Abstract: Why Do Patients Deceive Their Providers? Judgment, Punishment, and Marginalizing Experiences

◆ Kelly Merrill Jr., The Ohio State University
◆ Jesse Fox, The Ohio State University

Often times, patients engage in deception or omit information when communicating with their health care providers (Curtis, 2015). In fact, patients find it difficult to share specific details with authority figures and providers (Lewis et al., 2011). This deceptive behavior can result in negative consequences, as patients might not receive the care that they need (Jung & Reidenberg, 2007). While previous research has identified motives as to why individuals may deceive their providers (Burgoon et al., 1994), little is known about this phenomenon. Thus, the current study seeks to better understand why individuals are deceiving their health care providers.
College students (N = 211) responded to both quantitative and qualitative measures associated with deception in health care settings in an online survey. Participants were aged between 18 to 44 (M = 20.76, SD = 3.15), were 42.7% men, 55.9% women, 0.9% nonbinary, and 0.4% identified as having another gender identity. The sample also included various racial/ethnic identities: 71.1% White/Caucasian, 10.4% Black/African American, 9.0% Asian, 4.3% of multiple racial/ethnic identities, and the remaining participants identified with other racial/ethnic identities. Data collection is currently ongoing with a broader population.
Independent sample t-tests found that patients who had deceived their provider (M = 3.99, SD = 0.66) trusted their provider significantly less than non-deceivers (M = 4.24, SD = 0.62), t(209) = 2.76, p = .006. Deceivers (M = 3.79, SD = 0.58) were also less satisfied with their provider than non-deceivers (M = 4.24, SD = 0.62), t(209) = 3.07, p = .002.
In the qualitative data, a few themes emerged regarding why individuals deceive their providers. The two most common reasons are to avoid judgment from others, specifically a present family member or the provider, and to avoid possible consequences for engaging in illegal behavior. Another theme was marginalizing experiences. Of the 131 deceivers, 27 indicated that the deception was due to feeling marginalized based one or more of their social identities. Some identities that individuals acknowledged as being marginalized include gender identities, age, sexual orientation, race/ethnic identities, and veteran status. Participant 19, for example, lied about his sexual activity because he feared being judged for identifying as bisexual and stated he “… didn’t want to come out to anyone, including my health care provider.” Participant 189 said he lied about his drinking habits because “I did not want to fit into the stereotype of alcoholic depressed veteran.” When asked how they felt about deceiving their health care providers, some participants indicated that they were “regretful for not being honest,” as stated by Participant 51. Most participants (22/27) indicated that they did not address this situation with their provider, and only four participants indicated that they changed providers.
These findings provide interesting implications for practice. Providers should cultivate trusting relationships with their patients, as this is not only related to the patient’s satisfaction of the patient-provider experience, but also both trust and satisfaction can help avoid instances where the patient feels that deception is necessary.