3 ways to tell if patients are lying

Research shows that 28 percent of patients admit to being dishonest with their physicians--but doctors guess the number is even higher, according to a recent Wall Street Journal article.

Why do patients lie? The reasons vary--they're embarrassed  or they're trying to influence a doctor's treatment or recommendation, for example. However, experts say the following techniques can help physicians ferret out patients' fiction.

1. Watch for clues
According to the WSJ, many doctors look for signs of lying, such as avoiding eye contact, frequent pauses in the converstion, unusual voice inflections and other signs of anxiety.

However, Jeffrey Knuppel, a correctional psychiatrist who treats prison inmates, warned Physicians Practice in 2010 that such nonverbal cues aren't always reliable. "People make a lot of assumptions that it takes more effort to lie than to tell the truth or that people get nervous when they lie but that's actually wrong," he said. "For some people, lying comes naturally. It's the truth that may cause them more anxiety."

2. Ask specific questions about high-risk topics
The most dangerous lies patients tell have to do with untruths about what prescription, over-the-counter and herbal medications they are--or aren't--taking, Glen Stream, a primary-care physician with the Rockwood Clinic in Spokane, Wash, told Physicians Practice.

Elizabeth Lee Vliet, an Arizona-based internist, told the WSJ that she asks patients about OTC drugs specifically and directly. "Patients are medicating themselves with so many over-the-counter herbs and supplements," she said, which can have potentially dangerous side effects, particularly in combination with prescription drugs.

3. Be moderately skeptical
Rather than being suspicious of every patient claim, Knuppel advised doctors consider what each patient has to gain or lose from their encounter with the healthcare system. "Is it pride, disability payments, medication?"

Consider multiplying or dividing patient-supplied numbers by a small factor to get closer to the truth, and work to detect early signs of medical consequences that indicate a patient is not telling the whole truth.

To learn more:
- read the article from the Wall Street Journal
- see the article from Physicians Practice