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Help your doctor help you
By Courtney Westlake

So you tell a few little white lies when you go in for your regular checkup, or you're too embarrassed to talk to your doctor about a certain symptom you've been experiencing?

The only one you're hurting is yourself.

"Be honest with your provider because this is a partnership," advised Dr. Janet Albers, a family physician with Southern Illinois University School of Medicine. "The doctor and the patient are both working for the best health of the patient."

According to local physicians, there are several things that doctors want their patients to be completely upfront about:

1. Medical history. It is imperative that your physician knows your family medical history and your personal medical history, Albers said.

"We even need to know chronic problems you have and surgeries you have undergone; often we base future treatments on that," she said. "We need to know what other providers and care you receive so we can coordinate your care."

There are a number of conditions or diseases that run in families that put their family members at a higher risk, including heart disease, certain cancers, depression and anxiety, said Dr. Christina Ventress, a family practice physician at Family Medical Center of Chatham, which is part of Memorial Health System.

"A lot of diseases in the path of physiology deal with family history. For certain conditions, like heart disease or cancers, it plays a big part in letting doctors know if we need to be more aggressive with screenings," Ventress said. 

2. Lifestyle habits. Whether you drink alcohol, do or don't exercise regularly, smoke cigarettes or have multiple sexual partners, your doctor needs to know, end of story.

Relaying information about your lifestyle is critical, involving conditions like heart disease, hypertension, diabetes

and more, Albers said.

"This is the mainstay of what we do," she emphasized. "It's so hard for people to be honest about some of these. All people have struggles, but you have to be able to be honest with your doctor."

Dr. Craig Backs, chief medical officer for St. John's Hospital, said he has found, in general, the majority of people are upfront about whether they engage in a certain habit, but exactly to what extent is a little harder to squeeze out of them.

"In medicine, we're taught to multiply by two or three as to the amount of drinks a patient says he or she has in a given day," he said. "Cigarettes are also underestimated. But knowing the truth makes it much more likely that the physician will have a complete picture of the individual's habits, actions and values so we can tailor their health-care treatment to the patient's needs and desires."

3. What other treatments you are receiving and what medications you are taking. And not only can prescription or over-the-counter drugs affect what treatment plan your doctor might prescribe, but so can herbal supplements and vitamins.

"I think it's important to help patients recognize that the concept of drugs differs from individual to individual," Backs said. "Doctors need to probe carefully to include all things a patient might be ingesting."

In family medicine, for example, primary care physicians need to be aware what other specialists a patient might be seeing and what medications they could be taking in order to coordinate the patient's overall care.

"Herbals and over-the-counters are definitely medications, and they can interact with prescription drugs," Ventress said.

4. Cultural and spiritual beliefs that may affect health care or treatments.

"That Jehovah's Witnesses are opposed to blood transfusions is a well-known one, but there are many others," Albers said. "Doctors need to know this, so we can work with our patients."

"Dietary preference is also something doctors might want to know," Backs added. "Any personal value or belief system that is unique would be helpful to know."

5. Your emotional state. Patients often have trouble discussing issues such as being a victim of domestic violence, suicide attempts and emotional thoughts and feelings in general, Ventress said.

"Those are embarrassing topics that might have happened to them, or it happened so long ago, they might try to suppress that," she said. "Those kinds of things contribute to your state of mind and your health. Unless you can talk to your doctor or therapist about that, they're not going to get better."

Backs said physicians hope patients are honest from the start of an appointment.

"Patients often express concerns about things early on, and then as we're finishing up, the conversation then comes to the thing that was really bothering them in the first place," he said. "This creates a situation where the most important thing gets pushed off."

Patients should worry more about a lack of physician understanding and knowledge than to the reaction of the physician when being open with their doctor, Backs said.

"Anything, no matter how embarrassing or how guilty they feel, patients should know that physicians are there to help, and are sworn to keep the information they receive from patients absolutely confidential," he said.

Story published Friday, September 5, 2008 ( Volume 3, Number 5 )

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