LOS ANGELES _ Some things are better left unsaid _ and that includes certain aspects of your medical condition, doctors say.
In a nationwide survey of 1,800 physicians, 17 percent had some level of disagreement with the notion that they should "never tell a patient something that is not true." Not only that, but 11 percent of those surveyed acknowledged that they had told a patient "something that was not true" in the past year.
The survey, led by Lisa Iezzoni, director of the Mongan Institute for Health Policy at Massachusetts General Hospital in Boston, didn't ask doctors for specifics about the type of untruths they told. But at least some of them were probably more than just spin _ in another question, 55 percent of doctors acknowledged they had "described a patient's prognosis in a more positive manner than warranted."
One motivation for shading _ or flat-out hiding _ the truth appears to be the fear of being sued. The survey found that 34 percent did not completely agree that "all significant medical errors" should be disclosed to patients, with 20 percent saying they had withheld information about medical mistakes in the past year.
Many doctors were also uncomfortable revealing all of their financial ties to companies that make drugs and medical devices. In the survey, 35 percent disagreed with the notion that such ties should always be fully disclosed.
The researchers noticed a few interesting trends:
_General surgeons and pediatricians were most likely to agree that all serious medical mistakes should be reported to patients, while cardiologists and psychiatrists were most likely to disagree.
_General surgeons, pediatricians and anesthesiologists were least likely to see the need for sugar-coating a patient's prognosis; internists and psychiatrists were more sympathetic to the idea.
_Pediatricians and psychiatrists were most likely to admit to having told an "untruth," and general surgeons and cardiologists were most likely to say they had not told a lie in the past year.
Although the Charter on Medical Professionalism dictates openness and honesty between doctors and patients, the survey results "raise concerns that some patients might not receive complete and accurate information from their physicians," the researchers wrote. They added that in real life, doctors probably shade the truth more often than they would be willing to admit in a survey (even though it was anonymous).
In some cases, doctors might not be telling patients the whole truth in order to "avoid upsetting them or causing them to lose hope," the researchers wrote.
The survey results are published in the February issue of Health Affairs.