A patient may fail to disclosure important clinical facts for a number of reasons. The astute clinician can often reduce these barriers by establishing a good rapport and a bond of trust with the patient.
Reasons for not disclosing certain key bits of medical information:
(1) The doctor never asked.
(2) I already told someone about it before.
(3) It didn't seem important.
(4) I did not want to bother the doctor.
(5) I was embarrassed to tell the doctor because of:
(5a) a difference in gender
(5b) a difference in age
(5c) a difference in race or social status
(5d) I did something stupid
(5e) I did something I am ashamed of
(6) I am afraid that someone will find out (information will not be kept confidential)
(6a) an insurance company
(6b) an employer
(6c) a spouse or family member
(6d) friends or neighbors
(7) I did something criminal.
(8) I did something I am not supposed to do.
(9) I have to keep something "secret"
(9a) physical abuse
(9b) sexual abuse
(9c) substance abuse
