The New York Times reports on a new study that examined how doctors disclose information about themselves during patient consultations. The study found that disclosures are usually for the benefit of the doctor and rarely help the patient.
The study recorded 113 doctor-patient interactions and analysed the conversation for themes, timing, effect and number of self-disclosures.
Self-disclosure is usually specifically covered in clinical training and, if done carefully, is thought to enhance the relationship with the patient and make them feel more at ease.
In this case, the research team found that none of the self-disclosures were primarily focused on patient concerns and only 4% were useful, providing education, support, explanation, or acknowledgment, or prompting some indication from the patient that it had been helpful.
The study also contains a few transcripts, including this gem:
Physician: No partners recently?
Patient: I was dating for a while and that one just didn’t work out. . . . about a year ago.
Physician: So you’re single now.
Patient: Yeah. It’s all right.
Physician: [laughing] It gets tough. I‚Äôm single as well. I don’t know. We’re not at the right age to be dating, I guess. So, let’s see. No trouble urinating or anything like that?
As was found in a previous study, it was also found that the longer the doctor talked about themselves, the less likely it was to be useful.
We tend to think of medical diagnosis as a scientific process, but so much of it relies on conversation, with patients – to get their experience of symptoms, and colleagues – to get their opinions and advice. In other words, it relies as much on negotiation as diagnostic tests.
Another key element is how the doctor transforms the patient’s personal problem into a medical one, so he or she can apply medical knowledge and problem-solving techniques to it.
As found by a key study in medical sociology, doctors use various non-scientific strategies to interpret the objective medical symptoms while making a diagnosis.
When medicine is discussed as ‘part art, part science’, the art seems to be in how doctors interact with their patients and interpret their concerns, which seems to be equally as important as medical tests.