Physicians judge patients based on beliefs in medical misinformation

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Physicians and patients may develop negative views of patients who express their beliefs about incorrect or conspiratorial medical information, according to a new study.

Researchers tested the perceptions of doctors and patients and found both groups “believed that patients who share incorrect information with their physicians will be penalized for their honesty.”

“People worry about their doctors looking down on them – and it turns out that’s an entirely rational concern,” lead researcher Samantha Kleinberg, PhD, said in an accompanying news release. Kleinberg is associate professor in computer science at the Stevens Institute of Technology in New Jersey.

“Our study suggests that doctors really do judge patients harshly if they share information or beliefs that they disagree with,” she said. Kleinberg is co-author with Onur Asan, PhD, of Stevens Institute of Technology, and Jessecae K. Marsh, PhD, of Lehigh University. The article, “Perceived Penalties for Sharing Patient Beliefs with Health Care Providers,” was published in Medical Decision Making.

Misinformation seems to be everywhere

Physicians know well there is no lack of medical misinformation circulating and making its way into the belief systems of patients. Some examples: Vitamin C cures colds, and eating sugar causes diabetes, both cited by the authors. They noted a survey that found 49% of people believed in at least one health-related conspiracy theory, and that was before the COVID-19 pandemic sparked wide public debate over the veracity of medical research.

The study

The authors used three groups of adult test subjects:

• A general group of 185 people
• 311 people with and without diabetes, a prevalent condition that necessitates open communication between doctors and patients
• 207 primary care physicians

They were asked to imagine a patient new to town, recently diagnosed with diabetes, and having the first visit with a new doctor. At that visit, the patient offers a belief statement.

The experiments included belief statements that were correct; that were incorrect, but reasonable to believe; that were incorrect and unreasonable to believe; and that were unreasonable to believe with elements of a conspiracy theory. To test participants’ judgments, the researchers analyzed three constructs involving how people believed the patient’s doctor would perceive the patient; how people evaluated the patient’s ability to manage the disease; and how people perceived the patient’s trust in doctors.

Across the board, patients were perceived more positively when presenting true statements, and more negatively when presenting incorrect or conspiratorial statements, according to the study.

“We found that our subjects viewed people negatively if they held mistaken beliefs—but viewed them much more negatively if they held more unreasonable or conspiratorial beliefs,” Kleinberg said in the news release. 

That includes physicians.

Don’t penalize patients

The authors made clear: “We assert that patients should not be penalized for their incorrect beliefs. Laypeople are not supposed to have a medical school understanding of their health.”

That’s why they rely on physicians, but patients also may be guarded when sharing information about themselves with doctors, to avoid creating a negative impression of themselves, the study said. That can have real effects on how physicians and patients interact in shared decision making to develop treatment plans, the study said.

“If we want to have clear communication between patients and healthcare professionals, we need to change the way that doctors think about patients who are misinformed,” Kleinberg said. “Doctors need to overcome their tendency to judge patients, and actively encourage patients to share their thoughts – even their incorrect ones – much more freely than they currently do.”