Doctors know you're lying. About the smoking, drinking, taking medicine, lack of exercise, and for some patients, even symptoms. Said Dr. Bruce Rowe, a family doctor in suburban Milwaukee, in an interview with the AP: "Doctors have a rule of thumb. Whatever the patient says they’re drinking, multiply it by three. If they say two drinks a day, assume they have six."
Even fictional doctors like TV's Gregory House acknowledge our propensity to prevaricate: "I don't ask why patients lie, I just assume they all do." But doctors, it turns out, are just as guilty. According to a new study of more than 1,800 physicians nationwide, more than half said they had embellished a patient's prognosis to make it sound more favorable. Nearly 20 percent admitted they hadn't fully disclosed a medical mistake for fear of being sued. And 1 in 10 of those surveyed said they'd told a patient something that wasn't true in the past year.
Published in this month's Health Affairs, the study raises an obvious question: Why are patients and doctors lying to each other? Isn't our best interest to be forthright with the professionals we've tasked with overseeing our health? And aren't the sickest patients the ones most deserving of honesty, no matter how discouraging their future outlook?
"I was disappointed to see so many doctors not disclosing errors," said Arthur Caplan, a bioethicist at the University of Pennsylvania, to the Boston Globe. “They may dodge a bullet, but if it’s found out later, they can really get clobbered for not telling the truth—to say nothing of the patient consequences."
While most agree that honesty is the best policy, there's plenty of gray area. For example, is it right to inform the parents of a premature baby of their child's bleak survival odds, knowing that there are occasional miracles? Should doctors who prescribe placebos be honest with their patients and risk the treatment's effectiveness? And what about doctors who occasionally lie to each other to get their patients faster treatment?
Like any relationship, it's a two-way street. As patients get better informed (thank you, WedMD) and medical records go up online, the days of medical misdirection may be winding to a close, leaving doctors with little choice but to be forthcoming with news both good and bad. As a result, hospitals are growing more aware of the importance of bedside manner, and med schools are shifting their focus towards students with demonstrable social and interpersonal skills. Some of these changes are already here: a growing number of medical centers are adopting policies that encourage doctors to say "I'm sorry" up front when mistakes happen. Not only are patients less likely to sue when doctors apologize, it also happens to be the right thing to do.