Don't be embarrassed to share problems, doctors say

There are certain things Americans just don’t want to say out loud – even to their trusted doctor.

And physicians know the familiar routine of getting their patients to open up to them.

“It typically starts by dancing around a question,” says Randell Wexler, a primary care doctor at The Ohio State University Wexner Medical Center.

“A patient might be evasive in some way, or we’re talking and then they say, ‘never mind.’ I remind them that everything stays in the room and that I share this with no one.”

Whether it’s hemorrhoids, erectile dysfunction, gastrointestinal issues or even a bad habit that’s hard to break, our culture makes some problems more difficult to talk about.

However, physicians are trained to treat patients without judgment, and their goal is simple: to help provide the tools and guidance to be as healthy as possible.

Seven more Ohio State Wexner Medical Center doctors explain:

The issues doctors know we’re embarrassed about 

“Sexual relationships, practices and worries are very high on the list of things patients are reluctant to tell me about,” says primary care doctor Camilla Curren.

In fact, several physicians mentioned sexual concerns, including erectile dysfunction, among the issues their patients are most hesitant to discuss.

“They may feel embarrassed about discussing intimate issues, or may feel it’s not relevant to other health issues,” says obstetrician/gynecologist Jonathan Schaffir.

“But problems with sexual function are very common, and having a healthy sex life is an important component of quality of life and general well-being.”

Dietary habits, issues with weight and substance abuse also rank high on the list.

“Patients often have trouble discussing anything – food, cigarettes, alcohol or drugs – that may be considered an addiction, which they view as a personal weakness in many cases,” Curren says.

“I view it as a medical problem I’d like to help them with.”

Anthony Michaels, the Ohio State Wexner Medical Center’s director of liver transplantation, says his patients are especially reluctant to share their alcohol intake or history of illicit drug use – important factors in preparing for transplants.

Bodo Knudsen, director of the Ohio State Wexner Medical Center’s comprehensive kidney stone program, notes that his patients are sometimes embarrassed to share how much soda they drink.

“This can be important information,” he says, “as some of these things may be risk factors for future stone episodes.”

Many patients are afraid to reveal to their doctor that they haven’t been taking their medication as prescribed.

However, primary care doctor Michael Langan reminds us that doctors and patients “are on the same team with the same goal.”

“Patients don’t have to try to please their doctor by saying they’re taking their medications when they aren’t.”

Mental health concerns, such as depression and anxiety, also are among the topics some patients balk at sharing.

Yet John Kissel, director of neuromuscular medicine at the Ohio State Wexner Medical Center, explains that most patients have some type of mental or behavioral health issue, so these patients are far from alone.

Why we don’t need to be embarrassed

“I wish patients would know we aren't here to judge them – just to help them,” Michaels says.

Besides, many doctors say: They’ve seen it all.

“There is almost no chance that a patient will tell me something that will shock me or make me think worse of them,” Curren says. “There is a good chance that I’ll be able to refer them to advice or resources that can help them, or reassure them that their behavior or ‘secret’ is relatively normal.”

One factor that causes some patients to hide a concern is that they don’t believe their issue can be helped. This is especially true when it comes to women’s sexual health.

But Schaffir wants his patients to realize that more medical products are always being developed to improve sexual health, treating problems from pain and dryness to lack of desire.

“Knowing that there is help available for such problems may encourage women to be more open with their physicians about sexual difficulties.”

Most important: Open, honest conversation eventually makes health care easier on both doctor and patient.

“As doctors, we’re a personalized resource to help each individual achieve their personal goals and optimal medical best,” says Riza Conroy, an Ohio State Wexner Medical Center primary care doctor.

“I don’t ever want to make a misinformed decision,” Langan says. “I count on my patients to be open and honest so that we can individualize the best possible plan for them based on their preferences, values and beliefs.”

Curren explains that speaking honestly about what’s really going on can also help doctors understand their patients’ perspectives on health and its effect on their lives.

“I really want the best for my patients,” she says. “If there is any helpful advice or referral that I can make, I’m going to do that. If not, I keep the patient in my thoughts and continue to be available to help them as I can.”