What do patients lie to their doctors about? Plus, tips to encourage them to tell the truth

Photo of doctor and patient hands while discussing medical records after health examination
In a new survey, 23% of people admitted they have lied to their doctors. (andrei_r/GettyImages)

Doctors often ask patients questions about their lifestyle choices, but, in some cases, they shouldn’t believe the answers.

That’s because 23% of people admitted they have lied to their doctors, according to a survey by TermLife2Go.

So what are people lying about? The survey of 500 people found:

  • 46% lied about smoking.
  • 43% lied about exercise.
  • 38% lied about drinking.
  • 29% lied about their sexual partners.

That doesn’t add up to 100% because some people said they lied about multiple subjects.

On the upside, most people (77% of those surveyed) are honest with their doctors.

Why do patients lie? Some 75% of respondents cited embarrassment as the reason. Another 31% said they lie to avoid discrimination, and 22% said they lie because they don’t think their doctor will take them seriously if they tell the truth. Those that lied to avoid discrimination were overwhelmingly female (80% female, 20% male).

RELATED: 5 proven practices to help doctors connect with patients

It’s hard for doctors to tell how often patients lie, Clark Madsen, M.D., a family physician, told TermLife2Go. “Doctors don’t have some sort of lie detector and aren’t trained like the FBI,” said Madsen, who suspects he gets lied to in about 30% to 40% of patient visits.

Most of the time, patients lie to keep the visit moving, thinking “sure, I’ll do that," or "no, I don’t have that problem,” said Madsen.

Sometimes, patients just tell doctors what they think their physician wants to hear, he added. For example, they will say they exercise more than they do. 

But other times, patients try to conceal information, and the lies can be more serious.

RELATED: Relationships and time with patients may be key to physician satisfaction, survey find

“I have caught many people telling me stories that don’t make sense or denying actions they have taken. This usually happens when they have an agenda and want the doctor to do something specific for them. If they have a problem and want a specific treatment, they will sometimes tell you they have taken other treatments or are allergic to certain medicines to force you to pick the one they want,” he said.

The survey found there are some gender differences when it comes to lies patients tell. More men lied to doctors about alcohol consumption than women (50% versus 32%). On the other hand, women were more likely to lie about sexual partners (33% versus 21%).

Madsen said gender differences could be the result of cultural norms for men and women. Patients either consciously or unconsciously try to meet those norms.

And there were differences based on age. Patients 35 and older are more likely to lie about their exercise habits than younger patients. Patients 35 and younger are more likely to lie about smoking. The age group most likely to lie about sexual partners are those 35 to 45.

RELATED: It takes both IQ and EQ to make an effective doctor

Most patients are honest, but that honesty isn’t always comfortable. In fact, almost half of survey respondents said they feel uncomfortable talking to their doctors about their sexual activities. 

On the other hand, 34% said they were comfortable talking with their doctor about anything.

Are there some lessons for doctors?

  1. Well for one, don’t lecture patients who admit to an unhealthy habit. One man said he lied about his alcohol consumption to avoid a lecture from his doctor, the survey found.
  2. Realize people may not be truthful if a parent or spouse is in the room. One young woman said she lied about her sexual activity because she didn’t want her mother to know what she was doing.
  3. A silent pause can sometimes bring out the truth. Madsen said he’s called patients out for lying, usually about once a month. "Usually all it takes is not responding when they lie to me and the silence makes people respond with the truth. Most of the time people will correct themselves quickly and we can go on,” he said.
  4. Don’t be judgmental. “I try not to look judgmental because I want them to feel welcome to correct themselves and not hide further,” said Madsen. “Usually when they see that I am on their side and not their adversary they open up and will tell you things they have told no one else. This is a sacred trust and very important to me.”
  5.  Don’t get confrontational if you suspect a patient is lying. “Sometimes patients will double down and proclaim their innocence and can even become aggressive at times. We don’t like to get in arguments and usually will hear patients out but these relationships usually become toxic and patients will often seek out another physician,” Madsen said. “We train physicians to always act in the best interests of the patient and that includes if you are being lied to or coerced to do something that you think will harm them more than help.”
  6. Let patients know that you have their best interests at heart. You want them to understand that as a doctor you have no other motives than to help them.
  7. Make patients aware of the consequences of lying. For instance, if they lie about medications they take, they might be prescribed something that interacts and can have serious health effects. Some people will say they have problems or symptoms to get a treatment, but the treatment can cause serious problems as well, and they are putting themselves at unnecessary risk, Madsen said.
  8. Recognize that some lies can be dangerous. The most prominent example is patients taking dangerous medications in a way that the doctor did not prescribe and then lying to the doctor about it. “Hospitals are filled with patients who take narcotic medications this way. There is no objective measure for pain and so doctors have to trust the patients when they say they are in severe pain. We will try other medications but patients frequently say they are allergic to the alternatives and/or the alternatives do not work. They try and force us to prescribe certain treatments but the safer treatments often work better. This applies to surgery as well,” he said.