Is physician self-disclosure related to patient evaluation of office visits?

Mary Catherine Beach, Debra Roter, Haya Rubin, Richard Frankel, Wendy Levinson, Daniel E. Ford

Research output: Contribution to journalArticle

54 Citations (Scopus)

Abstract

CONTEXT: Physician self-disclosure has been viewed either positively or negatively, but little is known about how patients respond to physician self-disclosure. OBJECTIVE: To explore the possible relationship of physician self-disclosure to patient satisfaction. DESIGN: Routine office visits were audiotaped and coded for physician self-disclosure using the Roter Interaction Analysis System (RIAS). Physician self-disclosure was defined as a statement describing the physician's personal experience that has medical and/or emotional relevance for the patient. We stratified our analysis by physician specialty and compared patient satisfaction following visits in which physician self-disclosure did or did not occur. PARTICIPANTS: Patients (N = 1,265) who visited 59 primary care physicians and 65 surgeons. MAIN OUTCOME MEASURE: Patient satisfaction following the visit. RESULTS: Physician self-disclosure occurred in 17% (102/589) of primary care visits and 14% (93/676) of surgical visits. Following visits in which a primary care physician self-disclosed, fewer patients reported feelings of warmth/friendliness (37% vs 52%; P = .008) and reassurance/comfort (42% vs 55%; P = .027), and fewer reported being very satisfied with the visit (74% vs 83%; P = .031). Following visits in which a surgeon self-disclosed, more patients reported feelings of warmth/friendliness (60% vs 45%; P = .009) and reassurance/ comfort (59% vs 47%; P = .044), and more reported being very satisfied with the visit (88% vs 75%; P = .007). After adjustment for patient characteristics, length of the visit, and other physician communication behaviors, primary care patients remained less satisfied (adjusted odds ratio [AOR], 0.45; 95% confidence interval [CI], 0.24 to 0.81) and surgical patients more satisfied (AOR, 2.22; 95% CI, 1.12 to 4.50) after visits in which the physician self-disclosed. CONCLUSIONS: Physician self-disclosure is significantly associated with higher patient satisfaction ratings for surgical visits and lower patient satisfaction ratings for primary care visits. Further study is needed to explore these intriguing findings and to define the circumstances under which physician self-disclosure is either well or poorly received.

Original languageEnglish
Pages (from-to)905-910
Number of pages6
JournalJournal of General Internal Medicine
Volume19
Issue number9
DOIs
StatePublished - Sep 2004

Fingerprint

Self Disclosure
Office Visits
Physicians
Patient Satisfaction
Primary Health Care
Primary Care Physicians
Emotions
Odds Ratio
Confidence Intervals

Keywords

  • Faction
  • Patient satis
  • Patient-physician communication
  • Patient-physician relationship
  • Physician self-disclosure
  • Professionalism

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Is physician self-disclosure related to patient evaluation of office visits? / Beach, Mary Catherine; Roter, Debra; Rubin, Haya; Frankel, Richard; Levinson, Wendy; Ford, Daniel E.

In: Journal of General Internal Medicine, Vol. 19, No. 9, 09.2004, p. 905-910.

Research output: Contribution to journalArticle

Beach, Mary Catherine ; Roter, Debra ; Rubin, Haya ; Frankel, Richard ; Levinson, Wendy ; Ford, Daniel E. / Is physician self-disclosure related to patient evaluation of office visits?. In: Journal of General Internal Medicine. 2004 ; Vol. 19, No. 9. pp. 905-910.
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