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Personal Disclosure by Physician may Harm Patients

In well-intentioned efforts to establish relationships, some physicians tell patients about their own family members, health problems, travel experiences and political beliefs. University of Rochester School of Medicine and Dentistry investigation has found these personal disclosures have no demonstrable benefits and may even disrupt the flow of important patient information.

The investigators found physician self-disclosures in about a third of patient visits. The disclosures were often non sequiturs, unattached to any discussion in the visit and focused more on the physicians needs than the patients needs.

The disclosures interrupted the flow of information exchange and valuable patient time in the typically time-pressured primary care visit. Investigators found no examples of a physician making a statement that led back from the self-disclosure to the patients concern.

Most doctors think self-disclosure is a good idea for building relationships, said Susan H. McDaniel, Ph.D., lead author of the article and a professor of psychiatry and family medicine at the University of Rochester School of Medicine and Dentistry. The health care system now requires doctors to see many patients. Visits to the doctor often are short and anything that is a waste of time takes away from getting to what the patient needs.

The psychologists and physicians who conducted the investigation began the research believing that self-disclosure was an effective way to encourage patients to say more about what really troubled them.

We were hoping to find that physician disclosure would be a part of patient-centered care, encouraging the patient to open up and offer additional valuable information, said Howard B. Beckman, M.D., a co-author of the article and a clinical professor of medicine and family medicine at the School of Medicine and Dentistry. Instead we found these disclosures to be doctor-centered and to benefit the docto
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