You’re filling out forms at the doctor’s office, and you check the box indicating that you’ve never smoked or that you don’t suffer from depression — neglecting to mention your pack-a-day habit of 30 years ago or the antidepressant you took this morning. Or your physician asks about daily alcohol intake, and you subtract a goblet or two of wine. And are you taking all your medications as directed? Yes, you answer, choosing not to mention you normally skip that hypertension horse pill because, honestly, you feel pretty good.
If you’re omitting a few such personal details at the doctor’s office, you have plenty of company: As many as 81 percent of patients intentionally withhold the truth from their doctors about how often they exercise, what or how much they eat, whether they regularly take a prescription medicine as instructed or if they’ve ever taken someone else’s medication, according to a 2018 study in JAMA Network Open. The most common reasons given for this frequent fibbing? Patients reported that they didn’t want to be judged or lectured by their doctor, and that they didn’t want to hear how potentially harmful their behavior was to their health. Avoiding embarrassment or not wanting to be labeled “difficult” were other reasons given.
“People want to put their best image forward with their doctor, so they tell their doctor what they think the doctor wants to hear,” says Nieca Goldberg, M.D., medical director of Atria New York City and clinical associate professor of medicine at the New York University Grossman School of Medicine. And yes, downplaying drinking is high on the list. “They’re self-conscious and don’t want to give the impression that they’re drinking too much. People also omit the intensity or frequency of their exercise,” she says. In other instances, it may not even occur to someone to mention a habit they had a long time ago (like smoking) but no longer do.
The rise of electronic health records also contributes to exam-room untruths. “People don’t want to share important but confidential information because someone could get access to the electronic health record,” says George Grossberg, M.D., professor and director of geriatric psychiatry at the St. Louis University School of Medicine. “They’re reluctant to disclose something that could be embarrassing but that could also impact their insurability.” This is particularly true with psychological issues such as depression or anxiety or sexual problems, he adds.
Whether intentional or not, these lies can create problems for your health and affect the care you receive. Here are a few examples of how patients’ lies of omission can come back to haunt them.
Undercounting your cocktails
“People almost never admit to how much alcohol they’re drinking; they underestimate,” Grossberg says. “All of us in medicine now realize there may be some health benefits to moderate alcohol intake throughout life. The trouble is, people have trouble stopping at moderate intake.” But it’s not just problems with alcohol itself that doctors need to know about. They also need to gauge how alcohol could interact with medications you may take for anxiety, high blood pressure, pain or other conditions.