Louisville Medicine Volume 66, Issue 6 | Page 39

OPINION DOCTORS' Lounge the fears of the patients we have cared for, and perhaps lost, before this one. Reading any chemo informed consent is an exercise in progressive misery. Yet some people have less intense side effects, and some people have all of them in spades. How much to tell people first, when the truth lies squarely in “bad road ahead” territory, is an exercise in caution, but also a duty to warn. We do not want the patient to be blindsid- ed, but saddling them with overwhelming fear might cause them to refuse tests and treatment that we think could really help in the end. So we speak carefully yet honestly, answer questions thoroughly, and hope that the intended message got through clearly. But, doctors lie too. We might lie by omission; we too might lie on purpose, to cover up a mistake if we can; we might hate to make ourselves look uninformed or out of date, and lie by guessing. We lie and say we are fine when we are so angry with the world we can barely walk, or we share our feelings with the patient, which is helpful at times. After all, it’s a partnership. If a patient lies to you and that lie makes you angry, stop and think: why? What did that mean to me, and to him? Then ask: “Why is it important for you to see it this way?” How often do our patients lie to us, or just not tell the truth, the whole truth, so help them God? According to psychiatrists who study such things, people lie to their doctors fairly often. Humans do this to avoid looking bad in some way; to make someone else look bad; to avoid shame; to avoid criticism; to avoid losing respect; to cover up something else; to get something we want; to self-aggrandize; and to get some kind of praise or attention that is lacking in our lives. Some people lie all the time, to themselves and to others, as a matter of course. Some people invent alternate lives and to them, these things really happened. Patients who have lost touch with reality GLMS MAKES House Calls WE KNOW YOU ARE BUSY SO LET US COME TO YOU! are not lying so much as describing their current worlds. As for our current world: telling the truth as we see it is how we will survive. Telling the truth is living with your real self. Telling the truth can be hard in the moment, but easy in the long run. Telling the truth is how you avoid self-pity and enjoy being grateful. Telling the truth is, simply, the difference between honor and disgrace. As Aleksandr Solzhenitsyn said, “Violence can only be concealed by a lie, and the lie can only be maintained by violence.” Dr. Barry practices Internal Medicine with Norton Community Medical Associates-Bar- ret. She is a clinical associate professor at the University of Louisville School of Medicine, Department of Medicine. Your GLMS Membership provides more benefits than you may know. We will visit your practice to discuss benefits and services to determine how we can better serve you. Here are some of our most common requests: » Hassle Reporting / Issues with Insurance Companies » Practice Management Resources » Physician Education & Compliance » Healthcare Policy & Advocacy » GLMS Membership Benefits, Programs, Services and Discounts » Provider Enrollment / Insurance Credentialing » MedCentral Hospital Credentialing » Security Risk Assessments and Tech Services » Physician and Patient Publications » Wear the White Coat Event » Specialty Speed Networking » Marketing / Social Media Call 502-736-6350 or email physician.education@ glms.org to schedule a visit for your practice. NOVEMBER 2018 37