Things your patients won’t tell you, but you need to know

Patients aren’t always forthcoming with their doctors. Learn about things patients aren’t sharing and how you can encourage honesty.

Five things patients won’t tell you, but you need to know

As a physician, you want your patients to be honest with you. It can help you build a more holistic image of their health, offer more effective treatment recommendations, and create stronger relationships between you and your patients.

Unfortunately, research shows that patients are not always forthcoming with their doctors. In fact, surveys show patients sometimes don’t share information that could be important to their care. The surveys found this especially true among women and younger people.

Below, we discuss five key things your patients might not be telling you and tips to help them open up so you can improve their care.

1. They disagree with your advice

Disagreeing with their physician’s advice is one of the most common things patients keep to themselves. Why would patients disagree? The reasons can be numerous, though often they think they know more about their own body and life situation. And sometimes they do.

They may already know, for example, that they need more exercise. But patients also know they don’t have time for a traditional workout in their busy life. Or maybe they’ve done extensive research online and developed a self-diagnosis that contradicts what you’ve said.

Patients are always welcome to speak up and say something to their doctor about a recommendation or a diagnosis. But many say nothing to avoid feeling judged, being seen as difficult or wasting your time. 


Instead of making a generic recommendation, help patients develop strategies suited to their unique situation. For example, how can a busy professional squeeze in exercise throughout their work week? Talk honestly with a patient about the information they found online. Finding creative solutions together may help patients value your recommendations and be more open to sharing.

2. They don’t understand your recommendations

A doctor’s visit can be overwhelming. Patients may not feel comfortable asking follow-up questions or asking you to explain a treatment plan. But that means they may leave an appointment not fully understanding what to do.

Lack of understanding is especially true of people with chronic conditions. Surveys showed that people with more serious illnesses (including people with chronic conditions) were more likely to withhold information from their provider, including any confusion about treatment recommendations.

Other factors can also affect a patient’s ability to understand and follow your recommendations. These factors include a patient’s education or socioeconomic status, the quality of patient-provider communication; and more.


Try the teach-back method to confirm a patient understands their treatment plan. Asking, “Do you understand?” makes it easy for a patient to respond “yes,” even if they don’t understand. Instead, ask, “So, going forward, how will you take your new cholesterol medicine?” This dialogue allows you to correct any misunderstandings.

3. They weren’t fully honest about their medical history

Sometimes, patients intentionally leave out crucial information in a medical history. Other times, it might be accidental.

Patients often leave out information intentionally because, well, a medical history is kind of a personal history. They may feel uncomfortable sharing specific details, even though those details can be vital to their future care.

Other times, patients don’t consider certain health events a relevant part of their medical history. For example, a broken bone may seem like a thing of the past, but it could indicate poor eyesight, weak bones or even neurological issues that can affect their future.


Remind patients they can share any detail with you. Provide examples of what would be helpful to note when reviewing their medical history, including hospitalizations, illnesses or surgeries.   

4. They didn’t mention (or downplayed) their bad habits

No one wants to admit they have bad habits. They can be embarrassing, especially if they are habits a patient feels they should have broken a long time ago. Many either hide or underestimate their habits because they want to avoid feeling judged.

For example, patients may over- or underreport how much they smoke, drink or exercise. They likely want to avoid being lectured or hearing how bad their habit actually is.


Avoid being confrontational in the face of misreporting. Whether intentional or not, people can become defensive when questioned or accused. Instead, try to explain that having the whole picture will let you better help them.

5. They feel nervous in general

Judgment and embarrassment are powerful forces that can keep patients from being open and honest with you. Fear may shape how patients act, but it’s not something they’ll admit or even recognize. Patients who feel uncomfortable will hold back for fear of making themselves feel worse.


Remind patients that you are not here to judge them. Rather, you want them to be open and honest so that you can help. Patients sometimes need to hear that honesty is the key to developing an effective, personalized treatment or lifestyle plan.

Getting patients to open up and share personal information can be challenging. A doctor’s visit can also overwhelm some people, leading to confusion and uncertainty. The key is to put patients at ease from the onset of an appointment or a new relationship. By building trust, patients will be more comfortable sharing information, which is better for everyone involved



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