Forums > Social Chat > On Honesty with Doctors
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HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
Posted:
I had an adolescent female patient and I did a good, thorough adolescent interview. Asked (with mom out of the room) about sex, drugs, all that good stuff. She answered negative for it all. But I got a sense that something was wrong, so I asked my attending if he wouldn't mind repeating the interview . And he did.
When he came back, he said that she had lied to me about sex. When he had asked why, she explained that she wasn't going to talk about her sex life with me because she felt embarassed to be talking about it because "here's this cute young doctor asking me about my personal life and I just didn't want to tell him because I'm embarassed."
According to my attending, this is a common phenomenon. So this puts me in a heck of a bind. I'll probably be able to get a good, accurate history out of my adolescent male patients, but what am I supposed to do about the girls?
What? Do I stick big fake warts to my face and stuff a pillow in my shirt? I'm seriously worried about the well-being of my patients if I can't get an accurate history. What do I do?
Any ideas? What makes you feel comfortable with a doctor who you find attractive?
I had an adolescent female patient and I did a good, thorough adolescent interview. Asked (with mom out of the room) about sex, drugs, all that good stuff. She answered negative for it all. But I got a sense that something was wrong, so I asked my attending if he wouldn't mind repeating the interview . And he did.
When he came back, he said that she had lied to me about sex. When he had asked why, she explained that she wasn't going to talk about her sex life with me because she felt embarassed to be talking about it because "here's this cute young doctor asking me about my personal life and I just didn't want to tell him because I'm embarassed."
According to my attending, this is a common phenomenon. So this puts me in a heck of a bind. I'll probably be able to get a good, accurate history out of my adolescent male patients, but what am I supposed to do about the girls?
What? Do I stick big fake warts to my face and stuff a pillow in my shirt? I'm seriously worried about the well-being of my patients if I can't get an accurate history. What do I do?
Any ideas? What makes you feel comfortable with a doctor who you find attractive?
-Mike
Certified Mad Doctor and HoP High Priest of Nutella
A buckuht n a hooze! -Valura
GOLD Member
playing the days away
7,263 posts
Location: The Middle lands, United Kingdom
playing the days away
7,263 posts
Location: The Middle lands, United Kingdom
Posted:
How does it make you feel if you're talking to a really cute gay patient? Is there anything mentally you have to overcome to get the job done? Maybe you could use a reverse of this?
But I guess it's all to do with the patient. You can't tell who will instantly act like this young girl has until they act like it.....so maybe in retro spect something can be done but....erm...oh I dunno....I'm not much use really am I!!
How does it make you feel if you're talking to a really cute gay patient? Is there anything mentally you have to overcome to get the job done? Maybe you could use a reverse of this?
But I guess it's all to do with the patient. You can't tell who will instantly act like this young girl has until they act like it.....so maybe in retro spect something can be done but....erm...oh I dunno....I'm not much use really am I!!
Let's relight this forum 
member
313 posts
Location: london,uk
313 posts
Location: london,uk
Posted:
I had to give birth with a very yummy attending student doctor and halfway thru i realised i was feeling a wee bit inhibited with him there......
..in the end i just decided to pretend he was an angel sent to help (i know it sounds loony but i was way past the being logical stage)and we all got on with it.Some major pushing later and out popped a little boy 
.Then my friend decided i should maybe name my kid after one of the people attending and as it was a little boy we asked the nice doc what his name was....turned out to be egbert! 
As to your problematic good looks,hmmm..........not a clue!
I had to give birth with a very yummy attending student doctor and halfway thru i realised i was feeling a wee bit inhibited with him there......
..in the end i just decided to pretend he was an angel sent to help (i know it sounds loony but i was way past the being logical stage)and we all got on with it.Some major pushing later and out popped a little boy .Then my friend decided i should maybe name my kid after one of the people attending and as it was a little boy we asked the nice doc what his name was....turned out to be egbert! As to your problematic good looks,hmmm..........not a clue!
SILVER Member
Pooh-Bah
2,014 posts
Location: Galveston, TX, USA
Pooh-Bah
2,014 posts
Location: Galveston, TX, USA
Posted:
That is a toughie, Lightning.
Maybe say something like "I know some of what I may be asking you might make you a bit uncomfortable, but I am just asking because your answers might better help me to diagnose what is wrong with you." Maybe also somehow say they have no need to feel embarrased about their behavior.
That is a toughie, Lightning.
Maybe say something like "I know some of what I may be asking you might make you a bit uncomfortable, but I am just asking because your answers might better help me to diagnose what is wrong with you." Maybe also somehow say they have no need to feel embarrased about their behavior.
SILVER Member
member
88 posts
Location: Nottingham (UK)
member
88 posts
Location: Nottingham (UK)
Posted:
I've had this problem before. You had the appropiate setting (sans parents) and other than that there's not a lot to really get round it in a short interview other than trusting your instincts and being confident/empathetic (all that communication gubbins); you did the right thing in doing that and getting your senior to go readdress the issue (since they are more likely tell them). That and female colleagues (Nurses or Doctors) will usually be great help in this situation. Also just normalising the situation (i.e. "Just a few routine questions you have ask everyone" can help), and maybe throwing in a short explanation about why you need to know (e.g. Lower abdo pain, ruling out several important conditions). The above point is also valid regarding your body language etc.,; I can't remember if you've done psyc but you've got the whole issue of transferrence here (your behaviour/feelings being influenced by patient's feelings and visa versa), it's a valuable tool to be aware of since it actually helps diagnose some conditions. Even so, there will be some pts who just won't tell you, it's one of those things.
Don't worry though, we all get a bit old and crusty round the edges eventually.. I'd take it as a compliment
I've had this problem before. You had the appropiate setting (sans parents) and other than that there's not a lot to really get round it in a short interview other than trusting your instincts and being confident/empathetic (all that communication gubbins); you did the right thing in doing that and getting your senior to go readdress the issue (since they are more likely tell them). That and female colleagues (Nurses or Doctors) will usually be great help in this situation. Also just normalising the situation (i.e. "Just a few routine questions you have ask everyone" can help), and maybe throwing in a short explanation about why you need to know (e.g. Lower abdo pain, ruling out several important conditions). The above point is also valid regarding your body language etc.,; I can't remember if you've done psyc but you've got the whole issue of transferrence here (your behaviour/feelings being influenced by patient's feelings and visa versa), it's a valuable tool to be aware of since it actually helps diagnose some conditions. Even so, there will be some pts who just won't tell you, it's one of those things.
Don't worry though, we all get a bit old and crusty round the edges eventually.. I'd take it as a compliment
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veteran
1,359 posts
Location: London/ Surrey
1,359 posts
Location: London/ Surrey
Posted:
You could always go with the classic 'You can speak to a female if you prefer', provided the hospital isn't too busy of course. Some might prefer to speak to a woman, but a lot of them will think 'no, I'm just being silly', and get on with it.
You could always go with the classic 'You can speak to a female if you prefer', provided the hospital isn't too busy of course. Some might prefer to speak to a woman, but a lot of them will think 'no, I'm just being silly', and get on with it.
The optimist claims that we are living in the best of all possible worlds.
The pessimist fears this is true.
Always make time to play in the snow.
False Eyelash
346 posts
Location: New York City
346 posts
Location: New York City
Posted:
Sounds to me like you should be prepared for all kinds. When I was that age I was so afraid of my parents I would not have lied to anyone in contact with them - no matter how attractive. Unless I thought I'd get in trouble in which case I'd have lied plenty.
I dont think the real issue is about you being attractive. I think it's more about the discomfort in talking about sex, combined with that crazyass need girls have to please/impress men around them.
And you handled it beautifully. No harm in a second opinion. An alternative might be to call them out on it, in a playful way. "You sssuuuuurrrrreee about that??" Or whatever. I also think it helps to let people know that you've heard it all before, and sex isn't such an earth shaker.
Good luck.
Sounds to me like you should be prepared for all kinds. When I was that age I was so afraid of my parents I would not have lied to anyone in contact with them - no matter how attractive. Unless I thought I'd get in trouble in which case I'd have lied plenty.
I dont think the real issue is about you being attractive. I think it's more about the discomfort in talking about sex, combined with that crazyass need girls have to please/impress men around them.
And you handled it beautifully. No harm in a second opinion. An alternative might be to call them out on it, in a playful way. "You sssuuuuurrrrreee about that??" Or whatever. I also think it helps to let people know that you've heard it all before, and sex isn't such an earth shaker.
Good luck.
All the freaky people make the beauty of the world.
GOLD Member
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
Posted:
I always do the stuff about reminding the patient about the fact that our conversation is completely confidential and that it will not be shared with parents or anyone other than medical staff and telling them that these are routine questions I ask all patients. It's well beyond that. I've even had older female patients not tell me about their vaginal pain and itching because they were embarassed. My lord! I'm wearing a white coat and tie! If you can't trust the guy in the white coat and tie with your vaginal itching, who CAN you trust?
As for the question of what would I do if it was a gay male patient, I think it's different because the assumption on the part of the patient is that I'm not gay. I'm not saying this out of insecurity, but I think that most patients don't realize I'm gay or fewer female patients would throw me out of the room for being male. There have been times when I've been tempted to flip my wrist and say, "honey, please. You have no idea how safe you are with me,"
They once did a survey that showed that good-looking people are more likely to succeed in industry and that ugly people do better in academia. Go figure.
I always do the stuff about reminding the patient about the fact that our conversation is completely confidential and that it will not be shared with parents or anyone other than medical staff and telling them that these are routine questions I ask all patients. It's well beyond that. I've even had older female patients not tell me about their vaginal pain and itching because they were embarassed. My lord! I'm wearing a white coat and tie! If you can't trust the guy in the white coat and tie with your vaginal itching, who CAN you trust?
As for the question of what would I do if it was a gay male patient, I think it's different because the assumption on the part of the patient is that I'm not gay. I'm not saying this out of insecurity, but I think that most patients don't realize I'm gay or fewer female patients would throw me out of the room for being male. There have been times when I've been tempted to flip my wrist and say, "honey, please. You have no idea how safe you are with me,"
They once did a survey that showed that good-looking people are more likely to succeed in industry and that ugly people do better in academia. Go figure.
-Mike
Certified Mad Doctor and HoP High Priest of Nutella
A buckuht n a hooze! -Valura
BRONZE Member
Mistress of Pink...Multicoloured
6,140 posts
Location: Over There, United Kingdom
Mistress of Pink...Multicoloured
6,140 posts
Location: Over There, United Kingdom
Posted:
I find that i am shy with all male doctors about female problems. I dont know why i just am.
I dont think that there is any way to deal with it really. I cant think of anything anyone could say to me that would make me less shy...
I suppose it's the way people have been brought up. My mum always took me to a femal doctor and such...
I find that i am shy with all male doctors about female problems. I dont know why i just am.
I dont think that there is any way to deal with it really. I cant think of anything anyone could say to me that would make me less shy...
I suppose it's the way people have been brought up. My mum always took me to a femal doctor and such...
Never pick up a duck in a dungeon...
I don't want a title.
940 posts
940 posts
Posted:
Wish I could help ya, hon. But I've never felt inhibited about telling cute guys about my vaginal itching.
Wish I could help ya, hon. But I've never felt inhibited about telling cute guys about my vaginal itching.
E pluribus unum, baby.
Pooh-Bah
1,662 posts
Location: Bristol
1,662 posts
Location: Bristol
Posted:
i know this is completely irrational, but i never tell doctors anything any more.
once i went to my doctor to get couselling and he asked me what i wanted it for!! i didn't want to tell him but i was so shocked he asked me that i told him, just kind of bllurted it out. Then he wrote on my permenant record!!!!! . I was so angry with him, i thought it was pretty uneccessary - he didn't really need to know and he really upset me.
now i never tell doctors anything except what they really really need to know and nothing else.
anyhoo - i guess the POInt i'm trying to make is that some people just want stuff off the record. it makes a huge difference.
i know this is completely irrational, but i never tell doctors anything any more.
once i went to my doctor to get couselling and he asked me what i wanted it for!! i didn't want to tell him but i was so shocked he asked me that i told him, just kind of bllurted it out. Then he wrote on my permenant record!!!!! . I was so angry with him, i thought it was pretty uneccessary - he didn't really need to know and he really upset me.
now i never tell doctors anything except what they really really need to know and nothing else.
anyhoo - i guess the POInt i'm trying to make is that some people just want stuff off the record. it makes a huge difference.
I had a dream that my friend had a
strong-bad pop up book,
it was the book of my dreams.
BRONZE Member
the henna lady
6,193 posts
Location: WNY, USA
the henna lady
6,193 posts
Location: WNY, USA
Posted:
A different doctor.
Sorry to say it my friend but I actually think you took the best course of action.
And sometimes it doesn't even have to do with you being young and cute, sometimes it is the self-conciousness of the patient and how they feel they will be perceived. It's why I lied to Dr.'s when I was younger. Let's see, there is also, with young people, lack of trust (not wanting you to tell parents, not believing you won't), not wanting to get in legal trouble (drugs), for me it was not wanting to have to go to therapy (eating disorder)... young patients can make up a million and one reasons to lie to a dr.
And I also have to say that with the older women, many do not feel comfortable with a strange male poking around down there, cute or not. They were taught to close their legs tightly and keep female problems to themselves. The problem becomes unbearable that they seek out help but the embarrassment and shame kind of overshadows the symptoms. And the older the women, generally the more beheldon to these ideals they are. It's a catch 22 for both the Dr's and patient. I had a woman dr. for that reason, though when I gave birth there were cute guys there..but at that point, I didn't care. They were the most compassionate after as well, and really interested, which I found comforting.
It is important to be honest, and unfortunately it is not only your job to treat patients but to recognise when they pull stuff like this, and adapt in the way that you did.
I wish I had more of an answer for you sweetie!
EDITED_BY: Pele (1078602033)
Quote:
What makes you feel comfortable with a doctor who you find attractive?
A different doctor.
Sorry to say it my friend but I actually think you took the best course of action.
And sometimes it doesn't even have to do with you being young and cute, sometimes it is the self-conciousness of the patient and how they feel they will be perceived. It's why I lied to Dr.'s when I was younger. Let's see, there is also, with young people, lack of trust (not wanting you to tell parents, not believing you won't), not wanting to get in legal trouble (drugs), for me it was not wanting to have to go to therapy (eating disorder)... young patients can make up a million and one reasons to lie to a dr.
And I also have to say that with the older women, many do not feel comfortable with a strange male poking around down there, cute or not. They were taught to close their legs tightly and keep female problems to themselves. The problem becomes unbearable that they seek out help but the embarrassment and shame kind of overshadows the symptoms. And the older the women, generally the more beheldon to these ideals they are. It's a catch 22 for both the Dr's and patient. I had a woman dr. for that reason, though when I gave birth there were cute guys there..but at that point, I didn't care. They were the most compassionate after as well, and really interested, which I found comforting.
It is important to be honest, and unfortunately it is not only your job to treat patients but to recognise when they pull stuff like this, and adapt in the way that you did.
I wish I had more of an answer for you sweetie!
EDITED_BY: Pele (1078602033)
Pele
Higher, higher burning fire...making music like a choir
"Oooh look! A pub!" -exclaimed after recovering from a stupid fall
"And for the decadence of art, nothing beats a roaring fire." -TMK
GOLD Member
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
Posted:
A simple "Before I tell you this, please put your pen down and don't write it in my chart" will get me to put my pen down and not write it in the chart.
Quote:
anyhoo - i guess the POInt i'm trying to make is that some people just want stuff off the record. it makes a huge difference.
A simple "Before I tell you this, please put your pen down and don't write it in my chart" will get me to put my pen down and not write it in the chart.
-Mike
Certified Mad Doctor and HoP High Priest of Nutella
A buckuht n a hooze! -Valura
Pooh-Bah
1,662 posts
Location: Bristol
1,662 posts
Location: Bristol
Posted:
can i swap?
i want you instead of mine. (especially if you're as cute as you say...!)
can i swap?
i want you instead of mine. (especially if you're as cute as you say...!
) I had a dream that my friend had a
strong-bad pop up book,
it was the book of my dreams.
SILVER Member
100 characters max...
2,996 posts
Location: Sydney, NSW, Australia
100 characters max...
2,996 posts
Location: Sydney, NSW, Australia
Posted:
Sometimes I lie, well don't tell the whole truth, to doctors. And they could be male or female. Sometimes I don't feel the whole truth is relevant. In fact sometimes it is intensely personal. And sometimes I am just embarassed.
I know that I am in the wrong. I know I am not the one with the medical training, so how would I know what is relevant. But I do it anyway. Human beings are not sensible and rational.
You handled it well, trusted your instincts, and got someone else who she would be more comfortable with to do the examination. That is the right thing to do. You got to the truth in the end, even though you may not have heard it directly from her.
Sometimes I lie, well don't tell the whole truth, to doctors. And they could be male or female. Sometimes I don't feel the whole truth is relevant. In fact sometimes it is intensely personal. And sometimes I am just embarassed.
I know that I am in the wrong. I know I am not the one with the medical training, so how would I know what is relevant. But I do it anyway. Human beings are not sensible and rational.
You handled it well, trusted your instincts, and got someone else who she would be more comfortable with to do the examination. That is the right thing to do. You got to the truth in the end, even though you may not have heard it directly from her.
It was a day for screaming at inanimate objects.
What this calls for is a special mix of psychology and extreme violence...
GOLD Member
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
HOP Mad Doctor
13,925 posts
Location: San Francisco, CA, USA
Posted:
I am not always honest with doctors, incidentally. BUUUUT, in my case, I know why they are asking the questions and I know what information they really need.
For example, my physician does not need to know that I am gay because I already get regular HIV testing and I know at least as much about safer sex practices for gay men than he does. So as far as preventative health goes, I sort of take care of myself.
However, what I am doing is pretty risky and shouldn't be done by anyone without a medical education.
I am not always honest with doctors, incidentally. BUUUUT, in my case, I know why they are asking the questions and I know what information they really need.
For example, my physician does not need to know that I am gay because I already get regular HIV testing and I know at least as much about safer sex practices for gay men than he does. So as far as preventative health goes, I sort of take care of myself.
However, what I am doing is pretty risky and shouldn't be done by anyone without a medical education.
-Mike
Certified Mad Doctor and HoP High Priest of Nutella
A buckuht n a hooze! -Valura
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