Not-So-Full Disclosure: Lies Between Patients and Physicians
A Dishonest Relationship
Patient and doctor relationships are confounding at best. They require mutual confidence, open communication, and trust. But what is trust, really? Dictionaries describe it as "the assured reliance on the character, ability, strength, or truth of someone or something." It stands to reason, therefore, that when one of these elements, such as truth, is missing, trust cannot exist. Why, then, do patients and doctors lie to each other?
In their days of training, residents learn that if a patient says he has four drinks a week, the real answer is eight, and the same can be said of cigarettes and illicit drugs. The not-so-subtle message here is that patients lie. To confirm this, a 2009 survey found that 28 percent of patients admitted to occasionally lying or not sharing information with their health care provider. Common lies ranged from diet and exercise habits to sexual histories, medication adherence, and supplement consumption.
Motivation for Deceit
Patients may be motivated to have their physicians think they are more disciplined than they really are, but some factors even reward patients for lying. For instance, one who exaggerates symptoms may get an appointment sooner than if he or she tells the truth. Patients may also provoke doctors into ordering more extensive diagnostic procedures to squelch their fears. And finally, they may lie to obtain secondary opinions, to protect their careers, or to acquire affordable health insurance.
A 2004 WebMD survey found that 45 percent of 1,500 patients admitted to lying to their physicians. The primary reason half of those patients lied was to avoid judgment from the doctor. Thus, patients often hide the truth to save face. In addition to the reasons listed above, these individuals also lied about seeing chiropractors and alternative health care providers, again to keep physicians from judging them.
A Two-Way Street
This is, however, only one-half of the complexities that go into the patient and doctor relationship. Having said that, it stands to reason that doctors also lie, not only because they can, but because they are not infallible to human folly. A survey published in February 2012 in the journal Health Affairs revealed that two-thirds of doctors agree they should share serious medical errors with their patients, but one-third did not completely agree. This means these health care providers would lie if they felt it necessary.
Nearly two-fifths of responding physicians also said they did not disclose their financial relationships with drug and device companies. And more than 55 percent of the respondents said they previously described a patient’s prognosis in a more positive manner than the facts might have supported.
Little White Lies
As new rules are designed to measure and improve the way doctors and hospitals deliver care, it’s possible even more white lies will be delivered. Doctors will tell these to ensure patients receive individualized care, while patients will continue to evade judgment from those who are supposed to help them. We’ll just have to see how medicine continues to deal with the ever-changing and increasingly intricate patient and doctor relationship.