Why Do Patients Lie to Doctors? The "31%" That Revealed the Invisible Wall in the Consultation Room

Have you ever been asked these questions by a doctor in a hospital consultation room?

"How much do you drink?"

"Do you smoke?"

"Are you taking your medication properly?"

"Have you been feeling mentally stressed recently?"

There are many questions that patients find difficult to answer.

Even though they drink every night, they might say, "Two or three times a week." Even if they hardly take their prescribed medication, they might say, "I mostly take it." They might answer "No issues" regarding weight gain, sexual concerns, family problems, or mental health issues.

These experiences are not limited to a few special patients.

In a survey conducted by YouGov and the healthcare service company Doctolib in Germany in March 2026, 31% of 1,043 adults reported having hidden important health information from their doctors. Among those aged 18-24, the percentage rose to 45%.

Interestingly, 87% of those who had hidden information understood that not disclosing important information to their doctor could negatively impact their health.

In other words, many people know they shouldn't hide information, yet they still can't bring themselves to talk about it.

The unseen aspects of "patients lying"

If we simply dismiss this issue as "patients lying to doctors," we miss the essence of the problem.

According to the Doctolib survey, it wasn't just the symptoms themselves that were often concealed.

While some people didn't accurately convey their symptoms, personal and social circumstances like family and economic issues, mental problems, smoking, weight, and failure to follow dietary or lifestyle guidance were also difficult topics to discuss.

The prominent reason for this was the fear of being judged negatively by the doctor.

35% cited "fear of criticism or being thought poorly of" as a reason, and 31% cited shame or embarrassment. There were also cases where people withheld information to avoid treatment or medication.

Thus, what patients are hiding is not just "facts."

Underlying this are emotions like,

"I'll get scolded if I say I live like this."

"I might be seen as someone who can't manage themselves."

"I'm embarrassed to be thought of as coming to the hospital for something like this."

"I don't want to be labeled as having a mental problem."

"I might be blamed if I say I couldn't take my medication."

These emotions exist.

From the healthcare provider's perspective, it's about "not being able to diagnose without accurate information."

Meanwhile, from the patient's perspective, it's about "if I say something accurate, I might be judged."

There is a significant perception gap between doctors and patients here.

The "difficulty in talking" highlighted in another survey

This trend was not only confirmed by one survey from Doctolib.

In a Forsa survey conducted by Germany's public health insurance BARMER in January-February 2026, 18% reported having refrained from discussing health issues with their doctor due to shame, embarrassment, or mistrust.

There was also a gender difference, with 13% of men compared to 23% of women.

By age, 28% of those aged 18-29 found it most difficult to talk, compared to 13% of those aged 60 and over.

When looking at what is difficult to discuss, topics include relationships, partner issues, sexual health, domestic violence, and abuse—issues that cannot be resolved by simple physical symptoms alone.

Notably, in the BARMER survey, 92% of respondents said they trust their doctor with health issues.

It doesn't necessarily mean "I don't talk because I don't trust my doctor."

Even if you trust the person, embarrassing things are still embarrassing.

Even if you trust your doctor, explaining things like sexual issues, violence, addiction, or economic problems verbally can be a significant psychological burden.

This is a feeling that might be easily understood by Japanese people as well.

In Japan, "short consultation time" cannot be ignored

So, what about Japan?

We cannot directly apply Germany's 31% figure to Japan. Naturally, the healthcare system, culture, and survey methods differ.

However, when considering whether there is enough time to "tell the truth," Japan also faces significant challenges.

According to the Ministry of Health, Labour and Welfare's 2023 "Patient Behavior Survey," 28.8% of outpatient consultations at general hospitals lasted "less than 5 minutes," and 41.0% lasted "5 to less than 10 minutes."

In total, about 70% are under 10 minutes.

Of course, it's not a simple matter of short consultation times equating to lower quality of care.

Some patients only need blood pressure checks and regular prescriptions, while others have been seeing the same doctor continuously, making short times sufficient.

However, for a patient to say, "Actually, there's one more thing I'd like to discuss," there needs to be a time buffer.

You enter the consultation room.

The doctor looks at the electronic medical record.

You explain your symptoms.

You receive the examination.

You get explanations about medication or tests.

In the meantime, 5 or 10 minutes pass.

And then the doctor asks,

"Is there anything else?"

At that moment, you remember there are still many patients waiting in the waiting room.

So,

you answer, "I'm fine,"

and leave.

Within that "I'm fine," there might be information that was actually necessary for the consultation.

In Japan, patients often strongly perceive doctors as "experts" or "teachers," thinking they shouldn't interrupt the consultation or say unnecessary things.

There are domestic studies and recommendations suggesting that for patients and healthcare providers to participate equally in decision-making, it's important to reduce "patients being passive" and the psychological barriers to conveying their thoughts to doctors.

Even with doctors' confidentiality obligations, psychological barriers remain

"Doctors have a duty of confidentiality, so you can say anything."

Some might think this way.

In Japan, it's a criminal offense under Article 134 of the Penal Code for doctors and others to disclose secrets learned in the course of their duties without a legitimate reason.

Patient secrets are protected by law.

However, being protected by law and feeling "safe to talk" are separate issues.

For example,

"If I honestly talk about my drinking, will I get lectured?"

"If I consult about the possibility of a sexually transmitted disease, will I be looked down upon?"

"If I say I'm taking psychiatric medication, will even my physical symptoms be treated as mental issues?"

For patients feeling this way, simply explaining "your secrets will be kept" is not enough.

What is needed is not just information security but psychological safety.

On social media, voices say "it's not out of malice that patients lie"

On social media, posts related to this issue can be seen.

 

In a post by a Japanese general practitioner on X discussing patients' "lies," it was pointed out that patients don't have malice, but rather reasons like embarrassment or fear of being scolded by the doctor.

This perspective is important.

The moment you label patients as "liars," it becomes even harder for them to talk.

Conversely, from the patient's side on social media,

"If I talk about smoking, it feels like all subsequent symptoms are blamed on smoking."

"If I convey information about mental illness or medication, will I face prejudice?"

"I'm scared that sensitive information will remain in electronic medical records."

Such concerns are repeatedly expressed.

In overseas medical communities, reasons for not being honest about drinking, drugs, mental illness, or sexual issues include "shame," "fear of being judged," and "anxiety about it being recorded in medical records."

Of course, social media posts are not public opinion polls.

Opinions of vocal users may stand out, and it's not possible to estimate the proportion of society as a whole from posts alone.

Still, it's interesting that the emotions of "embarrassment" and "not wanting to be judged" reflected in survey data also appear as actual patient words on social media.

The expected solution: "Digital Questionnaires"

One potential solution to this problem is digital questionnaires before consultations.

Even if it's hard to say in person, one might be able to answer on a smartphone screen.

Facing a person and being asked,

"How much do you drink per week?"

"Do you have any sexual problems?"

"Are you experiencing violence from family?"

"Are you taking your prescribed medication as directed?"

is psychologically different from answering while looking at a screen alone.

In surveys related to Doctolib, among those who hide things in person, there are those who say they could answer more honestly with a digital questionnaire that ensures confidentiality.

Thus, the value of digitalization is not just in shortening reception times.

It can also play a role in capturing information that can't be said in the consultation room before the consultation.

In Germany, there is relatively high interest in the medical use of health apps and wearables.

In a survey conducted by Deloitte in July 2026 with 2,000 Germans, 63% said they were willing to share health data from smartphones or wearables with their doctor, and 83% positively evaluated the use of such data in treatment with the patient's consent.

Digitalization doesn't necessarily mean "distancing doctors"

When it comes to digitalizing healthcare,

there are concerns like "everything will go to smartphones, losing human touch"

or "doctors and patients will stop talking."

However, depending on how it's used, the opposite can be true.

If before the consultation, patients can organize and input

symptoms,

medication status,

lifestyle habits,

sleep,

mental state,

family environment,

and topics they want to discuss,

then doctors can use the limited consultation time not for "extracting information from scratch" but for "discussing important information with the patient."

In the PRO B study by Charité, which tracked 909 metastatic breast cancer patients across 52 facilities, a system where patients regularly reported their status digitally and the medical team responded to abnormalities confirmed reductions in fatigue, improvements in physical function, and decreased hospitalizations.

Digital tools did not replace doctors but functioned as an "additional line" to deliver small changes from patients to the medical side.

This aligns with Japan's push for medical DX.

The Ministry of Health, Labour and Welfare aims to standardize and share information generated in diagnosis, treatment, and prescription to create an environment where citizens can receive higher-quality medical care.

When advancing the digitalization of questionnaires in Japan, it is insufficient to only consider the benefits for medical institutions, such as "streamlining reception work."

It's important that patients can safely input information they find difficult to talk about.

That doctors can check it in advance.

That doctors, after seeing the input, can start the conversation with "Thank you for telling me" instead of blaming the patient.

Only when all this is included does digital questioning have the potential to change communication between doctors and patients.

However, "digital means safe" is not always the case

On the other hand, treating digitalization itself as a panacea is dangerous.

If patients are to input extremely sensitive information such as

drinking,

drugs,

mental illness,

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