection from it. She would have to stay for a day or two though. I will tell you that right off, I didn’t believe a word he was saying but I didn’t know why.
I sat there waiting and thinking about this over and over. And I waited and waited. Went out to the nurses station again and asked what was going on with my mother. This was just ridiculous but they tried to cover up whatever was going on again. Then I asked to see the Supervisor. She said that she was sorry and she would check on this personally. She told me that they had just recently finished my mother’s second surgery and she was actually in recovery. She also went and talked with the Doctor who did the corrective surgery. He would be down to talk to me as soon as he was all cleaned up.
Ten minutes later a second Doctor came in to talk with me. He said that the first doctor didn’t do Xrays to see where her colon had adhered to her abdominal wall, as it usually does in someone who has had so much radiation therapy. This is a standard procedure in such patients. So he cut right through her colon as he made the first incision. Then he attempted to fix it himself but finally had to call an abdominal surgeon. So he came as soon as he could and was really mad at the first doctor for not having ordered a pre-surgical Xray. He said ‘I just can’t cover up for him.’
Then he said that my mother was in trouble here because if the colon didn’t work or she developed infection, he would probably have to go in and do a colostomy. I was in shock. She comes in for a ‘small’ Laparoscopic procedure and ends up having to have a colostomy? He said they would have to know within 48 hours and if they didn’t, then he would have to go ahead with the colostomy. I told him that my mother was a good healer, but that if she knew that she might have to have a colostomy, she would just give up. I begged him not to tell her until they knew for sure. He said that he understood, and wouldn’t say anything until they knew for sure.
Luckily after 2 days she finally moved her bowels! She was saved by a really good Doctor. He was reasonable, caring, listened to my plea, and thought about her depression and took it all into consideration.”
Didn’t Get To Say Goodbye.
“Because of a doctor’s lies, we lost the ability to say goodbye to my mom. My mother was diagnosed with stage 4 pancreatic cancer one week prior to her passing away. About 4 months prior, she had been visiting all of us in California for the holidays. She started getting severe stomach pain and was taken to the emergency room. Since it was the holidays, the doctors weren’t very diligent and did not perform additional tests after they saw her white blood count was over 15K. They mis-diagnosed her as having enteritis. They gave her some antibiotics and pain meds, then sent her on her way. If they had done some extra blood screens or even an MRI, they would’ve seen that she was (most likely) stage 2 at that time. This was not the lie, just a tragic error.
My father drove her back to the midwest so she could be in her home and recover. She still had the abdominal pain, well after the antibiotic course was completed. However, her main symptom was excessive sleeping. She could not stay awake for more than 2–3 hours a time, sleeping 10–15 hours in between the times she would be awake. This had gone on for about 2 months, before my dad had told me that something was wrong & had been trying to get her to the doctor. Being a woman from the farms of the midwest, being tough through illnesses was a way of life for her. When I finally got her on the phone, I told her she needed to be seen by someone. She reassured me that it was just the wintertime and she was just tired. After another 2 months, she finally relented and went to the doctor. Within 6 hours, she was admitted to the Oncology ward and she called me with the news on Tuesday mid-morning.
By that evening, I flew to my parent’s home and drove straight to the hospital. I checked in with the doctor and he began to tell me her condition. I have some medical experience having had worked at several major biotech companies. This is the lie: the doctor told me the workup on her blood tests were in the normal range, but she was not a candidate for surgery. He said she was Stage 3 and they did not have an indication that it had spread. I challenged his assertions because it didn’t make sense. Her bloodwork was normal, but she was Stage 3? She’s Stage 3 and it hasn’t spread? Not possible. We were all distraught & I believe that’s why he lied to us. How do I know this was a lie? I didn’t at that time. The hope he gave all of us was that ‘she was an excellent candidate for chemotherapy. She will have a great chance at remission. We will start on Monday. I will schedule the appointment.’
She didn’t make it to Saturday. The doctor sent her home with us on Wednesday morning, with the promise of the Monday chemo appointment. By Wednesday evening, she was beginning to show signs of disorientation. On Thursday morning, we called the doctor because she was walking the house like a zombie and was not sure where she was or what was going on. She was asking what was happening to her and where she was. When we got her to the doctor’s office, he didn’t say much or act surprised at all. He asked us to wait while he contacted the hospital’s hospice ward and had her transferred. She fell asleep on the gurney and never was conscious again. She passed away the following afternoon.
If the doctor had told us the truth, we would have had more quality time to talk with my mom, knowing she was hours away from being unconscious. We did exchange our ‘I love yous’ when she was in the hospital on the first day, but the theft of those last hours with her are such a deep crime to our hearts, that doctor will never know. His lie to us had no benefit in any way. If you can’t tell the truth, then you shouldn’t say anything.”
All For The Money.
“Greed, dehumanization of patients, self delusion – I know far too many doctors who’ve abandoned their values to obtain wealth. I won’t sugarcoat this. It isn’t pretty.
Let me start by saying that the vast majority of physicians want what’s best for their patients and will do whatever they can to achieve that. The majority of the time they might say ‘white lies’ – committed in order to avoid the emotional pain of the present moment. The ‘BLACK LIES’ I’m about to describe, however, can only be committed by living in a continual state of cognitive dissonance.
First, it’s important to understand that for every dollar spent on health care, only about ten cents goes for physician charges. The big money goes to the health care facilities – hospitals, labs, etc. The ability of physicians to own their own medical service facilities and to refer patients to those facilities allows them to double, triple or even quadruple the amount they would receive from physician charges alone. Now you may ask, quite appropriately, ‘Isn’t there a law that prohibits this?’ The answer is that the Stark Law supposedly keeps physicians from referring patients to entities which they own. The problem is that there are many loopholes in the Law and it’s not all that hard to circumvent.
Since I take care of cancer patients for a living, most of my experience with the abuse of self-referral relates to physician owned cancer treatment centers. The most highly reimbursed outpatient procedure for these centers is called IMRT radiation therapy, they get a kickback of $10k – $40k per patient.
I see some patients for second opinions after their original surgeon or oncologist has done their best to steer them to the center they own. One patient told me that when he left his urologist’s office, he felt like he’d just spent an hour with a used car salesman. I also see many patients that were originally mistreated for money who now have recurrent cancer or treatment complications.
I have seen men with low grade prostate cancer who were told to get radiation therapy immediately, even though they were good candidates for active surveillance. Patients have told me things their original doctor had said when they ask him/her about alternative methods of treatment – the list of crazy explanations is too long to list here, but includes ‘If you go have proton therapy, it will melt your prostate.’
Some doctors place markers in their patient’s prostate at the same visit when they gave them their diagnosis (markers that make it physically impossible for the patient to have proton therapy later). Literally – ‘You have cancer, but don’t worry, I’ll inject some markers in your gland so you can have IMRT.’ They take away that option while the patient is still trying to process the news of their cancer diagnosis.
The fact that these doctors know better is borne out by the fact that they still send patients who are themselves physicians or are otherwise VIPs to see me for proton therapy. All other patients become fodder for their treatment mill.
Many doctors who own treatment centers tell patients they will be ‘fired’ from their practice if they choose to go anywhere else for treatment.
Studies of practice patterns have found that doctors who own their own pathology labs do twice as many biopsies as those who don’t.
A dermatologist in town put an x-ray machine in his office for treating skin cancers and charged medicare millions of dollars per year.
It’s not always self referral that drives doctors to steer patient’s toward their own modality of treatment. I am currently treating a man who’s had four extensive plastic surgical procedures (which have included removing his nose and rebuilding it) for a basal cell skin cancer that could have been cured with a few weeks of radiation. The reason I’m treating him now is that $100,000 worth of surgery still didn’t cure his skin cancer. Otologists operate on vestibular schwannomas (tumors of the nerve for hearing) leaving them deaf and sometimes with half their face paralyzed, when the cure rate is just as good with stereotactic radiation without the risk of facial paralysis.”
The Nurse Who Could Not Be Silenced.
“I have many chronic disorders, and spend a lot of time in doctor’s offices and hospitals.
Many years ago, I had to have a scan of my abdomen. I was also in the process of interviewing a new General Practioner that would be able to help me manage and deal with my whole caseload. So, I had the scan results sent to this one particular doctor I was seeing for the first time. Just a small portion of my records, so I could see if she was a good fit.
I was in the exam room and the nurse comes in and says your results are not good you have multiple tumors on both of your kidneys. I’m a little stunned, but ok, it’s not the worst news I’ve been given in a doctors office. I asked a few questions and she leaves to get the doctor to help better explain what’s next. The doctor apologizes for the nurses behavior kicks her out of the room and proceeds to tell me that the nurse had no right to tell me about the tumors (which she then calls cysts) in my kidneys because it wasn’t relevant. I didn’t understand how growths on my kidney wasn’t important, if it’s benign and doesn’t cause any issues fine, but the scan didn’t show that. When I was checking out of the doctor’s office, I overheard the nurse getting fired, apparently this wasn’t her first offense. Needless to say, that doctor didn’t pass my interview process.
Over the years I’ve had about 20 benign cysts removed that were causing problems because of their location. I have many more that don’t need any intervention. The ones that were removed have definitely increased my quality of life.
So, I thank that nurse for not following her doctors rule. I don’t know if or when the cysts would have been found otherwise.”
Lies And Stupidity.
“Doctors and nurses both.
1) If you don’t terminate, x/y/z will be wrong with your child and it will be horrible for you and your child. (The lie told to my step-daughter right before the appointment was scheduled without her consent. When I looked up the ACTUAL side effects on the unborn child of the medicine she was on, they were actually very, very mild.)
2) You’ll probably gain some weight because it makes your body think you’re pregnant and you’ll end up craving certain foods more, but other than that, it’s 100% safe. No actual risks. (The lie told to ME before I went on the shot for the first time. It caused me to bleed for SIX MONTHS STRAIGHT and triggered my PCOS, completely stealing my fertility. Last I checked, that’s a lost worse than ‘a little weight gain.’)
3) She’s fine. (The lie an ER nurse told the attending physician and her supervisor even though I was screaming my head off as she was trying her 5th attempt to get an IV in me and had blown all the veins previously. Obviously, a patient who is screaming and crying in pain and BEGGING for the procedure to not be attempted again is not ‘fine.’)
4) You’re only 21. It can’t possibly be a heart issue. (The lie a nurse practitioner told my step-daughter when she went in with severe chest pain. For the record, my step-daughter was born with a hole in her heart and there is a family history of heart issues starting at a young age. They delayed an EKG until she’d been there several hours. Thankfully, it was only a severe panic attack.)
5) There’s no point in x-raying the hand. The finger is clearly not broken. It folds over exactly like the other one. (Um, no, it doesn’t. It folds under the ring finger. The other one folds next to the ring finger. To this day it folds under the ring finger and I can’t bring it flush against the ring finger without a lot of discomfort.)
6) If you’d lose weight, you wouldn’t get bronchitis. (Really? Funny. Last I checked bronchitis was purely pathological and one’s weight had nothing to do with it. This same doctor also prescribed weight loss as the cure for pneumonia and my chronic ear infections. Oh, and my favorite when she pinpointed my weight as the reason I stepped on a nail that went through my shoe and into my foot.)”
Reducing The Stress.
“About the prevalence of disease: When I say, ‘Oh, it’s very common in people of your age/profession,’ they immediately feel a bit relieved. So we might be skewing the percentage to 20-30%, but patients stop pondering ‘why me?’ and there is a definite positive change in the outcome.
About the duration of treatment: For example I would never tell a patient that they have to take treatment for the rest of their life. This decreases compliance a lot. So I tell them at least for a year, that actually sounds much better. If they get good results, increasing duration little by little hurts a lot less.
About how painful a particular procedure might be: I’d say this is pretty subjective. Some patients are scared even about the prick they are going to get for local anesthesia. If I feel that they are being unusually paranoid about the pain, and the procedure could actually make a lot of difference, I might tone down the intensity of pain a notch.
Also, unless the patient asks a very particular question, I would not mention very rare side effects of the drugs. I definitely tell the patients to monitor symptoms of common adverse effects expected, but in all cases whenever I write a drug I tell them that chances of side effects are rare and the drug is by and large safe, which is not really a lie.”
Trying To Lift Her Spirits.
“My aunt’s best friend suffered from liver cancer terminal stage (stage 4). At this stage cancer can’t be cured by any means. But she was a cheerful & full of life person. Her doctor decided he wasn’t able to declare his diagnose as it would make her sad & it would deteriorate her condition. He thought the patient’s cheerfulness & spirit can improve their condition. So her doctor lied to her by said: ‘Look at patient besides your bed. He is also suffering from cancer. He is at stage 1. You know, the lesser the number means it’s the most severe condition. But you on stage 4, meaning you will be fine.’
So every time her friends visited her, she told them this. Her friends played along despite knowing the truth.”
Many Reasons To Lie.
“Examples of me lying to my patients: ‘It might be a heart condition. We’ll take you to the hospital to do tests I can’t do here in the emergency office. Better safe than sorry.’ I was almost certain it was a heart attack, but saying that could cause my patient to panic and thus more stress on the suffocating heart.
‘It will be all right.’ These words slipped out of my mouth before I could stop myself. A patient had broke her hip and was scared and in pain. My own grandfather has been recovering from a hip fracture for several months already and the end outcome is very uncertain…and as a doctor, I know he’s actually quite lucky for his age. I didn’t want this granny to suffer like he is so I lied to make her, and myself, feel better for at least a short while.
‘There is no emergency dermatology service.’ This was to a parent whose child had some pustules on their skin that had been there for over a month. They wouldn’t see their GP about it during all that time, but coming to the emergency office with a simple sore throat and then asking about the pustules too seemed perfectly reasonable to them. To be fair, I wasn’t actually certain if there is an emergency dermatology in our area, but I said this in order to teach people to use family physicians for family-physician grade problems. Primary care is the foundation of a healthcare system; emergency care should be reserved for people who need to be treated immediately.”
What They Think The Patient Wants.
“There’s a type of doctor who lies out of a misguided sense of authority. I was appalled when a tennis teammate, who had recently been appointed as an ER doctor in a large hospital, told me he ‘regularly’ lied to patients. And then espoused a theory that seemed perfectly 19th century to me: ‘Patients want to hear an answer. So when I don’t know the answer, I just tell them whatever, so they stop thinking about it. A doctor must always give an answer.’
But now for something much more serious: end-of-life care. I recently read a discussion between dozens of doctors, on Medscape, about the efficacy of chemotherapy, which is low as we know, especially in end-stage disease, where it is very very low. Doctors know this. And unless chemo is truly palliative (meaning reducing the tumor can reduce pain or difficulty breathing), the majority of doctors would not, themselves, take chemo in what they know to be hopeless situations. Some would never take it, period.
So why do they still recommend it to patients? Perhaps surprisingly, many doctors felt that that was what the patient wanted, and that the patient did not want to be told that there was no more hope left. That patients want to go on to the bitter end – and that end may be all the bitterer for it.”
Fear, Guilt, Greed.
“Certainly they do especially when they make promises they can’t keep. ‘We will get it all out,’ ‘Nothings wrong,’ and ‘In six weeks with this treatment you will feel better.’
My sister had a colonoscopy everything supposedly was fine according to the report and yet three days later she is having major surgery to resect the bowel. And then no one would admit the obvious. Either the doctor missed something or he nicked the bowel.
Lately, we have information of doctors performing heart surgeries on individuals that didn’t need them. Not just once but many times. Will doctors change billing codes to up a bill? Does a psychiatrist change a diagnosis because one will create more billable hours? It’s been done.
Sometimes doctors are intimidated by the problem and will just go with ‘nothing is wrong’ despite something being wrong and not taken care of until someone actually does the work.
More recently we have seen doctors being paid well to take ghost written accounts or studies that are made up and/or developed solely by pharmaceutical companies to entice other in the industry to use a certain drug and add their names to them.”
“Every Day.”
“The short answer would be no but it would not be completely true.
First, the use of placebos is a lie. It was tolerated when I started practicing in the seventies but is now prohibited. But I can remember two situations in which I used them with great benefit to the patient.
Second, we are often asked to, usually by families who don’t want their relative to know that they have cancer. In that case we use what Stefano called ‘therapeutic silence’ unless the patient asks a direct question about his condition: we then have to respond truthfully. But sometimes the patients themselves ask not to know the truth.
Third, I can imagine at least one situation in which a doctor may have to for the patient’s sake. Imagine a chronically depressed patient is just recovering from a very serious suicidal attempt. The first thing you are asked when you get in the room is: ‘Did you receive my biopsy report?’ Indeed you have: it is positive and looks really bad. It might be tempting, if not necessary, to conceal that information at least at that time. And here ‘therapeutic silence’ won’t work, you would need to lie.
So do I lie in my palliative care practice? No, as a rule I don’t. Do I use ‘therapeutic silence’? Every day.”