Patients Commonly Withhold Information from Doctors

Researchers at Middlesex Community College (MXCC; Middletown, CT, USA), the University of Utah (Salt Lake City, USA), the University of Iowa (Iowa City, USA), and other institutions conducted a study involving 4,510 adults in order to examine the frequency of patient nondisclosure of medically relevant Information and their reasons for doing so. Participants were recruited via two online surveys, one using Amazon Mechanical Turk (MTurk) from March 16 to 30, 2015 (2,096 respondents), and the other via Survey Sampling International (SSI) from November 6 to 17, 2015 (3,011 respondents).

The results showed that 81% of the MTurk participants and 61% of the SSI participants said they had avoided disclosing at least one type of information, with the most common reasons for nondisclosure not wanting to be judged or lectured, not wanting to hear how harmful a particular behavior is, and being embarrassed. In both groups, women, younger participants, and those who rated their own health as poor were more likely to admit they withheld information. Most withheld the fact that they disagreed with the doctor's recommendations or that they didn't understand the doctor's instructions. The study was published on November 30, 2018, in JAMA Network Open.

“Many respondents in these surveys intentionally withhold important information from their clinicians, and were most likely to do so when they disagreed with or misunderstood their clinician’s instructions,” concluded lead author Andrea Gurmankin Levy, PhD, MBe, of MXCC, and colleagues. “Patient failure to disclose medically relevant information to clinicians can undermine patient care or even lead to patient harm. A better understanding of how to increase patients’ comfort with reporting this information may improve the clinician-patient relationship and patient care.”

“An awful lot in medical care depends on the patient history, and we know we're not always getting the full story. Full disclosure puts the burden and responsibility on the patient, which may not be a practical way to solve this communication problem,” said Arthur Elstein, MD, a retired physician of the University of Illinois (Chicago, USA), in an accompanying commentary. “Instead, health care professionals should be aware of the nondisclosure issue and look for ways to uncover details in a technical way, such as an impersonal online survey before face-to-face appointments.”

Related Links:
Middlesex Community College
University of Utah
University of Iowa