Stigmatization, Dishonest Patients, and Challenges of Diagnosing COVID-19: A Review of Physician-Patient Communication in Indonesia

Abstract

Many studies and information about COVID-19 and its social stigma are widely available to the public, both through accurate and fake news. Little is known, however, whether stigma can prevent some patients from telling the truth about their illness, making it difficult for doctors to diagnose and immediately take appropriate action. This study aims to investigate physician-patient communication and doctors’ challenges when diagnosing suspected COVID-19 patients. It uses mixed methods approach to examine this phenomenon. Quantitatively, we distributed an online survey of physicians (n = 221). The survey results showed that 55% respondents stated that 1-2 patients out of every 10 patients lied or covered up about their illness, 27% physicians identified that from every 10 patients they met 3-5 of them not telling the truth, while the rest (10,9%) assessed that 6-8 patients amidst 10 patients did not speak the truth about their illness. Qualitatively, we conducted a focus group discussion and four interviews. In the FGD, we asked five doctors who often met suspected COVID-19 patients. The findings suggested that the majority of FGD participants confirmed our survey results and all participants believed that there was a link between the stigma of COVID-19 and patients’ dishonesty. Results from four informants in the interview and health communication theories are also discussed.

Keywords: COVID-19, stigma, doctor-patient communication, concealed information