Self-Disclosure By Physicians To Patients Wastes Time, Has No Benefit

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Empathy, understanding and compassion from physicians are moreeffective than self-disclosure in personal conversations with patients,according to a study published Tuesday in the Archives of Internal Medicine, USA Today reports. The study, conducted by University of Rochester School of Medicine and Dentistryresearchers, involved 100 internists and family doctors who agreed tohave two unannounced "standardized patient" visits in 2000 or 2001.

Thepatients were middle-aged white actors trained to play patients witheither gastrointestinal reflux disease or medically unexplainedsymptoms. Audio recordings of patients' office visits were analyzed forcontent and intonation, and cases where a physician suspected thepatient was an actor were not used. According to researchers,physicians in 38 of 113 visits talked about themselves and thoseconversations seldom were prompted by a patient's question (Rubin, USA Today, 6/26).

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Thestudy found that self-disclosure by doctors wastes patients' time andcauses physicians to lose focus during office visits. Researchers saidthat there was no evidence that self-disclosure by physicians helpedpatients or developed rapport. In addition, four out of five times whena doctor interjected personal information, the physician never returnedto the topic being discussed before the interruption.

Howard Beckman, medical director at the Rochester Individual Practice Association and an author of the report, said, "We found that the longer the disclosures went on, the less functional they were."

PsychologistSusan McDaniel, associate chair of the department of family medicine atthe University of Rochester and lead author of the study, said, "Ithink all of us on the team thought self-disclosure is a potentiallypositive aspect to building a doctor-patient relationship and that weourselves were quite good at it," adding, "We were quite shocked" bythe study results. "We realized that maybe not 100% of the time, butmost of the time, self-disclosure had more to do with us than with thepatients," McDaniel said (Kolata, New York Times, 6/26).

Reprinted with permission from kaisernetwork.org. Youcan view the entire Kaiser DailyHealth Policy Report, search the archives, and sign up for email deliveryat kaisernetwork.org/email. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, afree service of The Henry J. Kaiser Family Foundation.

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