Here are the top 10 ways how and why doctors lie. See if you recognize any.
1. Doctors lie about work hours. When logging actual work hours exceeding the weekly “80-hour cap,” new docs are cited for duty-hour violations. Labeled as inefficient, overworked residents may be sent for a psych eval and prescribed stimulants to force compliance. “We were all taken into a room by the program director and told to lie that we had no work-hour violations.”
2. Doctors lie in medical records. Rushed visits lead docs to falsify records by checking items in the EMR that were never done. “Writing WNL [Within Normal Limits, more like “We Never Looked”] on a physical is the biggest lie. How can you do a complete physical in fifteen minutes?” “Acronyms and text shortcuts are the only way to be ‘efficient’ enough to keep up with the workload.”
3. Doctors lie on billing. Packing medical records with items never done allows upcoding to higher-level visits and increased reimbursement (plus productivity income). “We had lectures in our hospital on how to ‘code properly,’ to basically commit insurance fraud.” “Doctors who lie get paid more and work less.”
4. Doctors lie on residency evaluations. “After we complained about working conditions, we were coached on how to respond on our ‘proctored surveys’ so our program would not lose accreditation. I know this is illegal. If I refuse to comply, I risk retaliation.”
5. Doctors lie about their mental health. To prevent license repercussions, physicians lie on applications for hospital credentialing and med board licensing when asked about status of mental health conditions. “After reading about one woman’s journey through hell after being honest on application questions, I sought care an hour away. I drove an hour in another direction to nervously fill prescriptions for antidepressants,” reports a doc. “I required several meds to stop thinking of suicide all day every day. My suicidal thoughts were 100 percent work-related.”
6. Doctors lie about their self-confidence. In the “fake it till you make it” culture, new docs often practice medicine with poor teaching and supervision, then pretend to have all the answers. “I watched colleagues often act and speak very confidently even when I knew they didn’t totally know what they were talking about.”
7. Doctors lie to patients. When Medicare covers a procedure, suddenly more beneficiaries “need” the intervention. Financial incentives lead to excess surgeries without informed consent. “I quit my program due to all the unnecessary surgeries on patients who died. We were killing patients.” “I lie all day long, telling people they have to go on meds in order to meet the guidelines.” “I lie on almost every lab order slip.”
8. Doctors lie to doctors. Docs embellish personal statements, boast, “I never study.” then promise, “It will get better when you’re an attending” even though life may get worse (on call for six hospitals and double the workload with all the liability). Here’s a big lie: Doc asks, “How ya doing?” Doc replies, “Good.” Then dies by suicide.
10. Doctors lie on death certificates. Doctors cover up suicides (especially doc suicides) as accidents—including accidental overdoses on drugs they prescribe every day—huge lie to preserve reputation of deceased and for life insurance payout to family. “In England, such was the stigma that as a forensic pathologist I could not label a death a ‘suicide’ unless there was a suicide note,” says Dr. George Lundberg. “In Coroner’s Court, I would have to call obvious suicides, by New York standards, ‘death by misadventure.’” Death certs are altered to comply with financial/occupational incentives and cultural norms to uphold accepted narratives.
Examples—Lies of omission: “When I don’t know the cause, but I have to write something. That’s a form of lying.” I’ve seen OBVIOUS diagnoses (and therapies) of patients deleted by my attendings because they did not fit a narrative or would be “problematic.” I do think we are forced to “lie” simply because there isn’t an ICD-10 code to cover what’s going on. Pandemic lies: “My patient died by a stroke hours after booster. With no specific code, it’s like begging admin to put a microscope on you.” One doc told me: “If a patient had COVID at one time, then I’m putting it on the death cert so we get higher reimbursement, plus FEMA will pay funeral costs.”
I consider myself honest, yet I’ve succumbed to 8 of 10 of these lies.
Why do “honest” doctors lie? Three reasons:
1. Avoid punishment
3. Financial gain
Like most people, docs will lie to avoid punishment and to preserve their job, identity, ego, status, and money. Doctors can be incentivized by bribes. Many are conflict phobic people pleasers who don’t want to stray from the narrative or risk being culled from the herd. To recover we must first be honest with ourselves in this professional confessional. Only then can we stop our habitual lying and chronic distortion of the truth—to be self-actualized as real healers on this planet.
Pamela Wible pioneered the community-designed ideal medical clinic and blogs at Ideal Medical Care. She is the author of Physician Betrayal: How Our Heroes Become Villains, Human Rights Violations in Medicine: A-to-Z Action Guide, Physician Suicide Letters — Answered, and Pet Goats and Pap Smears. Watch her TEDx talk, How to Get Naked with Your Doctor. She hosts the physician retreat, Live Your Dream, to help her colleagues heal from grief and reclaim their lives and careers.
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