Thursday, September 13, 2012

Want The Truth?

In a scene in the play and movie of the same title, A Few Good Men, written by Aaron Sorkin, there is the following scene involving the interrogation on the witness stand of a Colonel Jessep, played by Jack Nicholson in the movie, by a Lieutenant Kaffee, played by Tom Cruise in the same movie.

It goes like this:

Witness Jessep: You want answers?
Lawyer Kaffee: I think I'm entitled to them.
Witness Jessep: You want answers?
Lawyer Kaffee: I want the truth!
Witness Jessep: You can't handle the truth!

That line is considered one of the most notable movie lines of all times.  However, for me, it poses a much larger question. Do people always want the truth?

We know that in social situations, the truth may be best avoided. For example, if your friend just got a awful haircut or your spouse gained some weight, when asked, should you always be honest? Some may argue that one should always tell the truth, but I think we can mostly agree that a white lie such as expressing approval of someone's new clothing (that they are currently wearing and which you wouldn't be caught dead in) may be the right thing to do on the spot. Later on, may be a different story.

Nevertheless, when people come to a doctor they should always expect and always receive the most honest answer the doctor can provide. Quite frankly, it really doesn't matter if they can handle the truth, they are legally obligated to it and should expect no less. And by truth, I mean all the facts.

That's the way I feel about the preponderance of information disseminated by mass media to the unwary public. The media may believe that it is more important to create an emotional response than to give you the actual facts. A reporter who interviewed Dr. Oz conveyed to me that this was his belief. He thinks he should nudge people in the right direction rather than give them the facts. You may agree, but I am vehemently opposed.

Why? Since opening MDPrevent in 2010, I have encountered hundreds of patients who were not explained all of their previous blood results. Every time I see an old blood laboratory result, I query patients if the doctor who ordered the test ever discussed all the listed abnormalities. Unfortunately, most of the time the answer is no.

The most commonly ignored laboratory findings appear to be pre-diabetes and early signs of anemia.  The doctors are so busy turning off the red light (the reason the patient came to see them for in the first place) that they are essentially ignoring the yellow lights at risk of turning red.  When I ask other doctors why this is the case, I get the expected answer. There simply isn't enough time to address problems that haven't yet happened.

To that I say phooey!  Medicare and other insurances pays doctors more for the more time they spend with you. The doctor's first obligation is to the patient in front of him or her. If they need more time than scheduled, they should schedule another appointment. But there is no excuse not to review all your findings and discuss ways to avert greater problems.  An ounce of prevention may be worth a lot more than a pound of cure--it may be worth your overall health and life.

If you have had blood work in the past two years and there were any abnormalities (numbers out of range) noted on the results, I urge you to ask your doctor to explain what the results mean and if they indicate a potential longer-term problem. Such discussions are necessary. Trust a doctor when I tell you it is best to be aware of everything (not to obsess or get neurotic) even if action is unnecessary and imprudent.

From my perspective, an educated consumer is the best patient. You may sometimes have trouble handling the truth, but you are entitled to it, the truth and nothing but the whole truth, from your doctor.

1 comment:

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