To any physician, the fact that patients aren’t always entirely honest about their health concerns will come as no surprise. Health issues are tremendously personal, and we all know how challenging they can be to discuss. Yet the more detailed and accurate the doctor-patient relationship becomes, the better equipped both parties are for success.
How honest are patients in the exam room? Why aren’t patients always truthful? What can be done to fix it? To dig into these important questions, Zocdoc teamed up with research firm Kelton Global in a nationally representative patient survey. You can read the press release or see our full infographic, but one high-level set of findings we particularly want to share is this: Not only have nearly half of all Americans avoided telling their doctor about a health issue because they were embarrassed or afraid of being judged, but also around a third say they have withheld details because they couldn’t find the right opportunity, didn’t have enough time during the appointment, or weren’t asked the right questions by their doctor.
“As doctors, we expect patients will withhold information in the exam room. There is a lot of emotion around personal health, and we get that,” Zocdoc founder and president Dr. Oliver Kharraz noted in the release. “But I think many doctors would be surprised to hear they’re getting half-stories often because they haven’t left enough time to ask.” To keep the conversation going, we asked a group of physician thought-leaders for their take on these findings, below. Want some quick upshots? Check out Zocdoc’s tip sheet for doctors who want to cultivate more honesty in their patient relationships.
I found the survey data interesting and unfortunately not all that surprising. The paternalism of medicine has all sorts of side effects, and patients feeling judged is one of them. What I like here is the profound opportunity we have. People are communicating in a host of new ways via Skype, SMS, Facetime, social networks, and even photo-sharing channels like Instagram. What we have to do in healthcare is harness the opportunity to provide better bi-directional channels for patients and families to share concerns and health quandaries that elevate ease of sharing vital information. Privacy will always need to be a precondition when thinking on the patient-physician partnership, but we shouldn’t use it as an excuse not to leverage the new tools at our disposal. These one-to-many platforms of our time provide exceptional opportunities for education in our population. But they also provide potential windows for more intimate and personalized care. If we do our job well, we will use this data as a wake-up call to find ways to be relevant and ultimately more useful to the patients we serve.
This survey makes it clear that honesty and trust are often lacking in the exam room. Most striking, however, is the why. Healthcare providers are more burdened than ever before. No longer are doctors able to focus all of their energy on patient interaction – asking the right questions and actually spending time listening. Now, physicians are spending valuable time in an exam room typing on a computer or checking off electronic boxes. Declining reimbursement forces doctors to see more patients in less time in order to meet the financial obligations of running a practice. Ultimately, patients suffer.
The results of this study are very interesting, but they really shouldn’t surprise us. The 15-minute office visit has wreaked havoc with the doctor-patient relationship. Add to that the insertion of digital technology such as computers and iPads into the exam room and it becomes very difficult for patients to make meaningful interpersonal connections with their doctor (and vice versa). Elsewhere in the survey, we learned that 18 percent of women and 11 percent of men would be more likely to disclose bad health to someone like a manicurist or a fitness professional than their doctor. Like doctors, these are professional listeners. But unlike doctors, these individuals have more time with us, usually at least an hour. Think about the last conversation you had with your stylist, looking eye to eye via the mirror, as you leisurely shared your story. As Dr. Kharraz suggests in the press release, perhaps expanding opportunities to share information via before-and-after office visit interactions can help, and we do know from prior studies that some people will disclose sensitive information via technology when they won’t during an office visit. If we think about this information carefully and involve patients and families in the process of designing solutions, perhaps we can begin to regain some of the trust that characterized doctor-patient relationships of the past.
Unfortunately, these results don’t surprise me. For a number of reasons over the last couple of decades, the traditional doctor-patient relationship has eroded significantly. One of the biggest reasons is a lack of face-to-face time with patients, with many physicians having to spend the vast majority of their day navigating computer systems and ticking boxes. We need to swing the pendulum back to direct patient care, focusing on better communication through open-ended questions and above all else compassion and trust in medicine