121. Patients Lie. Or Do They? How HVAC Customers remind me of patients

Hey Doc,

Were you taught that patients lie?

I was.

Somewhere during training, the idea got planted that our job is to uncover the truth because patients won’t always tell it. Then I became an attending and started experiencing it myself.

You spend twenty minutes counseling a patient. You draw diagrams. You answer questions. You document everything.

Then somehow…

“Nobody explained that to me.”

“The doctor never told me.”

“I never saw the doctor.”

If you’ve ever walked back to your office wondering whether you’re losing your mind, this episode is for you.

What surprised me is that it wasn’t until I left traditional practice that I gained enough distance to see these situations differently. And recently, while helping run our HVAC business, I watched my husband experience the exact same thing physicians deal with every day.

A customer insisted he hadn’t been told something that had been explained multiple times.

Sound familiar?

In this episode, I’m talking about why these interactions can feel so demoralizing, why they contribute to resentment and burnout, and how a little compassion can sometimes protect you more than the other person.

Not because patients are always right.

But because carrying around the belief that it’s you versus them is exhausting.

In this episode, I discuss:

• Why “patients lie” may be one of the most harmful lessons we learn in training
• How being repeatedly questioned can create resentment and burnout
• The surprising parallels between medicine and running an HVAC business
• Why people often misremember conversations without malicious intent
• How documentation protects us when memory and perception don’t match
• The role compassion plays in preserving your career longevity

If you’ve ever felt unseen, misunderstood, or questioned after doing your absolute best for a patient, this episode is my reminder that I see you.

And I believe you.

🎧 Listen now.

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Transcript

 Patients lie. Were you taught that in medical school? I was. I don't actually remember if it was med school or residency, but I distinctly remember it being ingrained in me in training that patients lie. That's just what they And it is our job to excavate the truth. And then as I became an attending, I was affected by it directly, where I would spend time discussing things, going over treatment results and plans of care, and then they would turn around and say, " Nobody ever explained this to me," or, "That doctor didn't say anything." Or the worst, I know you've experienced this, "I never saw the doctor." And it's so many different scenarios that encompass patients lie, and it can really be a, its own singular source of burnout when you have to deal with these situations day in and day out it's like a certain flavor of gaslighting that is just like, "What the fuck?" Like, " Is it just me?" Like, I know I said this stuff, and then if you're like me, honesty, doing my job is very, very important to me. So I'm just like, well, if this person is saying I didn't say it, I start questioning myself. I'm like, "Wait, did I forget? Did I forget to say it? Did I..." But no. Look, I documented it. So now you have me questioning myself, and I know I told you, and it can be demoralizing. It can be frustrating. It can make you feel as though this whole career was a mistake, and it can make you resentful. And it's only when I left traditional practice, so not even when I left medicine, but when I left the office, that I grew, I grew some compassion. And I think there was even, like a study that kinda backed up what I'm about to say, that the majority of people are not malicious. They are not trying to deceive us People don't tell the truth to their doctors or about their doctors for all sorts of reasons, some of which are not even conscious, some of which are they really didn't remember, they were distracted, they, they didn't understand. And there's a certain burden of responsibility on us to make sure that they do. But you know, right? There are certain situations where you have them repeat, you give them a video, you drew a diagram, and then they still come back and say, not that they didn't understand, but that you didn't tell them. So it can be so frustrating and can be just have you questioning your entire career. And I don't know if I would have been able to have that compassion and perspective, for people that do it if I hadn't removed myself, because a lot of the growth that I had as a physician came after I left the office. Like, I don't think I was able to have the level of openness and compassion being in the thick of it. I don't... I- I... It's a special person that can do that, and I was not one of those people, And I do think that there is room for compassion there and understanding because there are a whole bunch of very legitimate reasons why patients may not tell us the truth. And I want to-- I promise I have a point, which is I... You're actually not going to guess where my point is going. But I wanted to start off this way and tell you that I understand how you feel. How you feel is valid. I, I know you explained it to that patient. I know you told them. I know you drew a picture. I know you told them multiple times. I know you saw them in pre-op. I know you told them and they said they understood. I believe you, doc. Just know that. I believe you. I see you. I know you are an excellent physician that cares. That cares, because there are a lot of people who just believe that we do not care. I came into contact with a group of them very recently. I was out networking for our business, our HVAC business, and I sat in a group of professional women, highly educated, and the head, the lawyer, fixed her mouth in front of me to just be like, "Yeah, well, these doctors don't care." And I was just like, " Bitch, what?" Anyway, I didn't say it like that, but I want you to know that I know that you care So I hope you feel seen. I know it doesn't help much because I'm not the one doing your evals. I'm not the one paying your salary. But I hope it helps you a little bit to know that somebody sees the bullshit that you have to deal with, and they understand. I do. And the reason that this came up more recently for me was because in this episode of how running an HVAC business is just like practicing medicine, my husband was the one on the receiving end of the lies. And I'm gonna come back and talk about that, that phrase as well, because it's really not healthy for us to propagate that idea that we must be adversarial, and we must not trust our patients. They're human, just like we are, and understanding them and their motivations, how they perceive us and all of that is valuable. Like I said, it's difficult when you're in it. It's easy for me to say. I'm not in front of them every day. But I, I do think it is harmful the way that we bring up residents and medical students and train them in this way, and maybe that's not happening anymore, cause I know this generation is a lot different. But anyway, oh my God, so many tangents. But let me come back to it. My husband was on the receiving end of some lies, some customer lies, and he was very upset, and because I had had over a decade's worth of this experience, I was able to recognize it and talk him down because just like you, he was very understandably upset. So we went out for an emergency call. The AC wasn't working. there were ailing parents in the home. The son was there to take care of them. He came from out of state, and all of a sudden, the AC upstairs is not working, he's like, "I need to get my sleep so I can take care of these people." Like, I understand, right? I have sick parents as well. I get it. We will be So my husband went out there, to get the AC working again. And the unit was very old, and he found that there was an issue causing it to not work, and then there was a separate performance issue that while it was working, probably meant it wasn't working the best. So two separate things. The guy was like, "Just fix the thing that will turn it on. I don't want to pay for the performance My husband was like, "You sure?" He's like, "Yes, I wanna use my home warranty." " Okay, 'cause this is gonna be a lot of money." And he was worried about spending a bunch of money. His parents were gonna sell this house. This wasn't even his house, so he just wanted it on. My husband told him multiple times, "I'm not going to deal with this performance issue. Do you understand?" He's like, "Yes, I'm gonna use my home warranty." He told him, I think no less than three times, that it's on. The performance issue was not f- even fully evaluated because it, there was no point. You said from the beginning, and we respect what people say, " Don't deal with that. I will call the home warranty." The next day, we get a message from this man saying, " The unit isn't performing. I thought you fixed this." And so my husband wa- there was steam coming out of his ears. He was like, "What?" He's like, "I, I, I told you. Like, I told you multiple times." And so when we called him, he was like, "Well, yeah, didn't you fix that performance issue?" luckily, I was the one who called him. And I was like, "Yeah, no, that wasn't, that wasn't a part of this service, we, we understood that you wanted to use your home warranty for that, so we fixed the issue that turned the AC on like, like you wanted." And he just kept saying, "Yeah, you know, I th- I thought, I thought you fixed that, you know? I, I didn't expect this wasn't happening before you came here." That was his second lie because come to find out that he told my husband when he got there Yeah, these two rooms always get really hot," and that's what he was... That was the performance issue he was calling about now He was like, "You, you told me that this was a problem before, and now you're saying it was working just fine before we came." So understandably, being the high-integrity perfectionist that my husband is when it comes to his work, he was very upset. And I immediately recognized it and was able to validate him and very importantly, remind him that this is why we document. And I was just like, whoa, is this medicine or is this HVAC? Like, that is the only way we have to protect ourselves. Well, now, if you have an AI scribe, you have transcripts. So it's like, you know, especially if you're in a one-party state like Texas, you have recording now to protect yourself. But, you know, that's why our phone systems record, you know, because people will say all sorts of shit. And I had to tell him, it's like you can't believe that every single person is malicious and out to get you. I think it is a more peaceful way to move through life and particularly this business, believing that people are just trying to do their best. They are just trying to make it, and there may be some collateral damage on the way. And what I was very proud about my husband for... Is that proper English? I feel like it's not, but I feel like you know what I mean. I was proud of my husband in that moment, he was able to take a step back and reflect and be like, yeah, well, you know, he was a little bit distracted at the time. He was dealing with his parents, so, you know, maybe it didn't land or whatever. He was able to give him a little bit of grace, a little bit. And I, I appreciated that, but it just really showed the parallel and how much of a customer service game we have found ourselves in, in medicine and in the home services industry. the same dealing with people. I had, like, a flashback to all of the many times that patient's recollection of situations were different than mine. That's a nice way to say it instead of patients lie. You know, that's so adversarial. Because you know what else I realize as well? When I am a patient, sometimes I lie not on purpose, but I forget things. You know that, that, that patient where you ask them, "What meds are you on?" They're like, "None." And then you look in their chart and they on like 15 medications, and you read it out and they're like, "Oh yeah, yeah, I am on that." "What is this hydrochlorothiazide for?" "Oh yeah, I have high blood pressure." What do you mean? I asked you. I asked you if you're on medications. I asked you if you had medical problems." The answer was no to both. You could look at that and say that person was lying, Or we could have a little bit of compassion and grace, and I have definitely been that person where I have a lot going on in my mind, man. Like when people ask me if I've had surgery or any other medical problems, I usually just say no. But that's not true. Anyway, my, my goal for this episode is to regale you with the stories of an OBGYN owning an HVAC company, but really to just share how similar these situations are, and most importantly, to validate you. I think it is important, even if it's from a practical stranger on a mic that you're listening to, it's important for people to recognize what you have to deal with, help you know that you are not crazy, to confirm that you are in fact being gaslit. To give you a little sprinkle of perspective and a push for, for grace and openness. Not too much of that, just a little, a little bit. You know, I, I am still your coach. I, I still want to expand you and your capacity, most importantly, because the grace and forgiveness and the expansion isn't really for the patients. It is for you. It is for the longevity of your career, just like it was for my husband. Because if it is firm in your mind that it's you against them and you don't understand why they lie it's not peaceful. I don't think you're gonna last. You're gonna quit. You're going to change jobs. You're going to change specialties, Hopefully, I could prevent all of that, or some of it at least, by introducing some of these ideas. So it really still always is about you and your happiness and being able to stay in the career that you worked so hard for, if that is your choice. That's why I bring you these stories. And one last thing, because I can always pull so many lessons out of everything. Just to remind you, if you have ever thought that you have no transferable skills, that's another main reason that I tell you these stories. I really would not have thought that my experience dealing with patient's reality being different than my own would have helped me in this business. But here we and that is a skill. A skill knowing that you need to protect yourself with documentation and knowing how to mentally deal with those types of challenges. Those are skills, and they are, they are big ones. You have transferable skills from every interaction, every situation that you have been in. Every lesson that you have learned as a physician can be transferable. You are a leader. You are a highly skilled technician. You are a fourth-order thinker. there are so many things that you can do and be because you are a physician, so I better not ever hear you say, "Doc, all I am is a physician. All I know how to do is medicine." You are so much more than that because you are a physician and because you're an amazing human being, and you can do whatever you want if that is your choice Don't forget it, doc. Yeah, I started off with one, one point, but I just had to sprinkle that in there because it is evident every single day that I am in this business. It is evident every single time I talk to my clients and I see the people that are out here being successful with half of our training, half of our knowledge, half of our leadership skills, half of our problem-solving ability. You can do anything. You are amazing. And don't you ever forget it And if you do, come back here every Wednesday and I will remind you. And I will see you on the next episode of Stethoscopes and Strollers