Jeremy, in my personal experience, yes, doctors do place these things in your record based on your word alone. I’m sure you’ve seen it yourself: when you sign in, often they have a questionnaire asking you to list all the supplements and medications you are taking, so right there if you reveal something it goes on your record. In conversation with my PCP, I would casually mention some health condition or event in the past, and then be surprised to see it pop up in my records (UCLA uses the MyChart portal where I can access my medical records, physician notes etc.).
Perhaps you can ask your doc if you can discuss something off the record, and then have him not record that in your file, but that’s something you must ask about first, don’t just blurt out “I’m taking X, can you please keep this off the record”, but “can I tell you something, and you won’t record this in my file?”. Don’t be shocked if he refuses, and for a very good reasons too - in evaluating your health, treatment plan, test results etc., they must know all the meds you are taking to evaluate properly, diagnose, triage, make sense of results, symptoms, interactions etc. Rapa is a very powerful drug. What is the doc supposed to do - s/he sees tons of patients. Unless the drug is in your records, do you expect them to remember “oh yeah, Jeremy is taking rapamycin, not in his medical record”. Worse, if his diagnosis or treatment plan takes into account a drug not in your records, it will look mighty strange to an outside observer - a malpractice suit, or at least a reprimand for not following standard of care guidelines. He can’t turn around and say “gee, it was appropriate care, because the patient was taking this secret off label drug which I failed to record” - that’s how you lose your license. You are putting your doc in a no win situation. The moment you tell him, he’s in a terrible bind. Asking him not to record this is asking too much on many levels.
My personal solution - you do you, I’m just reporting my approach - is not to burden my doc with such unwinnable binds. I explained why in a thread dedicated to this exact topic “do you tell your doctor you are taking rapamycin”.
Of course a lot depends on your doc, is s/he ok with life extension, prevention and 3.0 medicine or are they by the rulebook cogs. Are they knowledgeable about rapa or is it something they know nothing about, so their contribution to your health will be nil. Is insurance, medicare, concierge service relevant to your situation and in what way.
Not a simple decision. YMMV.