“I don’t ask why patients lie, I just assume they all do.”

Anyone who is familiar with the show House should recognize this quote from the main character, Dr. Gregory House, whose extremely cynical philosophy regarding patient honesty (or more accurately, patient dishonesty) results in his less than desirable bedside manner.  When I first started watching this show I remember thinking that the extent of patients’ lies must be an exaggeration, and that surely, this was not an accurate reflection of patients’ communication styles with their physicians.

A little research however, and a recent trip to my new family physician, has caused me to reconsider my perhaps naïve former point of view.

So…do patients lie?  According to a WebMD survey1, it seems we do.  Of the 1,500 respondents, 45% admitted to lying to their physician.  As you can probably guess, a number of common themes emerge when it comes to what we will and will not disclose to our doctors.  “I don’t smoke,” “I never eat fast food,” and “I exercise regularly” are all prominent fibs that your doctor has most likely heard.

Of those respondents who admitted to lying:

  • 38% lied about following their doctor’s orders
  • 32% lied about diet and exercise
  • 22% lied about smoking
  • 16% lied about alcohol consumption
  • 12% lied about illicit drug use

Patients may lie out of shame or embarrassment, to avoid perceived judgment, to gain secondary incentives (e.g. prescription medication or disability payments), or to simply present themselves in a more positive light1,2.  While some of the reasons for lying may seem obvious, and even understandable, the short and long-term consequences of lying may not be immediately apparent.

Our doctor’s ability to provide us with an accurate diagnosis depends on our ability to provide reliable, truthful, and complete medical information.  And that includes telling them those things we would rather keep to ourselves.  At this point, you’re perhaps wondering the reason behind my own recent dishonesty?  Well, let’s just say when asked how many drinks I consumed in a week and given the options of a) 1-2, b) 3-5, or c) 6-9, my immediate thought was “what comes after c?”  Although these little fibs may seem harmless at the time, they can have long-term consequences for our health.  Lying about the amount we drink or even omitting over-the-counter medications we take can lead to serious interactions with other drugs down the road.  Lying about the amount we exercise can also lead to serious complications, especially for people with high blood pressure and cholesterol, who are already at increased risk of cardiovascular disease.

Bottom line?  We expect the best from our doctors and that can only happen when we are willing to be completely honest with them.  Effective doctor-patient communication is a two-way street, so while it may be embarrassing at the time, come clean with your doctor, it will be worth it in the long run!

Jenny Eastabrook

  1. Editorial Survey on WebMD Health, “Why Do You Lie to Your Doctor?” Sept. 3, 2004.  Accessed from http://www.medicinenet.com/script/main/art.asp?articlekey=46985.
  1. Palmieri JJ, Stern TA. Lies in the doctor-patient relationship. Prim Care Companion J Clin Psychiatry. 2009; 11(4):163-168.