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When Clients Lie
Years ago, I hosted a radio show where I had the opportunity to interview medical providers from many specialties about their work with patients. One of the recurring themes was that “Patients lie.” Now – you might wonder why that would become a theme, but the answer is quite simple. It was important to discuss it during the show because smart patients need to know that their providers assume they are lying as a part of the diagnoses or treatment they provide. (Good advice for smart advocates, too.) Here are some examples: An anesthesiologist told me that patients are always asked how much alcohol they drink. Whatever answer the patient gives, is then (at least) doubled when it comes time for the anesthesiologist to determine how much anesthesia to administer during surgery. (An honest patient may not receive enough anesthesia based on that “doubling.”) Endocrinologists ask their diabetes patients whether they are watching their carb intake. The patient may say “yes,” but when the provider sees an A1C value that is too high, they just assume the patient has lied instead of seeking another cause for that too-high A1C. (That’s problematic if there truly is another cause.) Many primary doctors and nurse practitioners told me that when they ask a patient if she smokes, and she says no, they may not believe her if she has a history of smoking. (An honest, smart patient needs to be aware that untrue judgment is being made.) So what does all that have to do with patient advocates? With few exceptions, most advocates are big-hearted people-lovers who want to lend assistance to patients who we know aren’t getting what they need from the healthcare system. We are generous and focused on finding the solutions patient-clients need in the areas of care and the cost of care. We are sympathetic. We are empathetic. We just want to help. So, when we enter into a relationship with new clients, as we get to know more about them and their situations, about their needs, their insurance coverage, even their ability to pay us for the work…