Should doctors ever lie? 11% say they have

Survey finds many physicians do not fully disclose errors to patients

How honest are physicians at your hospital? A new study in Health Affairs finds about one in three physicians say they do not believe they should disclose all serious medical errors to patients.

For the study, Massachusetts General Hospital (MGH) researchers in 2009 surveyed nearly 1,891 physicians to determine how closely medical professionals adhere to the American Board of Internal Medicine Foundation's Charter on Medical Professionalism, which calls for physicians to be honest and open with patients.

Lying to patients: Overall, 83% of respondents agreed with a statement that said physicians should never lie to a patient. However, 11% of participants said they had lied to a patient or a patient's guardian in the preceding 12-month period, while 55% said they had explained a patient's prognosis more positively than was warranted.

Disclosing errors: Meanwhile, about 34% of physicians said they only somewhat agreed or disagreed with the statement that physicians should disclose "all significant medical errors to affected patients." Nearly 20% of the physicians surveyed said they did not fully disclose a mistake to a patient within the past year for fear of being sued.

The most honest physicians: According to the findings, women and underrepresented minorities in medicine were more likely to be honest with patients. For example, 8% of female physicians reported lying to a patient in the past year, compared with 13% of male physicians.

Overall, cardiologists and general surgeons were the least likely to say they had lied to a patient in the past 12 months, and pediatricians and psychiatrists were the most likely. Meanwhile, physicians practicing at medical centers or universities were more likely to think it is necessary to disclose medical errors than physicians at smaller practices.

According to study author Lisa Iezzoni, the director of MGH's Mongan Institute for Health Policy, the findings suggest that patients "do not get the full story" and may "not be able to make an informed choice about the best course of action for their care." She warns that "[u]ntil all physicians take a frank and open approach to communication, it will be very difficult to enact patient-centered care more broadly" (Iezzoni et al, Health Affairs, February 2012; Lowes, Medscape Medical News, 2/8; HealthDay, 2/8; Marcy, "Capsules," Kaiser Health News, 2/8).

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