Little White-Coat Lies

There are big lies. And little lies. And somewhere in between there are the lies we tell our doctors. Even back in the day, Hippocrates, the father of modern medicine, knew that those pesky Greek patients might tell a fib or two. To find out if they were stretching the truth, Hippocrates measured their pulse rates.

Janie Hoffman's doctor didn't have to do that. During a routine visit, Hoffman's doctor asked her if she was still smoking. Hoffman said, "No, I quit." Her doctor then looked at her and said: "I guess that pack sticking out of your purse is for a friend." Still looking for an out, Hoffman replied: "How did that get there?" It would have been smarter for Hoffman to suffer the embarrassment and 'fess up. It may be painful, but telling your doctor about your questionable health habits like eating vats of junk food, or talking about socially risky behaviors like overindulging in alcohol, illegal drugs or unprotected sex, could save your life.

That's not always obvious to patients who sometimes feel that telling a fib, or omitting information, can be less angst-inducing than listening to a diatribe about the dangers of certain lifestyle choices. "I'm not stupid and everyone knows that smoking is bad, but who wants to hear a lecture?" says Hoffman, a Los Angeles marketing executive who kicked the habit (honestly) not long after that visit and has been tobacco-free for more than five years. Apparently, not too many of us. According to survey done by WebMD, Hoffman is among the 13 percent of 1,500 respondents who actually admitted they lied to their docs. Thirty-two percent only admitted they "stretched the truth," which is a lie by any other name.Our lies cover the gamut. Nearly 40 percent of folks lied about following a doctor's treatment plan, and more than 30 percent lied about their diet and exercise regimens. Folks were also not truthful about smoking, risky sex, alcohol intake, recreational drug use, taking medications as prescribed, second opinions, and the use of alternative therapies and supplements, among other things.

Not telling your doctor about all the health products you're taking, even if they seem innocuous, can be particularly risky. A study that appeared in the Journal of the American Medical Association in December shows that about one in 25 adults between the ages of 57-85 are putting themselves at risk for major drug interactions when mixing prescription drugs, such as a commonly prescribed blood thinner, with over-the-counters like aspirin, vitamins and supplements, such as the popular ginkgo biloba. "Patients have to come clean about the various things they put in their bodies," says Dr. David C. Thomas, associate professor of medicine, at New York's Mount Sinai School of Medicine. "We ask questions for a reason."

Doctors believe that most patients don't walk into their offices intending to lie. But they know that fear of judgment, the desire to appear to be a good patient, a lack of understanding about why certain questions may be asked, and even insurance worries, often lead them down the path of duplicity.

And when it comes to fibs, doctors have heard it all. "The classic is that a lot of patients will underestimate the number of sexual partners they've had," says Dr. Deborah Lindner, an OB/GYN at Northwestern Memorial's Prentice Women's Hospital in Chicago. She concedes that "after a certain number" that particular lie doesn't "really matter that much," but women who deceive themselves and don't practice safe sex, for example, run the risk of sexually transmitted diseases not to mention problems with fertility. "No one wants to admit to risky sex, or having multiple partners, or smoking, or drinking too much," says Lindner. "But people must understand we ask these questions not because we are judging someone, but to keep them healthy."