The fear of being judged or held in a lesson partly explains the temptation of patients to hide certain medical information. With potential medical consequences.
Trust, which should be one of the keys to the patient's relationship with his doctor, is not obvious. According to a study of about 4500 people, seven out of ten patients have already lied in the area of their medical examination. These agreements with reality refer, for example, to their diet, to their sports practice, to the regularity with which they take their treatment or to their adherence to the therapeutic protocol proposed by the professional.
These omissions or falsities can have medical consequences. "A lack of knowledge of some elements from the practitioner can lead to a deviation of its clinical approach, a prescription drug overdose, or even contraindicated, or to carry out further unnecessary tests", observes Dr. Antoine Giacomini, family doctor in Strasbourg.
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The study conducted by the social scientists of Middlesex Community College (Massachusetts, USA) aimed to measure the extent of the phenomenon and to understand its implications. His conclusions are published in open access in the journal Jama Medical Education. Patients interviewed on the Internet were asked to indicate, for seven categories of information held by researchers, if they had already failed to tell the truth to their doctor.
The result of this survey is surprising: "most of the interviewees admit that they have deliberately concealed information on at least one topic". In detail, more than a third admit that they did not show his disagreement with the practitioner; a quarter did not understand his instructions but dared not tell him; almost one in five did not follow the treatment correctly; 11% took drugs prescribed to someone else (without admitting it).
Fear of being mistaken for a "bad patient"
"If these results are generalizable, it means that doctors do not regularly have all relevant information, which can affect the quality of care – especially for chronically ill people," the study authors say. Why such a lack of trust? Respondents say they do not want to be judged or listened to by their doctor. They were afraid of being mistaken for "bad patients" or thought that information did not count. "It happens more and more often that patients fear wasting their doctor's time, especially in medical deserts," says Dr. Jacques Auger, Charente-Maritime general practitioner.
According to this specialist in the doctor-patient relationship, "it is up to the practitioner to do everything possible to avoid misunderstandings that could be harmful." He must keep in mind that his responsibility is not only to explain correctly, but also to make sure that his patient understands " . "The well known inclination to the patient to lie should not scare the doctors," adds Dr. Giacomini, observing that some disciplines, such as addictology, are more worried. "As in every human relationship, trust needs time to build." Alas, this is what we lack today. "