DISHONESTY IN PATIENT DISCLOSURES TO HEALTHCARE PROVIDERS

Purpose: Patient honesty with healthcare providers is critical to quality patient care. If providers are not aware of their patients' unhealthy behaviors and concerning symptoms, then providers cannot address these issues, and may even make contraindicated recommendations. Thus, the purpose of this study is to examine the extent to which patients withhold information from their healthcare providers.

Methods: 2,010 people completed an online survey through MTurk, an online resource through Amazon.com that conducts online surveys with adult volunteers for a small monetary reward. The survey asked participants whether they ever avoided telling a healthcare provider any of 19 types of information (Table 1), and if so, the reasons for and conditions of the nondisclosure.

Results: Participants had a mean age of 36 (SD=12.4), 49% had completed college or more, 84% were White, and 60% were female.  Across the 19 types of information, 2-46% of participants avoided sharing it with their healthcare provider (Table 1). Multiple regression revealed that females, younger participants, Whites, those with more education, and worse self-rated health were significantly more likely to have avoided sharing with their healthcare provider (p<.049 for all).

Conclusions: The results reveal that it is not uncommon for patients to withhold important information from their healthcare providers. A better understanding of how to make patients comfortable reporting this important, though potentially embarrassing, information is critical to improving the physician-patient relationship and patient care.

Table 1.

Type of information (in order of presentation)	% who avoided telling healthcare provider the information
Didn't understand provider's instructions	32%
Disagreed with provider's recommendation	46%
Didn't exercise	29%
Had unhealthy diet	25%
Took a certain medication	16%
Did not take prescription medications as instructed	23%
Took someone else's prescription medication	14%
Drank alcohol or how much drank	17%
Smoked or how much smoked	15%
Were depressed or how depressed	23%
Had an embarrassing symptom	16%
Had unsafe sex or how much had unsafe sex	11%
Used recreational drugs or how much used recreational drugs	16%
Have been abused	7%
Have been sexually assaulted or raped	4%
Suicidality or severity of suicidality	10%
For participants with minor children (N=593):
Child had an unhealthy diet	5%
Child has a lot of “screen time”	11%
Did not use the recommended car seat	2%