Do you smoke? What do you eat? How often do you exercise each day? How much do you weigh? Evidence shows that patients often provide incomplete or inaccurate information during consultations, with direct implications for diagnosis and treatment decisions. What may help improve disclosure remains a key clinical question.

The health tech company Doctolib surveyed 312 practicing physicians on this issue. The findings, shared with Medscape’s German edition, showed that 31% of physicians reported that patients do not fully disclose information in about half or all consultations. Only 8% reported never encountering this issue.

A nonrepresentative patient survey supports these findings. Overall, 31% of respondents in Germany reported having withheld important health information from their doctor at some point. Among younger individuals, this proportion increased to 1 in 2. Many acknowledge that this behavior could endanger their health.

Physicians in the Doctolib survey cited a loss of trust, along with incorrect or delayed diagnoses, as key consequences of incomplete disclosure. “When patients omit important information, at best it leads to unnecessary costs due to superfluous diagnostics, and at worst it can even lead to hospital stays and invasive procedures,” said Ivo David Rimpl, MD, specialist in General Medicine and Surgery, at the Weilrod Medical Center in Hesse, Germany.

Hidden Drivers

Shame and fear of judgment appear to drive much of this behavior.

Patients reported concealing not only symptoms (27%) but also mental or psychological problems (24%), alcohol consumption (12%), and cigarette consumption (17%), according to the patient survey by Doctolib. Physicians attributed untruthfulness in the consultation room primarily to fear of judgment or negative evaluation (34%) and feelings of shame or embarrassment (33%). In addition, 27% believed that patients withhold information to avoid certain treatments or medications.

Patient responses aligned with these observations, with 35% identifying fear of judgment as the main reason for withholding information.

Findings from US surveys show a similar pattern, with 60%-80% of patients reporting that they have withheld information or been untruthful to their physicians.

Digital Solutions

The Doctolib survey suggests that many patients are more forthcoming when completing digital preconsultation questionnaires. Almost 60% of those who report lying to their doctor say that they can answer more honestly in a questionnaire than in a face-to-face conversation.

Most physicians emphasized the role of communication. Approximately 34% reported actively working to create a more trusting and open atmosphere during consultations.

“In face-to-face conversations, many people have worries, fears, feelings of shame, or a guilty conscience. These inhibitions disappear in digital communication with AI or a questionnaire,” said family doctor Shireen Darwesh, MD, from Oberhausen in Germany.

“In general, 67% of the doctors surveyed consider honest communication to be important or very important for the success of the treatment,” according to the Doctolib survey.

This story was translated from Medscape’s German edition.