You may know better than to tell the whole truth when your girlfriend asks if she looks fat in her skinny pants, and it turns out the habit of being less-than-truthful goes beyond love relationships to include the doctor-patient relationship as well. In fact, not all doctors believe that honesty is the best policy, according to a recent survey published in Health Affairs. When a team of researchers surveyed almost 2,000 physicians nationwide, they discovered that:

-34 percent of doctors do not completely agree that they should disclose serious medical errors to patients
-Nearly 20 percent of physicians said they had not fully disclosed an error to a patient in the previous year because they feared the admission would trigger a malpractice case
-Nearly two-fifths said they did not completely agree that they should share their financial relationships with drug and device companies to patients
-Just over one-tenth said that they’d told their patients something that was not true in the last year
-55 percent of doctors said they often or sometimes described a patient’s prognosis in a more positive manner than the facts might support.

There are often a number of motivations for why humans dance around the truth (try to think about your own when it comes to your girlfriend and the pants: you don’t want to start or a fight or you want her to be happy). Likewise, there may be a variety of reasons why doctors may be less than 100 percent truthful, from fear of malpractice lawsuits to the fact that it’s really hard to tell a dying person that they are dying. “We don’t know the exact reasons for many of these findings, but it is a caution sign that patients need to be aware of,” says Lisa Iezzoni, MD, lead study author and a physician and professor of medicine at the Harvard Medical School and director of the Mongan Institute for Health Policy at Massachusetts General Hospital in Boston.

An important thing to remember is that not all patients are created equal, so a one-size fits all treatment approach may not be the most effective. “Doctors are trying to do the right thing, but patients have to speak up about their own individual values and lifestyle needs because everyone is different,” says Dale Vidal, MD, director of The Center for Informed Choice and Dartmouth-Hitchcock Medical Center. “If you don’t speak up, doctors will make assumptions based on their own experiences and perceptions of what you might want—and their approach may not be the best fit for you.”

Try these six moves to ensure that your communication with your doctor is honest.

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1. Be open yourself

“Having open and honest communication with your physician benefits your health because the more you understand about why something is going to be helpful—such as taking a certain medication—the more motivated you’ll be to make those lifestyle changes,” says Dr. Iezzoni. So don’t hide your habit of downing a six pack in one sitting from your doctor, or that you’re hooked on Tylenol PM. It’s better to tell all for the best possible health outcome.

2. Know what you want

“Don’t assume that your physician knows what you want,” says Dr. Iezzoni. “There are some patients who don't want to know everything and would rather their doctor simply tell them what to do. But many patients want to make their own treatment choices, so tell your doctor if you want him or her to be very frank and open with you, and if you’d like to play an active role in the decision making.”

3. Educate yourself

“I’m a big believer in patients reviewing information about your treatment decisions before your appointment,” says Dr. Vidal. She suggests having a starting point discussion with your doctor by asking for recommendations on the best resources for your diagnosis. “This helps arm you with knowledge about your condition so you can have a more informed conversation with your doctor in terms of what will work best for you,” says Dr. Vidal.

4. Have a face-to-face

Schedule a time to talk in person rather than over the phone or email. “It is much easier to know if someone is being open and frank with you when you are looking into their eyes,” says Dr. Iezzoni.

5. Write down your questions in advance

PSA scores come back abnormal? Sitting in a hospital or doctor’s office can be nerve wrecking, so it’s easy for your mind to go blank. “Prepare questions in writing in advance so you can present them to your doctor when you meet,” says Dr. Vidal. “That way you won’t forget what you want to say.”

6. Speak your mind

“When something doesn’t feel right, I think it’s hard for patients to speak up because they don’t want to contradict their doctors,” says Dr. Vidal. It’s important to take charge of your health and voice your opinion because you know your own body better than anyone else. If you don’t understand something about what your doctor said, ask your doctor point blank and be specific. “Maybe you misunderstood the doctor, or the doctor misspoke because he or she was tired, “says Dr. Iezzoni. “Doctors are human as well.”