Are you always candid when talking with your doctor? For example, do you give your doctor an honest accounting of how often you exercise or drink alcohol? And do you speak up when you disagree with one of your doctor’s recommendations for improving your health?
If you aren’t entirely truthful with your doctor, you have plenty of company. In a new study, as many as 8 in 10 American adults admitted to lying to their doctor about a health-related matter.
Why are we less than forthcoming when talking with our doctors? We’re apparently too embarrassed to tell the truth, the study found. Also, we don’t want doctors to judge us — or lecture us — about any of our less-than-stellar health-related behaviors.
“They’re worried about being pigeonholed as someone who doesn’t make good decisions,” she added.
The study was published Friday in the journal JAMA Network Open.
Potentially dangerous omissions
Not being completely honest with your doctor can be harmful to your health, however. As Fagerlin and her co-authors note in their paper, to make accurate diagnoses and appropriate treatment recommendations, doctors rely on patients to disclose their symptoms and health-related behaviors, as well as their thoughts and feelings about potential treatments and other medical matters.
As an example of how nondisclosure can be dangerous, the researchers point to a patient who withholds details about the medications — including “alternative” or over-the-counter products — that he or she is taking. In those cases, the patient risks having the doctor unknowingly prescribe a medication that might interact in a potentially dangerous way with the other products.
This isn’t the first study to examine the question of whether patients give false information to their doctors. Nor is it the first to find that they do lie. But previous studies have tended to focus on a single issue, such as alcohol consumption or the use of complementary and alternative medicine.
The current study looked at several types of information that patients are likely to avoid telling their doctors, such as their true health behaviors, their use of alternative or over-the-counter medications, their disagreement with the doctor’s recommendations and their lack of understanding of the doctor’s instructions. It also took a deeper dive into the reasons why patients withhold that information.
For the study, Fagerlin and her colleagues conducted two identical online surveys. One involved 2,011 people who ranged in age from 19 to 79. (Their mean age was 36.) The other had 2,499 participants, all of whom were aged 50 or older. (Their mean age was 61).
In both surveys, the participants were asked whether they had “ever avoided telling a health care provider” that they
- did not understand the provider’s instructions,
- disagreed with the provider’s recommendation,
- did not exercise or did not exercise regularly,
- had an unhealthy diet,
- took a certain medication,
- did not take their prescription medication as instructed, or
- took someone else’ prescription medication.
Eighty percent of the people in the first survey acknowledged that they had avoided telling a doctor or other clinician one of the seven types of medically relevant information. In the second survey, 61 percent admitted that they had done so.
Almost half (46 percent) of the people in the first survey and almost a third (31 percent) in the second one said they hadn’t told their clinicians that they disagreed with the clinician’s recommendation. Significant percentages in both surveys (32 percent and 24 percent, respectively) also said they had not disclosed that they didn’t understand the clinician’s instructions.
As for lying about their health-related behaviors, 1 in 4 of the respondents in the first survey and 1 in 5 of those in the second did not disclose that they had an unhealthy diet, and similar percentages of them failed to tell their doctor that they did not exercise.
“I’m surprised that such a substantial number of people chose to withhold relatively benign information, and that they would admit to it,” said Andrea Gurmankin Levy, the study’s first author and a social scientist at Middlesex Community College in Middletown, Connecticut, in a released statement.
In both surveys, the people most likely to say they had failed to disclose medically relevant information to their health care providers were women, younger people, and those who reported that they were in poor health.
That last finding is particularly worrisome, say the study’s authors, as it indicates “that the very patients who are in greatest need of high-quality health care because of the complexity of their health may be more likely to compromise their care by withholding important information from their clinician.”
A two-way street
This study comes with several important limitations. The most glaring (and interesting) one is that the participants were asked to be truthful in their survey responses about being untruthful to their doctors.
But, as the authors of the study point out, if the participants were not entirely forthcoming in their survey responses, they probably gave answers they thought were more socially acceptable and therefore minimized the extent to which they withhold information from their doctors.
That “would mean that our study has underestimated how prevalent this phenomenon is,” said Levy.
The researchers aren’t blaming only patients for not being more open with their doctors.
“How providers are communicating in certain situations may cause patients to be hesitant to open up,” said Fagerlin. “This raises the question, is there a way to train clinicians to help their patient feel more comfortable?”
The researchers intend to explore that question and others — such as, are patients more open with doctors they have known for years? — in future studies.
But patients shouldn’t wait for their doctors to become more skilled at putting them at ease. Even if it does feel uncomfortable, be sure to answer all your doctor’s questions fully and honesty. After all, it’s your health that’s at stake.
FMI: You can read the study in full at JAMA Network Open’s website.