Research on Doctor-Patient Communication

Significance of Effective Communication

Effective communication between doctors and patients is crucial for delivering quality healthcare. Physicians depend on patients to provide complete and honest answers regarding their symptoms and health behaviors, which enables them to offer the best possible advice and treatment. However, the reality often deviates from this ideal scenario.

Study Overview

To explore why patients sometimes withhold information, researchers in the United States conducted two national online surveys. Their findings were recently published in JAMA Network Open. The researchers designed two surveys: the first utilized Amazon’s MTurk platform, where participants receive a nominal fee for their involvement; the second was conducted through the Survey Sampling International (SSI) platform, focusing on older adults aged 50 and above.

Survey Methodology

Participants were recruited online and asked about their willingness to disclose seven types of health information, including:
– Difficulty understanding the doctor’s instructions
– Disagreement with the doctor’s recommendations
– Regular exercise habits
– Dietary choices
– Adherence to prescribed medications
– Not following medication instructions
– Use of someone else’s prescription medication

Those who reported withholding information were prompted to explain their reasons.

Survey Results

The analysis included 2,011 respondents with an average age of 36 from the MTurk survey and 2,499 respondents with an average age of 61 from the SSI survey. Findings revealed that over 80% of MTurk participants and more than 60% of SSI participants had not disclosed at least one relevant health detail. The most common reasons cited were a desire to avoid judgment and concerns about being labeled as making poor health choices.

Implications of Findings

These surveys highlight a significant tendency among patients to withhold critical medical information from their healthcare providers. Dr. Angela Fagerlin from the University of Utah, a co-author of the study, noted, “Most people want their doctor to think highly of them. They’re worried about being pigeonholed as someone who doesn’t make good decisions.” This lack of transparency can hinder doctors’ ability to deliver appropriate advice.

Future Research Directions

Understanding the underlying reasons for patients’ reluctance to share information may help identify factors that facilitate or impede communication. For instance, patients might feel more comfortable with doctors they have known for an extended period. Dr. Fagerlin suggested that “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 conduct follow-up studies with in-depth face-to-face interviews to further investigate these issues.

References

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.
Press release: Why patients lie to their doctors? University of Utah Health https://www.eurekalert.org/pub_releases/2018-11/uouh-wpl112618.php