What do physicians tell patients about themselves? A qualitative analysis of physician self-disclosure

Mary Catherine Beach, Debra Roter, Susan Larson, Wendy Levinson, Daniel E. Ford, Richard Frankel

Research output: Contribution to journalArticle

35 Citations (Scopus)

Abstract

OBJECTIVE: Physician self-disclosure (PSD) has been alternatively described as a boundary violation or a means to foster trust and rapport with patients. We analyzed a series of physician self-disclosure statements to inform the current controversy. DESIGN: Qualitative analysis of all PSD statements identified using the Roter Interaction Analysis System (RIAS) during 1,265 audiotaped office visits. SETTING AND PARTICIPANTS: One hundred twenty-four physicians and 1,265 of their patients. MAIN RESULTS: Some form of PSD occurred in 195/1,265 (15.4%) of routine office visits. In some visits, disclosure occurred more than once; thus, there were 242 PSD statements available for analysis. PSD statements fell into the following categories: reassurance (n = 71), counseling (n = 60), rapport building (n = 55), casual (n = 31), intimate (n = 14), and extended narratives (n = 11). Reassurance disclosures indicated the physician had the same experience as the patient ("I've used quite a bit of that medicine myself"). Counseling disclosures seemed intended to guide action ("I just got my flu shot"). Rapport-building disclosures were either humorous anecdotes or statements of empathy ("I know I'd be nervous, too"). Casual disclosures were short statements that had little obvious connection to the patient's condition ("I wish I could sleep sitting up"). Intimate disclosures refer to private revelations ("I cried a lot with my divorce, too") and extended narratives were extremely long and had no relation to the patient's condition. CONCLUSIONS: Physician self-disclosure encompasses complex and varied communication behaviors. Self-disclosing statements that are self-preoccupied or intimate are rare. When debating whether physicians ought to reveal their personal experiences to patients, it is important for researchers to be more specific about the types of statements physicians should or should not make.

Original languageEnglish
Pages (from-to)911-916
Number of pages6
JournalJournal of General Internal Medicine
Volume19
Issue number9
DOIs
StatePublished - Sep 2004

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Self Disclosure
Physicians
Disclosure
Office Visits
Counseling
Anecdotes
Divorce
Sleep

Keywords

  • Patient-physician communication
  • Patient-physician relationship
  • Physician self-disclosure
  • Professionalism
  • Qualitative analysis

ASJC Scopus subject areas

  • Internal Medicine

Cite this

What do physicians tell patients about themselves? A qualitative analysis of physician self-disclosure. / Beach, Mary Catherine; Roter, Debra; Larson, Susan; Levinson, Wendy; Ford, Daniel E.; Frankel, Richard.

In: Journal of General Internal Medicine, Vol. 19, No. 9, 09.2004, p. 911-916.

Research output: Contribution to journalArticle

Beach, Mary Catherine ; Roter, Debra ; Larson, Susan ; Levinson, Wendy ; Ford, Daniel E. ; Frankel, Richard. / What do physicians tell patients about themselves? A qualitative analysis of physician self-disclosure. In: Journal of General Internal Medicine. 2004 ; Vol. 19, No. 9. pp. 911-916.
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abstract = "OBJECTIVE: Physician self-disclosure (PSD) has been alternatively described as a boundary violation or a means to foster trust and rapport with patients. We analyzed a series of physician self-disclosure statements to inform the current controversy. DESIGN: Qualitative analysis of all PSD statements identified using the Roter Interaction Analysis System (RIAS) during 1,265 audiotaped office visits. SETTING AND PARTICIPANTS: One hundred twenty-four physicians and 1,265 of their patients. MAIN RESULTS: Some form of PSD occurred in 195/1,265 (15.4{\%}) of routine office visits. In some visits, disclosure occurred more than once; thus, there were 242 PSD statements available for analysis. PSD statements fell into the following categories: reassurance (n = 71), counseling (n = 60), rapport building (n = 55), casual (n = 31), intimate (n = 14), and extended narratives (n = 11). Reassurance disclosures indicated the physician had the same experience as the patient ({"}I've used quite a bit of that medicine myself{"}). Counseling disclosures seemed intended to guide action ({"}I just got my flu shot{"}). Rapport-building disclosures were either humorous anecdotes or statements of empathy ({"}I know I'd be nervous, too{"}). Casual disclosures were short statements that had little obvious connection to the patient's condition ({"}I wish I could sleep sitting up{"}). Intimate disclosures refer to private revelations ({"}I cried a lot with my divorce, too{"}) and extended narratives were extremely long and had no relation to the patient's condition. CONCLUSIONS: Physician self-disclosure encompasses complex and varied communication behaviors. Self-disclosing statements that are self-preoccupied or intimate are rare. When debating whether physicians ought to reveal their personal experiences to patients, it is important for researchers to be more specific about the types of statements physicians should or should not make.",
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