What Your Doctor’s Really Thinking (But Won’t Say to Your Face)



Nancy Kalish




Here’s what your doctors would tell you if they weren’t worried about time, lawsuits, or hurting your feelings.




Put away your phone!

“I hate when patients text during a visit. It tells me that they do not value my time. I feel disrespected. I have left patients talking on their phone in the examining room and moved on to see another patient.”

Oncologists hate pink

“Of course raising money is great. But during breast cancer–awareness month, in October, everyone comes in thinking she has advanced breast cancer. Our patients hate it because they can’t go anywhere without being reminded of their disease

Don’t ask me to lie

“I’ll get a call from a daughter who says, ‘Don’t tell my dad I called you, but you need to know he’s having chest pains again.’ Now I’m not supposed to know, but I do know, which is bad for everyone. I want to sit down and say, ‘John, your daughter says you’re having symptoms that you’re not telling me about.’ I don’t like those kinds of secrets.”

Don’t ask me to lie

“I’ll get a call from a daughter who says, ‘Don’t tell my dad I called you, but you need to know he’s having chest pains again.’ Now I’m not supposed to know, but I do know, which is bad for everyone. I want to sit down and say, ‘John, your daughter says you’re having symptoms that you’re not telling me about.’ I don’t like those kinds of secrets.”

Your missed appointments really worry me…

“I want to give my patients the best care, so I get frustrated when they turn it around and accuse me of trying to ‘pay for my new boat’ instead of taking responsibility for their disease. When patients delay treatment, something as simple as a filling can become involved and costly.”

…But late is better than never

“When a patient finally comes in, years late, I walk in with a smile and an outstretched hand. ‘Where have you been, stranger? So glad you are here! Tell me, what has happened since I last saw you? I know patients are busy. I know it is not in our nature to think about our health, even though we should. With good health, you can always make more money. With more money, you can’t always buy good health. So the fact you are here is a good thing.’”

I’m not scared of your Google search

“When patients come in with three inches of printouts, I know I’m going to have a good conversation. But they’ve also almost always terrified themselves beyond need. I wish they would e-mail or call me so I could put things in perspective. But in general, patients who have researched their condition tend to educate faster and take better control of their care

I could use sympathy too
“Many doctors have depression, so don’t take it personally if they seem distant. Our greatest desire is to help patients. That’s why we delayed starting our lives until our 30s. Many doctors give up their own family life to overextend themselves to you. And they’re kind of a mess after years of doing that. I’d like to see more patients have more empathy for doctors. It would be so great if a patient said, ‘You look kind of frazzled today. Can I give you a hug

Tell me your story, not your symptoms

“I like it when my patients in the ER tell me things like ‘I was running my usual five miles when at mile one, I started to have chest pains that stopped when I sat.’ That’s much more helpful than just saying ‘I had chest pains

I contradict you very carefully

“Even if a patient is wrong about her problem, it’s not helpful to tell her so. Finding the right answer is the best way to dispel the wrong answer. I never try to shake someone’s belief until we have enough facts to do it.” —Mark Liponis, MD, corporate medical director of Canyon Ranch in Lenox

I trust your gut


“Parents are so smart and so intuitive and know what’s normal for their child and what’s not. So I always work to take them seriously.”

Sometimes I don’t know what’s wrong

“Doctors are supposed to know everything, but we don’t. When I’m worried about whether a treatment will work, getting sued is always in the back of my mind. It’s scary

I welcome your e-mails—within reason


tell all my patients that we need to be on the same page for surgery. If that means you need to e-mail me 30 questions, then it’s totally fine. But don’t expect that I’ll e-mail you back. I’ll call instead

I may cave to your pressure

“If you really want a test that’s not covered by insurance and not really necessary, I’ll give in as long as it’s not ridiculously expensive or invasive. In primary care, our relationship is important. If you feel like I resisted your seemingly innocuous request, you’re not going to trust me. This way, I keep you as a patient so I can steer you toward appropriate tests

I run late for good reasons…

It’s hard to be a patient, but it’s also really hard to be a doctor and walk into a new room every 15 minutes with a new family and new challenges. One person shows up late, and it creates a domino effect. But when a teen comes in and admits feeling suicidal, I’m not going to kick her out. Sometimes I want to go into the next exam room and say to the irritated person who’s been waiting, ‘You are so lucky your child is healthy. If you’ve never had to double your doctor’s time, you’re just really lucky.’ ” —Wendy Sue Swanson, MD

But you’d better have a good excuse if you’re tardy

“When patients are very late, the good doctor in me feels that there must be a valid reason, and I want to accommodate them. The bad doctor wonders how they could be so inconsiderate. Why should my other patients have to wait because someone else could not be punctual? Typically, I will see a late patient as long as it does not inconvenience other patients.” —David Broyles, DO

Second opinions help me too

“They could confirm my diagnosis, which means the patient will have confidence in it, and that could reduce my liability. And if the other doctors don’t agree, I might learn something

I read your body language

“A patient’s gaze tells more than any exam. A patient who is modifying his history — because of anxiety or concern about what I might say — makes poor eye contact, squints, and looks slightly distracted. If he is trying to control me, he may stare without blinking, ignoring things I say, and tend to give short answers. You can spot pain from the distant, glazed nonfocus of a patient’s gaze.” —James C. Salwitz, MD

I relish your tough case
“Here’s how I react whenever a new patient tells me, ‘Every other doctor said that this was all in my head.’ On a bad day, I might think, This patient has a million complaints, and I am never going to figure out what’s really wrong. On a good one, I will see it as a therapeutic challenge. Most days are good days.” —Kenneth Lin, MD, MPH

I never get over losing patients\

old doctor friend used to say that a piece of you dies with each of these cases. When you’re taking care of people for 15 years, you really get to know them and their families. I know all the children and the best vacations and who fishes. I go to most of the funerals. After someone has passed away, you wake up at 3 a.m. thinking about him or her.” —

I hate seeing you suffer

“I know the old joke that dentists like to inflict pain, but I hate it. I spend a lot of time telling patients to let me know when they feel they need a break or additional anesthetic. I think about those patients quite a while after the procedure.” —Colleen DeLacy, DDS

Your vaccination joke isn’t funny

“I deal all the time with parents who don’t want to vaccinate their kids. Some people get so scared by myth that they can’t pay attention to science. My job is to listen to their true concern and dispel their worry with the best science. But I can get really upset when they joke that their choice not to vaccinate is going to make my job harder. Yes, it does make it harder, and that isn’t funny at all.” —Wendy Sue Swanson, MD

Your vaccination joke isn’t funny

“I deal all the time with parents who don’t want to vaccinate their kids. Some people get so scared by myth that they can’t pay attention to science. My job is to listen to their true concern and dispel their worry with the best science. But I can get really upset when they joke that their choice not to vaccinate is going to make my job harder. Yes, it does make it harder, and that isn’t funny at all.” —Wendy Sue Swanson, MD

Why don’t you follow directions?

When I was new and patients didn’t take my advice, I would be like, ‘Why are you even seeing me?’ I’m still a little irritated, but I’ll try to probe what’s really going on. Maybe there’s a financial reason, or they didn’t understand directions. Sometimes patients won’t want to be helped until after a heart attack or a stroke. In a few cases, it may never happen. It’s been part of my maturation as a physician to feel comfortable with that.” —Kenneth Lin, MD, MPH.

11 Bad Health Habits That Doctors Need You to Stop Doing ASAP



Tina Donvito




You might think these things aren’t a big deal, but they can take a toll on your body over time. Do you have any of these bad habits?




Holding your pee

When you gotta go, you should go! Holding it in for too long is not good for your health. “Urine is like a creek or river,” says Grant Fowler, MD, vice chair of family and community medicine at McGovern Medical School at The University of Texas Health Science Center at Houston (UTHealth), and a member of the medical staff at Memorial Hermann-Texas Medical Center. “If you block it, the stream becomes stagnant and gives bacteria the chance to grow in the bladder, and maybe to move back upstream to your kidneys. Keeping it flowing minimizes the risk of infection.” Asif Ansari, MD, medical director of the Montefiore Medical Group, says holding it can put you at risk for bladder, kidney, and even prostate infections, especially if you have an underlying urological condition or are pregnant. In addition, some studies have shown that holding it for too long can actually stretch out your bladder, a condition called “infrequent voiders syndrome.” Plus, if you’re not going four to seven times a day (at least every four to six hours), you’re probably not drinking enough fluids, and may be dehydrated.

Constantly chewing gum



You might think gum gives you fresh breath, or maybe it helps alleviate tension, like squeezing an oral stress ball. But if you chew gum all the time, it could be putting too much pressure on your jaw. “The temporomandibular joint—at the top of the jaw—is a synovial joint just as seen in the knees,” says Jeannette South-Paul, MD, medical director of the community health services division of UPMC, Andrew W. Mathieson Professor and chair of the department of family medicine at the University of Pittsburgh Schools of the Health Sciences. “If you use those joints too much, you can develop arthritis, clicking, and pain.” Plus, swallowing too much air can lead to stomach upset, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).

Biting your nails

Another nervous habit that’s really not good for you is chewing on your nails. “Biting your nails can result in damage to the nails and infection of the skin surrounding it, called paronychia,” Dr. Ansari says. The spread of germs can work the other way, too. “In addition, this can introduce viruses into the body, resulting in upper respiratory and other infections,” he says. Dr. Fowler says you could also damage your teeth, or even crack a tooth! Plus, the psychological reasons why you do it need to be addressed. “Biting nails is usually a subconscious habit frequently made worse by anxiety,” Dr. Fowler says. “What is making you so anxious? Anxiety itself may not be dangerous, but it can affect the quality of your life.” A study from Canada found that nail biting is also caused by boredom and frustration—two traits of perfectionists, according to the research.

Skipping brushing or flossing
You’re tired and fall into bed without taking care of your teeth—we’ve all done it, right? Well, skipping a brushing or flossing is worse for you than you think, especially if you make a habit of it. “Skipping teeth brushing or flossing are the biggest risks for dental decay,” Dr. Fowler says. “And poor dentition is a risk factor for many things including major, overwhelming infections and malnutrition—especia lly in the elderly—and also cardiovascular disease.” Whoa, heart disease? Turns out, the connection is not yet fully understood, but studies have shown a link. The theory is bacteria in the mouth can move into the bloodstream, creating an inflammation of the blood vessels, according to the Cleveland Clinic. Brush twice daily, floss once a day, and see your dentist regularly to avoid this. “Not maintaining this routine contributes to cavities and gingivitis—gum infections and inflammation—the major cause of early tooth loss,” Dr. South-Paul says. Dr. Fowler also recommends an electric toothbrush to get to places regular brushes miss.

Staring at a computer all day

According to the American Optometric Association, the average American worker spends seven hours staring at a computer screen, which can result in computer vision syndrome. “Staring at a computer screen for extended periods of time can result in visual issues, including eye strain and even retinal damage,” Dr. Ansari says. Research from the National Eye Institute showed that nearsightedness among Americans ages 12 to 54 has leapt from 25 percent to 42 percent since 1971, likely due to more time indoors staring at screens. Dr. Ansari suggests following the 20-20-20 rule: Every 20 minutes take a 20-second break to stare at something 20 feet away. “This reduces the strain on your eyes and also increases blinking, which can soothe dry and irritated eyes,” he says. Plus, staring at bright screens (including phones and tablets) decrease quality of sleep, he says, so put the phone down before bed. Here are some more habits you didn’t realize were actually bad for you—and the best ways to stop them.

Sitting for too long

Along with staring at a screen, simply sitting all day has bad consequences for our health. “As a chronic behavior, [sitting] leads to all the risks associated with a sedentary lifestyle including weight gain, diabetes, and high blood pressure,” Dr. Ansari says. Although some research shows an increase in blood pressure or numbness specifically while sitting cross-legged, Dr. Ansari says those effects are only temporary, and won’t really affect long-term health. “Crossing your legs doesn’t cause clots except for those at risk of arthritis or high blood pressure, or those who are physically inactive longterm,” Dr. Fowler agrees. But, walking throughout the day helps to prevent arthritis, and can also help to prevent high blood pressure. “Most of the harmful effects are from the simple act of sitting for prolonged periods,” Dr. Ansari says. Studies show walking around periodically can help. When you are seated, it’s important to have good posture so you don’t get neck or backaches. “When you do sit make sure you scoot into the seat and use the back of the chair to help you sit up straight,” Dr. Ansari says. “This will help ease the tension on your back muscles. Your knees should be at 90 degree angles and your feet flat on the floor.”

Slouching

Whether sitting or standing, slouching actually has negative effects on your overall health. “If you are leaning over, our heads are very heavy compared to rest of body—it puts a lot of leverage on the neck,” Dr. Fowler says, which can lead to tension headaches. Leaning over is also really bad for your back. “This can increase the risk of a disc rupturing or herniating, resulting in pain and pinched nerves,” he says. Not sitting up straight can also cause some unexpected problems. “Poor posture while seated can cause abdominal discomfort and issues with digestion, including constipation,” Dr. Ansari says. This happens because your intestines get compressed, which studies show inhibit their ability to push food through the digestive tract. Plus, “slouching or hunching over can decrease the amount of air you are able to take into your lungs,” Dr. Ansari says. “Some studies have also shown that people with poor posture may be more prone to depression

Carrying a heavy bag on one shoulder


big purse can help us feel prepared for any situation, but unless it’s a backpack, it may be hurting your health. “When you carry heavy bags on one side, you disturb the angle of your neck, and it can cause pressure on the nerves that come between the vertebrae in the neck and provide sensation to the arms,” Dr. South-Paul says. “If there is pressure on the nerves as they exit the neck, one can experience numbness, tingling, and even pain in the shoulders and arms.” Ouch! The American Chiropractic Association says your bag should weight no more than ten percent of your body weight. The negative effects are even greater if you always carry your bag on the same side, so try to switch it up—and don’t use your phone while holding your bag, which throws off your alignment even more. But men aren’t off the hook either—keeping your wallet in your back pocket can cause back problems, too.

Wearing the wrong shoes

This is probably not news for women who wear high heels: They kill your feet, and your whole body can feel the effects. “Your footwear influences the health of your feet, knees, hips, and back,” Dr. South-Paul says. “We weren’t built to wear high heels, and that predisposes women to bunions, Achilles tendon tightness, and associated problems.” But it’s not just stilettos that are causing shoe woes—flip-flops and other shoes without support can damage your body as well. A study from Auburn University showed that wearing flip-flops actually changes the way you walk, which can cause problems from your feet up to your hips and lower back. For long-term use, make sure your feet and ankles are properly supported. For working out, make sure your shoes aren’t too worn. “If you are a runner, you systematically wear down the support within your running shoes—we often think your shoes are good for no more than 300 miles,” Dr. South-Paul says. “After that, even if the uppers aren’t raggedy, you have lost the necessary support in the soles of the shoes to protect your feet—predisposing the bones in your feet to soreness and stress fractures.” These 15 common bad hygiene habits are even worse

Not applying sunscreen everywhere

You know about the importance of sunblock to protect against the sun’s harmful rays—but it’s tempting to do a quick job putting it on, missing certain areas. “The most worrisome spots to remain covered are the face and trunk—as well as the hands and feet,” Dr. South-Paul says, which includes in between your toes and your nail beds. According to the Cleveland Clinic, the ears are the third most common location to get skin cancer, so make sure you slather sunscreen there. Other missed locations are the scalp (even if you have hair), eyelids, lips, neck, and armpits. Plus, you need to reapply, which is easy to neglect when you’re having fun in the sun. “Where most folks get in trouble is forgetting they need to reapply the sunblock every time they get out of the water when swimming,” Dr. South-Paul says. “But your skin never forgets the sun rays it absorbs, so protection is always needed.”

Having an erratic sleep schedule

Getting good and consistent sleep is crucial for our body’s overall functioning, but the temptation to stay up late or indulge in other bad sleep habits can take their toll. “What is problematic are those who have erratic bedtimes, watching TV and dozing off on an irregular schedule, using things like alcohol and caffeine to relax or alert you, or exercising too vigorously within an hour of bedtime,” Dr. South-Paul says. These behaviors are likely to disrupt sleep patterns, she says. What about hitting the snooze button? If you’re a serial snoozer and hit the alarm multiple times, you’re cutting down on good, constant sleep—plus, if you’re not ready to get up, it probably means you didn’t get enough sleep. According to some sleep experts, hitting snooze can set you into a new sleep cycle that you won’t have time to finish, leaving you in a state of sleep inertia that may cause you to be groggy throughout the day. Next, find out some habits you’ve always thought were healthy that you actually need to stop doing.

15 Health Myths That Make Doctors Cringe



Charlotte Hilton Andersen




Do you believe in “base tans”? Have you sworn off bread forever? Are you logging endless miles on the treadmill? Read this. Now.




The more water you drink, the better

Water may be the healthiest beverage (not to mention necessary to life) but you can definitely get too much of a good thing, says Neal Schultz, MD, NYC dermatologist, founder of DermTv.com and creator of BeautyRx. At best, overhydrating will have you peeing every 30 minutes and at worst it can kill you. There is a “right way” to drink enough water and it comes down to trusting yourself. Your body is great at knowing how much water it needs, so forget drinking eight cups a day or half your body weight in ounces or any other prescribed amount. “You should drink to your thirst, not to meet an arbitrary number,” he advises.

Getting a base tan can prevent sunburns

Even though skin cancer is the leading cause of cancer deaths in adults under 40, many people still hold the faulty belief that getting a “base tan” will protect them from sunburns and cancer, make them look youthful, or clear up acne. Not so, says Jennifer Caudle, DO, board-certified family physician and assistant professor at Rowan University. There is no such thing as a “little” tan and all tanning increases your risk of cancer. Nor will it help your skin, in fact, sun damage is the primary cause of wrinkles, she adds

Juice diets or other “detoxes” work

As long as you have a healthy liver and kidneys, your body can detoxify itself just fine, Apovian says. Moreover, trendy detox diets can harm you. “Drinking lots of juice does not assist with removing toxins from the body,” says Dr. Caudle. “In fact, many juices are high in sugar which can result in a blood sugar spike, quickly followed by a crash. Furthermore, being on a juice fast for an extended period of time may result in malnourishment.”

You can only get an STD through having sex

Sexually transmitted diseases” have “sex” right in the name so you might assume that is the only way to get them. Not so, Dr. Caudle says, adding that many people interpret that to mean only “traditional” penetrative sex and think that a condom is all they need to protect them. While condoms are definitely necessary, the reality is that you can get some STDs through any type of sexual contact, including oral sex and even just skin-to-skin contact if one partner has open sores, she adds. Condoms are a great start but they’re not the only precaution you should be taking

Gluten is bad for you

Gluten-free foods and diets are everywhere these days and many people believe that gluten, a protein found in some grains, is toxic to health or causes weight gain. Not true, says Caroline Apovian, MD, director of the Nutrition and Weight Management Center at the Boston Medical Center and professor at the Boston University School of Medicine. “Only about one percent of the U.S. population has Celiac disease and another small percentage may have a gluten intolerance, but if you do not have any of the above, eliminating gluten from your diet does not offer health benefits, including weight loss,” she says. Whole grains are a great source of fiber and vitamins and processed gluten-free versions of whole grain foods are often higher in sugar and preservatives, and lower in protein and fiber, making them the less healthy option, she adds