A Doctor on Why Patients Lie to Their Physicians

Dr. Alok Patel hopes to get patients to fess up on bad behavior.

April 01, 2016, 5:06 PM

— -- April Fool’s is here and everyone has a get-out-of-free card for the most inventive lie. Aside from the holiday of hoax, most people lie on occasion to avoid consequences or spare another person's feelings.

But your doctor will tell you that fibbing may be harmful to your health. While many people lie to doctors for social reasons, withholding health information can lead to improper treatment and not enough preventative health education.

Do You Lie to Your Doctor?

Mistrust in the doctor-patient relationship is likely a fault, to a degree, of both parties. But the patient has more to lose.

To try and understand this phenomenon, the ABC News Medical Unit talked to people about it on the streets of New York City. With camera and microphone in hand, we asked people:

“What do patients lie to their doctors about?”

People immediately blurted out topics like alcohol consumption, sexual encounters, eating habits, and whether or not they smoked. A few admitted to lying about taking prescribed medications and one individual said he withheld symptoms he was feeling.

As a physician, the impulse is to ask: Why? Lying is a serious commitment for the brain. The mind works harder to tell fibs than it does when giving honest responses; telling a lie involves planning, persuasion, and maintenance of your dishonest story.

So why would patients take on such a mental feat when telling the truth is so much easier? The responses:“You don’t want to get scolded by the doctor!”

“It’s embarrassing to tell doctors you’re a drunkard”

“You want to be a perfect patient.”

And a highly memorable response: “You like about not having sexual problems, especially men, because, you know, their machismo.”

Doctor’s office or not, lies help us avoid unfavorable social encounters. In some cases, it’s complimenting a friend's cooking and in others it’s denying that possible erectile dysfunction.

This a much larger social dilemma in healthcare. The ideal doctor-patient relationship needs clear communication in both directions. Sometimes, an obsession with preserving the ego is so strong that patients will fabricate stories. Perhaps the undertone is that physicians need to make patients feel comfortable and at ease before an onslaught of personal questions.

In some cases, a general distrust of healthcare as a system may find its way into the doctor-patient relationship. There are some variables out of the doctor’s hands: healthcare fees, follow-up appointments, insurance policies and testing.

So what’s a doctor to do? This was the final question of the dynamic questionnaire.

The majority stated that wanted to physicians to treat them as individuals, to clearly and honestly tell them why the questions were being asked, and to remind them of patient confidentiality. If compassion and honesty are proven ways to build trust among patients, then surely physicians can employ those tools alongside stethoscopes and prescriptions.

Even with limited patient-interaction time, physicians should do their best to guarantee that what happens in the clinic, stays in the clinic.

Doctors don’t intend to wield a scary moral compass over patient’s actions; they simply want to provide the best care possible. But in order to do that, they may need to take a step back, listen, and build rapport. Only then can they reach for those deep-dark secrets.

Dr. Alok Patel is a clinical instructor of Pediatrics at Columbia University and at the Morgan-Stanley Children's Hospital of New York-Presbyterian.

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