More than half of doctor's have described a patient's prognosis more optimistically than warranted and more than 10 percent have said something untrue to a patient, according to a study published last month in the journal Health Affairs.
Dr. Lisa I. Iezzoni, the study's lead author and a professor of medicine at Harvard Medical School told the New York Times that the study doesn't explain why a doctor would lie, but she suspected doctors might be worried about discussing sensitive topics like weight loss and offending patients or being too frank with patients with a terminal diagnosis.
Pauline Chen, a surgeon and frequent contributor to the NY Times' Well Blog, said doctors who believe in honesty struggle with this constantly.
"Our most important job as a doctor is to convey information, to translate between patients and what knowledge you have," she said. "But you have to think about how you translate the conversation. For example, if your patient is going into an operation with a 30% mortality rate, of course you can say to the patient 'most people get through this operation just fine.' But really there are a lot of different ways you can phrase that information that changes your transparency and honesty."
Chen will join The Daily Circuit Monday to discuss the topic. She will be joined by Eric Campbell, associate professor and director of research at the Mongen Institute for Public Health at the Harvard Medical School.
"I think patients need to be empowered to have very frank discussions with their doctors about the levels of truthfulness they expect from physicians and their healthcare team," he said. "It's not unreasonable to begin a discussion with your doctor and say, 'Look, I want you to be as honest as you possibly can. If an error occurred on my case, I would like to know about it.'"
How do those little white lies affect patients and how can we push for most honesty when it comes to our health?
People want doctors to be honest with them, even if the information is bad news.
How much honesty do you want from your doctor if the news is quite serious? Have you ever felt that your doctor was not being honest with you?
If you are a doctor: Have you been less than fully honest with a patient? Why?
Dr. Eric Campbell, "3 degree Gopher."
Dr. Pauline Chen's blog.
I think it is important to give high expectations to patients because the mind plays an imporatnt role in the healing process. Once an idea gets incorporated in your mind, it becomes a reality.
Rick from Apple Valley: "At 23 I'd rather my doctor be completely honest. When I'm supposed to die, I'll die. Having a doctor lie to me would just be frustrating."
The main role of a "provider" is to make a person not doing well feel better.
Most people coming to the US heathcare system assume that everything is doable and all disease curable. This hope will need to be maintained as much as possible while gradually introducing the gravity of the percentages used in describing risks or mortality of a procedure or a disease.
Is ALS really that hard to diagnose? My sister learned more from her first visit with her GP after a few stumbles than after being poked and prodded for 1 1/2 years.
I absolutely believe doctors owe it to their patients and families to tell the whole truth, ESPECIALLY if the patient's condition is potentially life-threatening.
Almost 15 years ago, my father was diagnosed with Stage IV glioblastoma (the same kind of brain cancer the late Sen. Ted Kennedy had).
This is pretty much a death sentence, and that was especially the case back then, before treatment had advanced very much. The neurosurgeon never, ever leveled with my dad or us about how grave his condition was -- rather, because he was able to remove the main tumor from my dad's brain, he just focused on that, and led us to believe there was hope for a full recovery.
As a result, as my dad's cancer started to return, despite intensive follow-up radiation and chemo, we were totally unprepared, and what was already a terrible experience was made even more painful for all of us (all the more so because my dad's oncologist didn't ever tell us the full truth till it was obvious my dad had only weeks to live).
My husband found out the real nature of my dad's type of cancer on the Web, and that was how we knew the truth.
As you can probably tell, I still have some residual anger over this. I felt the doctors were outright cowards about this...the truth of course would have been painful and scary, but at least we could have had far more realistic expectations, and might have started planning appropriately, and been spared a LOT of stress in the end. Thanks for letting me tell our story and vent!
I am 44 years old and was diagnosed with Parkinson's last fall.
I had done enough research on my own, so wasn't completely shocked by the diagnosis, but I wanted to hear 100% of the truth and got exactly that.
Dad was diagnosesd with a brain tumor 2 weeks ago and again, we needed to hear the sad gravity of it in order to make decisions correctly. Was sad but necessary.
As a hospice RN I see way too many cases where doctors haven't been forthright from the beginning.
I think all patients have a right to know everything to plan for the future. As discussed online, the time element in a clinic visit may hinder this type of discussion.
I would always want complete honesty.
Twelve years ago I was diagnosed with a rare cancer that few survive. Fortunately my health care providers were candid with me and I was able to be the decision-maker in opting for a radical treatment plan that the medical community would not have suggested without my bringing it up and deciding to go through with it.
It was a very rough treatment, but a dozen years later I am alive and pretty well and cancer-fee. I will never regret that decision.
Dr. Pauline Chen.
As an adult out-of-state daughter, I want my mother's physician to be honest with Mom.
As an 80 yr old non-compliant diabetic, she not only doesn't want to confront her illness but is certainly not going to ask questions to get that self-help information.
The family cannot convince her to comply with needed lifestyle changes. We need the doctor to help motivate her to care for herself.
Is ALS really that hard to diagnose?
My sister learned more from the initial GP visit after a few stumbles than she has after 1 1/2 years of poking and prodding.
Please talk about end-of-life options. When can palliative hospice care turn into full-blown hospice. I would do things differently if I were in her shoes.
It is so easy to look up a diagnosis on the internet.
As someone with training in Medical Transcription especially, but any information a doctor gives you can be researched on the internet by anyone. I think it is best to be well informed but in a empathetic way, or course.
Thanks Dr. Campbell for sharing these findings. This is a topic that we all know happen in a daily basis but nobody is brave enough to talk about it.
A doctor lied to me.
Consequently, I'll never trust a doctor again in my life. It may seem that I'm painting the entire profession with a broad brush, but patients need to protect themselves first, and not be vulnerable to someones agenda.
Over 5 years ago, when I went to my doctor with a lump in my abdomen, I wanted to know what it was.
My dr. said it was probably just fibroids, after a pelvic exam she wanted to see an x-ray. After the x-ray she wanted a CT scan.
After the CT she asked my husband and I to come by after office hours. That was a Thursday, the following Tuesday I met with a surgeon and had a large abdominal surgery 2 days later.
Dennis from Minneapolis: If a person isn’t interested in complete and total candor from their doctor(s), they are wasting the doctors’ time and their own time, money.
Link to article about lying to pregnant patients about fetal abnormalities: www.rhrealitycheck.org
Gwen: " As a spouse of a Family Practice Physician I think you touched on the MOST CRITICAL factor early on --TIME! Docs see 20+ patients a day."
As a college-educated person I wanted to know if this was cancer, so I could do some research. It wasn't until a week after my surgery that anyone was willing to commit to "cancer".
The surgeon's assistant told me during a phone call, and wanted to get off the phone so badly I could hardly get him to spell out the name of the cancer so I could look it up.
Fortunately, I was referred to another dr for further treatment, and he was fabulous.
I learned that the medical community didn't have time to explain things to me.
I had to be my own advocate and look things up and come to appointments with a list of questions--and to write down the answers. I'm now considered cancer free, but I would have appreciated greater candor from the beginning.
We often have family request that that their family member be admitted to hospice but not to tell them it's "hospice."
This is highly unethical. As a hospice nurse I think everyone has the right to know they are dying--and they most likely already know but are protecting their family members.
One of the hallmarks of transparency is trust, and one of the callers mentioned that trust is a two-way street.
It is; but in this age of electronic records with no provisions for privacy, anyone with access to the record from now until eternity can learn very private information.
This can include physicians and nurses, of course, but medical assistants, bookkeepers, lab techs, and almost anyone who is employed by the health care organization, and possibly the employer if the employer is self-insured.
This has put a chill on patients being totally upfront with their doctors since anything that is charted is available to all these people, and it may limit what a doctor is willing to share, particularly if the doctor is not sure of something dire, because s/he doesn't have any control of what happens to that information once it is entered into the medical record.
The whole issue of privacy has been gutted, so this discussion, useful as it may seem, is going to be increasingly irrelevant. Employees will have complete access to the patients' charts and may say (or bill for) anything, letting the cat out of the bag. Doctors may as well be completely candid, because the patient might get the information otherwise from someone far less qualified or from their HR department.
Urologist's are the worst.
Send a reporter to me and I'll educate them on the prostate business with doctors. It will make a great program. It is so crooked that it will make your head spin.
I am a victim that sued (a hospital) for their horrible procedure. They were 20 years behind. The doctor said "so what? I can do what I want and do not have to tell you what I'm doing." The enlarged prostate business is the biggest medical scam in the country.