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Personal comments by physicians distract from patient needs

r 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 doctor, not the patient. As a discloser myself, I was really devastated.

The investigation is part of a larger study of patient communication and health outcomes funded by the Agency for Healthcare Research and Quality. One hundred primary care physicians in the Rochester region agreed to participate, consenting to two unannounced and secretly recorded visits by people trained to portray specific patient roles.

The project produced 193 recorded first-time patient visits to primary care physicians. For the self-disclosure investigation, four recordings were eliminated for poor technical quality and 76 were excluded because the physician suspected the patient was not a true patient before the end of the visit. Self-disclosures were defined as physician statements about his or her own personal or professional experience.

Each investigator independently reviewed and analyzed 113 transcripts of patient visits, rating the content for self-disclosure and its effect on the patient. Thirty-four percent of the visits contained at least one self-disclosure. None of the self-disclosures were patient focused, while 60 percent were physician focused, the investigators concluded. Eighty-five percent of the disclosures were considered not useful and 11 percent were viewed as disruptive.

Here is an example of one brief exchange:

Physician: No partners recently?

Patient: I was dating for a while and that one just didnt work out . . . about a year ago.

Physician: So youre single now.

Patient: Yeah. Its all right.

Physician: (laughing): It gets tough. Im single as well. I dont know. Were not the right age to be dating, I guess. So l
'"/>

Contact: Michael Wentzel
Michael_Wentzel@urmc.rochester.edu
585-275-1309
University of Rochester Medical Center
25-Jun-2007


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