What Changes When People Can Tell the Truth About Their Health?

There are things we tell our healthcare providers easily: how we have been sleeping, a pain that will not go away, a medication that is bothering us.

Other things can feel harder to say.

“I have been drinking more lately.”

“I use cannabis most nights because it helps with my anxiety.”

“I took something, and I am not completely sure what was in it.”

Those are health facts, too. And they may tell a healthcare provider something important.

What we know changes what we can understand

Dr. Kima Joy Taylor has spent years thinking about what happens when we do feel safe and when we don’t talking honestly about substances and their health.

Her point is practical. A healthcare provider can only work with the information that makes it into the conversation.

Someone who says they are using cannabis to manage anxiety has shared more than information about cannabis. There is now an opportunity to understand the anxiety, too. Someone who mentions taking a medication differently than prescribed may open a conversation about pain, sleep, side effects, physical dependence or something else entirely.

The substance is part of the story, but it may not be the whole story.

As Dr. Taylor explains, healthcare often asks patients to live in silos: substance use over here, anxiety somewhere else, diabetes or sexual health somewhere else. Instead, she believes we should create space for people to bring their whole selves into the room, ask questions about all of their concerns, and partner with their providers to improve their overall health and wellbeing.

“That requires providers to check their judgment at the door. This is not about the provider. It is about the patient and the patient’s wellbeing. Make space for that.”

Judgment can cost us information

Dr. Taylor knows that honesty in a healthcare conversation is not always easy, especially when someone is unsure how what they say will be received. She names that hesitation plainly: “It’s scary to be honest.”

And sometimes the concern is about more than how someone will be received. People may fear very real consequences, including legal consequences or losing custody of their children. A good provider recognizes those concerns, protects information when they can, and is clear about when and what information they may be required to share.

That matters for reasons that go well beyond making a healthcare visit feel more comfortable. When someone leaves out information because they are worried about how it will be received, the person caring for them may be trying to understand their health with part of the picture missing.

Dr. Taylor is equally clear that responsibility does not rest only with the person sitting in the exam room. Healthcare professionals need to know how to have these conversations in ways that make honesty possible.

Dr. Mishka Terplan, an addiction medicine physician, places that responsibility squarely on healthcare professionals:

“The burden, I think, of responsibility for establishing trust or overcoming mistrust in patients rests on us.”

Dr. Terplan describes asking permission before discussing substance use and respecting the answer as one way clinicians can begin building the kind of therapeutic relationship in which people are able to share more.

Seen this way, trust is not just about having a good relationship with a healthcare provider. Trust can affect the information available to understand someone’s health. This works in both directions and is something very empowering for all of us here.

When we talk with our healthcare provider, substances belong in the conversation just as medications, sleep, stress and other parts of health do. We do not need to know what something means before we mention it. Figuring that out is part of the reason to have the conversation.

And when someone tells us something about their health, whether we are a clinician, parent, friend or someone else they trust, how we respond can affect what they feel able to share next.

A question worth taking with you

The next time you are talking about health, your own or someone else’s, consider asking:

Is there anything that might be easier to understand if there were more room to talk freely about it?

What we are able to understand can depend, in part, on what feels safe enough to say.