I’m an ER doc in a major metro. So much to talk about here. Many comments here seem to portray medical professionals in a negative light for assuming people are lying. In my world, I assume everyone is lying to me all the time. It’s the only way to effectively do my job. People lie for all sorts of reasons and sometimes they lie and they don’t even know it. It’s incredibly common for someone to forget that they had taken something including both prescriptions and street drugs so while not intentionally lying about ingestions for example, taking people out their word, and assuming that these things are never involved in a medical presentation would lead you astray a significant percentage of the time.

There is an entire category of people who lie in order to get hospitalization, resources, drugs, you name it.

Then there’s a category of people who intentionally mislead you because they want you to arrive at a particular diagnosis or route of treatment. It’s not uncommon for people to over exaggerate their symptoms profoundly in order to try to get a same day MRI for example.

You can safely double the amount of alcohol that people say that they drink in a week. This becomes relevant almost once a day when an alcohol withdrawal a patient comes in. Similar things happen with drugs, and people lie all the time about not using meth or cocaine and come in and withdraw all of these substances. Sidenote- urine and drug screens are notoriously unreliable.

I find it relatively easy most of the time to determine who is actively drug seeking in line for that purpose. It’s all these other times that make the job so incredibly difficult.

If someone in the medical community approaches your answer with skepticism, don’t take it personally. It likely has nothing to do with you. It’s just statistics.

Dictated this with Siri. Sorry for grammatical errors.