In 2018, U.K.-based Direct Line Life Insurance reported data suggesting that doctors and their patients might not have the most honest relationship when it comes to disclosing alcohol consumption. The study revealed that doctors typically only believe about 40 percent of patients while discussing their weekly alcohol consumption, and tend to mentally double the number of drinks the patient reports to get a more accurate depiction of their drinking habits.

The study also included the top reasons patients lie about their alcohol consumption: 20 percent claimed to not keep track of how much they drink, 14 percent were worried that the doctor would judge them, and 10 percent didn’t want the doctor to attribute their health problems to alcohol. Another common answer was that patients were surprised at how high the number came out to be when they added up how many drinks they had per week and decided to revise it down to the recommended intake.

Dr. Todd Shaffer, a family physician and member of the board of directors for the American Academy of Family Physicians, suggests that a patient’s honesty is completely dependent on the trust established in the doctor-patient relationship. As a practicing physician for over 30 years, Dr. Shaffer has noticed a clear difference between interactions with new patients and patients he has built a rapport with over years. “With newer patients, you need to build trust. A lot of people hold guilt about drinking, so you need to develop a relationship with them so they know you are there to help them and not judge them,” Dr. Shaffer says. Therefore, Dr. Shaffer wholeheartedly believes his long-standing patients, but when it comes to new patients, he says he only trusts about half to immediately let him in on their true drinking habits.

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While it is difficult to tell which patients are being dishonest based on appearances alone, Dr. Shaffer asks a few follow-up questions that can help establish a more accurate answer. However, he admits, “I might not get the whole answer on the first visit, but we will get more information with each appointment as we build the relationship.”

According to the Direct Line Life Insurance study, most of the folks who lie to their doctors about the number of drinks they consume per week do so because of guilt or embarrassment. But if there is one thing Dr. Shaffer wants patients to know, it’s that sharing an accurate depiction of your drinking habits is important to the full medical screen. “We aren’t the police or your nagging spouse,” he says. “We are just here to help you.”