doctor-patient communication

In two online surveys on doctor-patient communication, researchers investigated why some patients withhold information from their doctors.

Good doctor-patient communication is essential for successful patient care. Doctors rely on patients to answer their questions about symptoms and health behaviors fully and honestly, so they can give the best advice and treatment. However, the reality often falls short of this ideal. To understand the extent and reasons behind patients withholding information, researchers in the USA conducted two national online surveys. They recently reported their findings in JAMA Network Open.

The researchers developed two online surveys – the first delivered via Amazon’s MTurk platform, where participants are paid a small participation fee, and the second using the Survey Sampling International (SSI) platform in a sample of older adults (50+ years). Participants were recruited online and asked to report whether they had avoided telling a doctor about seven types of health information including: not understanding doctor’s instructions; disagreeing with doctor’s instructions; whether they exercise regularly; whether they had a healthy diet; whether they took a certain medication; whether they did not take their medication as instructed; whether they took someone else’s prescription medication. If a participant reported withholding information, they were asked about their reasons.

In total, 2,011 respondents of average age 36 years were included in the MTurk Survey and 2,499 respondents of average age 61 years in the SSI Survey analyses. Over 80% of MTurk survey takers and over 60% of SSI survey takers reported not disclosing at least one type of health information – most commonly disagreeing with the doctor’s recommendations or not understanding the doctor’s instructions. The most common reasons given for withholding information were not wanting to be judged or to be told their behavior was harmful.

These two surveys indicated that patients often withhold relevant medical information from their doctors. Dr. Angela Fagerlin from the University of Utah, one of the study authors, commented, “Most people want their doctor to think highly of them. They’re worried about being pigeonholed as someone who doesn’t make good decisions.” However, doctors may not be able to give the most appropriate advice if they don’t have all the relevant information.

Understanding more about why patients withhold information could help to identify factors that help or inhibit patients, for example whether patients are more open with doctors they have known for many years. Dr. Fagerlin added, “How providers are communicating in certain situations may cause patients to be hesitant to open up. This raises the question, is there a way to train clinicians to help their patients feel more comfortable?” The researchers plan to follow-up the surveys with more in-depth face-to-face interviews to help answer these questions.

Written by Julie McShane, Medical Writer

References:

  1. Levy AG, Scherer AM, Zikmund-Fisher BJ, et al. Prevalence of and factors associated with patient nondisclosure of medically relevant information to clinicians. JAMA Network Open 2018;1(7):e185293. Doi:10.1001/jamanetworkopen.2018.5293.
  2. Press release: Why patients lie to their doctors? University of Utah Health https://www.eurekalert.org/pub_releases/2018-11/uouh-wpl112618.php
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