That can be of genuine concern, say doctors and patient advocates. What happens in the doctor's office doesn't always stay in the doctor's office.
Anything and everything health-related that patients tell their doctors is supposed to go into their medical records. That information is confidential, protected under the federal Health Insurance Portability and Accountability Act.
For The Record
Los Angeles Times Saturday, June 13, 2009 Home Edition Main News Part A Page 4 National Desk 1 inches; 49 words Type of Material: Correction
Patient disclosures: A Health section article on Monday about how patients lie to their doctors and what can result said that Jerry Flanagan was an advocate with the Foundation for Taxpayer and Consumer Rights. The organization was formerly known by that name, but it is now called Consumer Watchdog.
For The Record
Los Angeles Times Monday, June 15, 2009 Home Edition Health Part E Page 4 Features Desk 1 inches; 48 words Type of Material: Correction
Lying: A June 8 Health article about how patients lie to doctors and what can result said Jerry Flanagan, quoted in the article, is an advocate with the Foundation for Taxpayer and Consumer Rights. The organization had been known by that name, but is now called Consumer Watchdog.
But in fact, it's only confidential until it isn't.
Whenever patients apply to buy individual insurance policies, and whenever they file claims under policies they own, the insurance company can request their medical records.
Patients can refuse to release the records, but if they do, the company can refuse to sell them a policy or refuse to pay claims. This is part of the deal patients agree to by signing on to the insurance contract.
And it doesn't take much in a patient's records to nix the sale of a policy. "A case of acne can do it," says Jerry Flanagan, an advocate with the Foundation for Taxpayer and Consumer Rights.
And there are other insurance complications. If, when processing a claim, the insurance company finds something in a patient's records that contradicts something the patient said when purchasing the policy, the company can retroactively cancel the policy, Flanagan says. Then it can demand reimbursement for any claims it has already paid -- even if those claims had nothing to do with the reason for canceling the policy.
"I would never advocate lying to your doctor," Flanagan says, "but I can definitely understand why someone might."
Dr. Ken Duckworth, medical director of the National Alliance on Mental Illness, suggests one scenario in which it might be tempting to lie. Say someone learns from a gene testing company that she is carrying a gene that puts her at risk for a disease for which there is no treatment or prevention. Then, he says, "it could be in a patient's interest to conceal that information."
Arthur Caplan, director of the Center for Bioethics at the University of Pennsylvania in Philadelphia, cites yet another hypothetical: Say a patient feels deserving of coverage for a certain condition or treatment, but his symptoms don't quite fit the insurance company's requirements. The patient might adapt the description of his symptoms to qualify for coverage, "and that might arguably be defensible or excusable."
Accuracy is vital
Sometimes, a doctor may be willing to help by overstating a patient's case.
