The Good, the Bad, and The Ugly of Disclosure

For anyone in the medical or therapy field, disclosure can be a tricky thing to handle. The balancing act of limiting and/or revealing any bias can become a tough obstacle to overcome when dealing with a patient. While it’s important to be transparent when dealing with a patient, revealing too much information can hurt the patient in the long run. Finding the right amount of transparency is key when dealing with a patient.

The Good

            In the healthcare field, honesty truly is always the best policy. Forming a bond through honesty will earn the trust of a patient and make difficult conversations easier. If the patient feels a sense of trust, there is a better chance they will accept any advice given. In a review by the Oschner Journal, the author, Jennifer Fong Ha states, “Effective doctor-patient communication is a central clinical function in building a therapeutic doctor-patient relationship, which is the heart and art of medicine. This is important in the delivery of high-quality health care. Much patient dissatisfaction and many complaints are due to breakdown in the doctor-patient relationship. However, many doctors tend to overestimate their ability in communication.”

Patient’s that communicate clearly with their caretaker are more likely to be satisfied with their treatment. A patient should feel comfortable and not just like another number being funneled through the healthcare system. Disclosing any biases shows transparency and will create a better understanding between you and your patient.

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Disclosure is a great way to gain the trust of a patient

The Bad

            Not enough disclosure, or communication for that matter, can create distrust between you and your patient. This doesn’t mean just blatantly lying, but withholding bias or other information shows that you do not fully intend to create a transparent environment. In Fong’s article, she states, “The doctor-patient interaction is a complex process, and serious miscommunication is a potential pitfall, especially in terms of patients’ understanding of their prognosis, purpose of care, expectations, and involvement in treatment. Good communication skills practiced by doctors allowed patients to perceive themselves as a full participant during discussions relating to their health.”

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Lack of communication can be detrimental to a patient, so make sure to be clear and honest

The Ugly

This balancing act between disclosure and non-disclosure sets up a paradox where too much information given can cause distrust within a patient, and not enough information given can cause distrust within a patient. Disclosure can also cause perverse effects even when biases are unavoidable. For example, surgeons are more likely to recommend surgery than non-surgeons. Radiation-oncologists recommend radiation more than other physicians. This type of “Specialty Bias” occurs simply because the specialized caregiver knows what they’re talking about and feel like that’s the best course of action to take.

Some patients can also feel pressured into accepting advice from a doctor who’s very transparent. They will sometimes be hesitant to undermine a caregiver when they are explaining the specifics of what they’re doing.

Although it’s always good to be honest with your patient, be sure to understand the various obstacles that could arise when it comes to bias, disclosure, and other trust-based issues.




Author: Troy Diffenderfer

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