Family medicine residents' and community physicians' concerns about patient truthfulness

Purpose: To assess how often family physicians question patient truthfulness, what factors influence them to do so, and how often resident physicians experience such doubts as compared with senior physicians. Method. In 1994-95, after half-day patient care sessions, 44 residents from the University of Kansas School of Medicine's three Wichita family practice residency programs and nine community family physicians associated with the programs recorded their impressions of each patient's truthfulness, what issues prompted concern about patient truthfulness, and their feelings about each encounter. Results. The residents doubted patients in 54 of 277 encounters (19.5%); the senior physicians doubted patients in 16 of 183 encounters (8.1%) (P = .003). Both groups had more negative than positive emotions toward such encounters, with no significant difference in feelings. The demographics of the resident and senior physician populations differed greatly. Conclusion. Although preliminary, the present study suggests that family physicians question patient truthfulness fairly often, resident physicians more than senior physicians, and that these physicians have some negative feelings toward such situations. Because such feelings may contribute to inadequate patient care, the authors recommend that further research is warranted to understand contributing factors and to guide the development of resident and student education programs in this neglected area of the doctor-patient relationship.