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University of Utah researchers examine why most patients have trouble being honest with their doctor

SHARE University of Utah researchers examine why most patients have trouble being honest with their doctor
FILE - Students walk past the "block U" on the University of Utah's campus in Salt Lake City, Tuesday, Oct. 20, 2015.

FILE - Students walk past the “block U” on the University of Utah’s campus in Salt Lake City, Tuesday, Oct. 20, 2015.

Chris Samuels, Deseret News

SALT LAKE CITY — A pair of questionnaires designed by University of Utah researchers found most patients are not totally honest with their doctors, a new medical paper shows.

The paper, published in the Journal of the American Medical Association's online resource JAMA Network Open on Nov. 30, said about 81 percent of patients questioned in one of its surveys said they "avoided disclosing" important health information with their physician.

Those responses were collected using an online survey service called Amazon Mechanical Turk, collecting data from 2,011 people.

"Most people want their doctor to think highly of them," said Angela Fagerlin, lead author of the study and chairwoman of population health sciences at University of Utah Health. "They're worried about being pigeonholed as someone who doesn't make good decisions."

Another survey commissioned by the U., using the service Survey Sampling International, used data from 2,400 people, 61 percent of whom also responded they did not share important information with their doctor. Respondents reached by the former had an average age of 36, while those who spoke with the later were 61 years old on average.

Both used nonprobabilstic respondent samples and collected their data in 2015, though the data was analyzed this fall. The paper said researchers "followed the American Association for Public Opinion Research reporting guideline."

Patients who withheld information from their doctor were generally trying to avoid discouraging or awkward conversations, the study found.

"The most commonly reported reasons for nondisclosure included not wanting to be judged or lectured, not wanting to hear how harmful the behavior is, and being embarrassed," the paper concluded. "In both samples, participants who were women, young, and with worse self-rated health were more likely to report withholding information."

Fagerlin told the Deseret News that disagreeing with the doctor's recommendations was the most common thing respondents reported being less than straightforward about. Other topics about which they were not forthcoming were not understanding the doctor's instructions, how healthy their diet is, what their medications are, and how frequently they exercise.

Leaving out these details can be harmful to the patient, said Fagerlin, who is also a researcher for the Veteran Affairs Salt Lake City Health Care System's Informatics Decision-Enhancement and Analytic Sciences (IDEAS) Center for Innovation.

"These things people don't think are a big deal could actually have a big impact on your health," she said. "They don't understand it can actually have pretty significant consequences."

Patients can do small things that help the doctor better serve their needs, Fagerlin said, such as admitting if they are worried about adding another medication to their regimen or have concerns about the cost of a treatment.

"Most physicians want to give you the best care tailored to your needs, but they're not mind readers," she said.

Still, Fagerlin said, doctors themselves must also examine why more of their patients don't feel comfortable being totally honest with them.

"How providers are communicating in certain situations may cause patients to be hesitant to open up," she said in a statement. "This raises the question, is there a way to train clinicians to help their patients feel more comfortable?"

For example, Fagerlin said, some doctors may be well advised to practice what is known as the "teach back method," in which they encourage the patient to repeat back their instructions — all while taking care not to do so in an intimidating way.

"If they're totally off script … then you can address those issues," she said.

Fagerlin is interested in future studies on patients' level of comfort when specifically discussing sensitive topics such as sexual assault or suicidal thoughts, as well as research looking at the extent to which patients also have trouble being honest with a doctor they have a longstanding relationship with.

Researchers from Middlesex Community College in Massachusetts, University of Iowa, University of Michigan and Wayne State University in Detroit also worked on the new study.