Sunday, July 01, 2007

Physician Self-disclosure

Rochester MDs wondered about the extent to which primary care docs take the Enough about you, what about me? attitude during office visits. In addition, they investigated whether or not physician self-disclosure (MD-SD) has a positive effect on patient/doctor interactions(1).

They analyzed 113 undisclosed 'standardized patient' visits with 100 volunteer physicians for the number and content of MD-SDs. One-third of the investigational visits contained an MD-SD. Of these, 40% were unrelated to the topic under discussion and a mere 21% of the visits returned to the previous conversational thread after the MD burst in with his/her information.

Whoa, this is sobering food for thought. I certainly have been known to bring up personal or family information when I feel it is pertinent to the visit at hand, particularly when something about that experience may help the patient to feel less odd about their symptoms or less nervous about trying a therapeutic strategy. In particular, I've brought up my experience with panic attacks while driving on the highway in order to decrease the patient's suspicion that I am easily dismissing their panic-driven symptoms as 'all in their head.'

Occasionally, however, I must admit that I go too far with what I consider a particularly amusing or fascinating story of a personal nature, but always related to the topic at hand. I recall telling myself "Time to shut up and listen," on more than one occasion.

The authors of this article conclude: There was no evidence of positive effect of MD-SDs; some appeared disruptive. Primary care physicians should consider when self-disclosing whether other behaviors such as empathy might accomplish their goals more effectively.

Point well taken!
1. McDaniel, SH, etal. Physcian Self-disclosure in Primary Care Visits. Arch Intern Med. 2007;167:1321-1326

No comments: