27 May 2012

Ain't that the truth?

It is unfortunate that one must be slightly skeptical of what patients say. Although the doctor-patient relationship is premised on mutual trust and truth-telling, some patients lie.

Mr. Williams came into clinic because he had lacerated his arm on a dirty, rusty metal fence. Dr. X and I were concerned about the risk of tetanus infection, which although potentially deadly is completely preventable through vaccination.
Dr. X: Did you get a tetanus shot in the past five years?

Mr. Williams: Yeah, I'm covered. I got the tetanus shot last year.
I didn't believe him and happened to have his chart in front of me.
Me: Dr. X, you might want to have someone check if there's a problem with your electronic medical record system! It doesn't show any record of Mr. Williams's having received any tetanus shots for at least the past 18 years--

Mr. Williams: All right, I lied. I didn't get tetanus. I just hate getting shots.
Although the lie was harmless, I found its brazenness upsetting. Everyone deserves medical care, but it is frustrating working to help those who do not take you seriously and who you cannot fully trust.

Ultimately, the doctor didn't pressure the patient into getting the tetanus shot. Telling the truth at the outset would have been the best policy.