Monday, January 12, 2009
Physician Self Disclosure
How much should the doctor talk about him/her self?
There have been a number of recent articles in medical journals that showed when physicians talk about themselves it can be distracting for the patient. One study showed that 40% of physician self-disclosures were unrelated to the patient's preceding remarks. In another article they found that primary care physicians talked about themselves to 30% of patients and it was not effective in conveying understanding or helping patients with improved self-care.
The only purpose of a physicians self disclosure should be if it is directly related to the patient's needs. It can be a way to facilitate understanding, increase rapport and relationship, or educate.
The Annals of Internal Medicine discussed ways physicians can reveal themselves to patients that would be in the patient's best interest.
Here are some examples:
Right: "So you have a new baby! I remember that time so well. How is that going for you?"
Wrong: "I was so bored when I stayed home with my newborn."
Right: "I understand that you are nervous about the colonoscopy. I know from experience that they sedate you well and use medications that take away the anxiety. Tell me what concerns you?"
Wrong: "I had a colonoscopy and I breezed through it. I was nervous, however, when they told me they removed a polyp but I felt better knowing I had it done and it ended up being benign so it all ended well."
Right: "I know how frightening your mother's diagnosis of Parkinsons is. Here is a website with more information and resources the family can tap into.
Wrong: " My mother was diagnosed with Parkinsons and it was such a strain for my father and the entire family. It worked out well to have a son as a doctor because I was able to intervene and get them the help they needed. I got her to the best specialist and she's on good medication now that I help manage."
If sharing pieces of your own life can improve the patient experience or education, self disclosure can break down walls and be a help in the relationship. Too much disclosure that isn't patient focused might just be self indulgent for the doctor. What do you think?
Posted by Toni Brayer, MD at 7:54 PM