A majority of physicians told a patient that his or her prognosis was more positive than the medical facts warranted within the previous year. More than a third say it is sometimes OK to shield significant medical errors from affected patients or hide financial relationships with pharmaceutical companies and device makers from patients.

These are just a few of the areas in which at least some physicians say that always telling patients the whole story is not the right way to go, according to a nationwide survey of nearly 2,000 doctors across seven specialties in the February issue of Health Affairs.

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A note on the white boards in hospital patients’ rooms saying, “I like clean hands,” can result in higher rates of hand-washing among health professionals, but a sign in the staff lounge urging hand-hygiene compliance probably will not make a difference.

These are among the findings of a rapid intervention-testing process used at seven hospitals in the Sentara Healthcare system, headquartered in Norfolk, Va., that pushed the hand-hygiene compliance rate to 92.5%. The nationwide hand-washing rate has hovered around 50%, depending on the study and measurement used.

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