Up to 80 percent of patients aren’t truthful with their healthcare provider.
When a physician asks health-related questions, they usually expect the wholehearted truth. After all, honesty is supposed to be the best policy. However, if you’ve stretched the truth to your doctor, you may not be alone.
A new study shows that between 60 and 80 percent of patients say that they haven’t told their doctors the truth or have withheld information from them.
This study was published in the JAMA Network Open journal by researchers at University of Utah Health and Middlesex Community College, Connecticut, in conjunction with authors from the University of Michigan, Wayne State University, and the University of Iowa.
They found that the most common reason for withholding information is patients not wanting to feel judged or lectured.
“While the idea that patients may not share everything with their clinicians is perhaps to be expected, we were surprised at how common it appears to be for patients to withhold information or beliefs,” said study co-author Brian Zikmund-Fisher, PhD, research associate professor of internal medicine at the University of Michigan in a released statement.
What the study found
Researchers examined results from over 4,500 responses across the country using two different surveys. One survey captured the responses from 2,011 participants averaging 36 years old. The other online survey was given to 2,499 participants with an average age of 61.
In both survey groups, those who were female, younger, or self-reported having poor health were more likely to respond that they failed to provide truthful answers.
With input from health service researchers, physicians, and psychologists, as well as group meetings and pilot testing, the surveys were refined to include seven questions. These questions covered areas that survey participants may not have been candid about, such as whether they had been adhering to treatment.
If a participant answered they hadn’t been truthful for any of the seven questions, they were then asked to recall why they made that choice.
The primary reasons for failure to disclose information were highest for items involving physician communication, which included disagreement with a physician’s recommendations and not understanding their medical instructions. This is followed by nondisclosure of relevant health behaviors, such as eating an unhealthy diet.
“There are certain topics where patients tend to not always tell you what is going on. I think that is particularly true in scenarios when a patient does not know you that well or there is a sensitive subject” says Dr. Barbara Keber, chair of family medicine at Northwell Health’s Glen Cove Hospital in Glen Cove, New York.
Study participants didn’t disclose information with their physicians primarily because they didn’t want to be judged or lectured about their behavior. This was followed by the lack of desire to hear how bad the behavior was for their health, as well as simply being embarrassed about their health choices.
Other responses included not wanting information in their medical record, not wanting to take up their healthcare provider’s time, and wanting their healthcare provider to like them.
“Most people want their doctor to think highly of them,” said Angela Fagerlin, PhD, senior study author and professor and chair of population health sciences at the University of Utah Health, in a statement.
“They are worried about being pigeonholed as someone who doesn’t make good decisions,” she said.
The risks of keeping information from your doctor
Patients withholding information about their health can make it more difficult for healthcare professionals to provide the right care, and it can be dangerous to the patients’ health.
Patients who aren’t forthright with their health information face unpleasant and sometimes life-threatening side effects from regimens their doctors give them.
“Healthcare clinicians need complete and accurate information about patient behaviors and beliefs if they are to best serve and guide their patients,” said Zikmund-Fisher.
Zikmund-Fisher acknowledged busy doctors can take steps to try to get their patients to be comfortable and open with them.
“Perhaps by acknowledging how common it is for patients to withhold information, clinicians may be able to make it easier for patients to share their concerns and acknowledge their less-than-ideal behaviors,” Zikmund-Fisher said.
“Such conversations will only occur, however, if clinicians address patients’ fears that they will be judged or lectured.”
Although the data presented is astonishing, this study has an interesting limitation: Survey participants may have withheld information about withholding information. This means the statistics could be even higher.
Keber pointed out how important it was for doctors to effectively communicate with patients.
“It all comes down to the mechanism of communication — especially in the patient that you do not know,” says Keber.
“Putting the patient at ease is key. The physician needs to open a line of communication to engage the patient, and only then will the patient engage back with you in a discussion that will allow them to open up about their health concerns.”
The bottom line
A recent study shows that between 60 and 80 percent of patients aren’t forthcoming or even lie to their physicians.
Misrepresentation most commonly occurred when they disagreed with their physician’s recommendations or misunderstood their instructions. Patients reasoned that they didn’t want to feel judged or be lectured.
More than half felt embarrassed about their health choices.
Dr. Rajiv Bahl is an emergency medicine physician and freelance health writer. You can find him at RajivBahlMD.com.