dr.'s appt.

[dexterhead]

Hi friends, I have been here forever and made little progress. Haven't been back in a while. I have an appointment for a complete physical tomorrow morning. I have been avoiding this forever as I am so afraid of what I have done to my body through my drinking. My question is (I am in the U.S.): how honest should I be with my doctor about my alcohol problem? Of course I will underplay the amounts, but does anyone have any advice? :thanks:

[Cashregister]

dr.'s appt.

Hey Dexter I hate to say this cause you probably don't want me to - but being completely honest with doctors is the only way I've gotten through life so far. Unless its for work or something I guess thats different but, especially if you want to kick this issue, it's better to be upfront- don't be ashamed docs have seen everything and heard everything and they can help you big time if you want to let them. The doc will think more of you for seeking help than playing it down I reckon.

[dexterhead]

dr.'s appt.

Thank you Cash. Part of my problem is our very messed-up health care system here in the U.S. I have no problem with being honest; just afraid of how it could affect me in the future.

[Cashregister]

dr.'s appt.

Yeah that makes it tough we have great system in oz it's not perfect but it's there for all who need it most of the time..
It will affect you more in the future if you continue to drink to excess mate - getting help now is a future builder

[Cashregister]

dr.'s appt.

Sorry that sounded like such a cliche but sometimes the sappy comments can be the right ones - sounded like a team retreat leader haha - now go get help!!

[pixie]

dr.'s appt.

It depends on what you hope to get out of it. I would be honest about overdoing it, if you really want to find out about any physical damage. Even if an MD does a thorough physical, they need to know your history in order to look for specific things or order tests they would not normally do.

Are you planning to ask for help in the way of drugs or referrals? They may take you more seriously on that front if you are honest. I understand the need to not have things documented in your records, it is a balancing act for sure. Good luck.

[NoraC]

dr.'s appt.

Dexter - I understand your concern. I had the same concern. For me, I finally decided that I wanted to be honest. I laid it all out there. What was the point of even bringing it up a little bit, if I wasn't going to be open about it.
I wish that I could tell you what to do. I worried about the insurance, medical records, etc. But, I needed to do this for me. And, I'm still glad that I did.
Good luck.

[Cashregister]

dr.'s appt.

Wow do they keep records -aren't drs meant to be confidential unless you're a threat to public safety etc that's awful

[Cashregister]

dr.'s appt.

I meant do they release your records they all keep them?

[NoraC]

dr.'s appt.

They keep the records but I was just worried if I would apply for other insurance. Ever have to release my medical records for any reason. When my husband had a car accident and we ended up having to sue the other insurance company, all of his medical records were there. If that would happen to me, they would see that diagnosis.

[DfromCT]

dr.'s appt.

I have a little expertise in this area, as I sell Electronic Health Record (EHR)software. It doesn't matter whether or not your doctor is using an EHR, ALL of your medical history that's been run through any insurance the past ten to 15 years has been captured and shared (legally) by the insurance companies. If you ever ordered a nicotine patch or birth control, or had a proceedure done, it's all confidential and private health data that is not allowed to be accessed by individuals, however it is tied to any insurance that covered any of it, and goes through a clearinghouse if/when you apply for other insurance, be it health or life insurance. It has nothing to do with Obamacare, either. (Im not a fan, but also think the GOP has it's propaganda machine blowing it out of proportion.) It's been going on since well before Barry O was thinking about becoming President.

That being said, I understand your reluctance to be frank with your doctor. Chances are they're using an EHR (if not they will be in the next two to three years, or they either get lower reimbursements at one end of the spectrum or in some states will not have their license renewed) and we all should be keeping our own personal health records electronically as well. Without going into a long diatribe as to why, the short answer is because in case of an emergency, you'd be much better off having the abiliity for you or a loved one to provide the COMPLETE record, which is probably scattered among a group of providers and specialists rather than someone guessing on whether or not they have the whole picture.

The same holds true with your doctor visit. Be honest. There are a number of areas that full disclosure will help the provider, and in some instances certain medical conditions that will be treated differently if they know your accurate drinking history. Depending upon what you run into health wise in the future, you risk getting a drug that could cause or aggrevate damage that alcohol has done, when there's alternative treatments that can be affective but not have an interaction with alcohol or affect weakened organs, body functions, etc.

The one thing I would keep from my doctor is smoking marijuana. Other recreational drugs should be disclosed because they have a broader and more serious affect on the body. But pot is much less apt to cause cancer than tobacco,and other than killing a few brain cells (and making you lethargic afterwards) it doesn't have nearly the affect on your health that alcohol and drugs like cocaine do. Smoking pot will have a negative affect on your premiums for things like life, (and in some cases auto) and health insurance, so why disclose?

When you see a psychiatrist or other mental health professional, the standard is to double or triple whatever the patient reports for alcohol use. I'm not sure if MD's do that, but I would recommend if you do tell the truth to have a frank discussion and tell him you're giving an accurate picture. Mention that you heard mental health professionals multiply self reported alcohol history, and that you are giving him an accurate count.

Cashy, I hate to tell you this, but most of the world shares medical information among the insurance companies. I know nothing about your neck of the woods, but I know in countries were medicine is socialized it's typically all part of a record they've been keeping for a very long time. I'm not sure how well they deliver that information to the providers (which should be the driving force behind keeping it, but it's not, it's about assessing risk and projecting future costs across a "population" of one sort or another). The US is actually late to bring medicine to the 21st century with electronic records and data sharing, most of the rest of the "developed" world has a big head start.

For those of you that know what the HITECH provisions of ARRA refer to, the real goal is to have patient medical data readily available so that the delivery of healthcare can be streamlined. A good EHR system, if the users buy into the training, will actually make the system more efficient from scheduling to treatment to billing. But many practices fight the process, thinking they're efficient as is, and end up blowing a great opportunity to be able to see more patients per shift (or finish their days earlier). And since there's government responsibility for setting standards of data exchange at both the state and federal levels, we're f*#king it up royally but making gathering data such as "hispanic or non-hispanic" or whether or not you requested an electronic summary of your record and call gathering such trivial information "meaningful use" of an EHR!

[Cashregister]

dr.'s appt.

Don't think we have reached that level here. You certainly don't have to have private health insurance to get health care here, nd if you choose to you get a tax rebate. There are usually 12 or 2 month waiting periods for
Pre existing conditions with private, but some as low as 2 months ( physio for example ). Insurance is
Pretty reasonably priced too. We have top level health cover with free dental for kids for 300 a month for a whole family.
I just told my insurer what my pre - existing conditions were and utilized public health in the interim. I dunno I'm going to ask my psych this evening but I'm pretty sure the records aren't passed around to companies - I will find out though

[Cashregister]

dr.'s appt.

I love my socialised system even conservative voters in oz would say no to stopping it - it's not perfect but it works

[Cashregister]

dr.'s appt.

He said "no" certainly not

[Cashregister]

dr.'s appt.

My psych that is