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Questions Your Doctor Didn’t Used to Ask

I had my annual physical the other day, and my doctor asked the typical battery of questions before the physical exam began. As we got to the end of the questions, I couldn’t help but note that she’d added a few questions that doctors didn’t ask in years past:

“Are you sexually active?” … and then:

“Is there any reason to think about an HIV test?” … and then:

“Is there any interaction with guns you’d like to tell me about?”

It was only the last one that really surprised me. I asked why she had asked it, and she said it occasionally led a patient to reveal a situation at home or work that was stressful to the point of unhealthy, and maybe outright dangerous — a woman living with her sister, e.g., whose sometimes-boyfriend carried a handgun and liked to come by drunk late at night.

I was a little unnerved, but even more impressed that my doctor is thinking so holistically about her patients, especially in an era when doctors are under such time pressure because of managed care billing.

Unfortunately, I didn’t have any wild tales of illicit sex or gunplay to tell my doctor. But if I did, I probably would have been comfortable doing so, at least from a confidentiality standpoint. This is the same doctor who told me a year ago that her husband was going and on on about how much he liked Freakonomics, but she held her tongue about knowing one of the authors.

“Why’d you do that?” I asked.

“Doctor-patient confidentiality,” she said.

I was impressed that she honored confidentiality for such a trivial matter, and in this instance I gave her a one-time dispensation for breaking it.