Does Your Doctor Stop Talking Enough About Himself To Listen To You?

Doctors talking too much about themselves: study


Bellinda Kontominas Medical Reporter
June 27, 2007 - 12:23PM

Doctors who tell their patients personal information are disruptive, ignore patients' health concerns and take up valuable consultation time, according to a US study.

Of 113 audio recordings taken of first-time visits to general practitioners in New York, more than one-third included at least one comment by the doctor about their family members, living situation, health problems, feelings, political beliefs, practice conditions or interactions with other health care professionals.

The study also found that, rather than building rapport, 85 per cent of the doctor disclosures were not useful to the patient and 11 per cent were deemed disruptive to the consultation. Only three disclosures, where the doctor said they had the same medical condition as the patient, were deemed useful.

The doctors' comments "were often non sequiturs, unattached to any discussion in the visit and focused more on the physician's needs than the patient's needs," said lead research, Dr Susan McDaniel, from the University of Rochester School of Medicine and Dentistry.

In only 14 per cent of cases was the doctor's disclosure a response to a patient's question and in no cases did the doctor attempt to steer the conversation back to the patient's concern.

These digressions could compromise the quality of patient care and be perceived as distancing, distracting, or uncaring.

In one example the doctor abruptly moves onto new topics.

Physician: So you're single now.

Patient: Yeah. It's all right.

Physician: (laughing): It gets tough. I'm single as well. I don't know. We're not the right age to be dating, I guess. So let's see. No trouble urinating or anything like that.

In another the patients could feel pressure to support the doctor.

Physician: Deep breaths ... Lay down for me. I don't know. I think I'll be panicked about the college time. I'm not sure I'm ready for that in any way. My daughter went to camp this week and everybody's saying, 'Isn't it so great?' And I'm like, 'No! I hate it! It's quiet! I don't have any friends!'

Patient: I hear ya. Right, right right. Yep.

Physician: No buddies to do things with!

Patient: Yup, yup.

Physician: ... All right. We don't like it! Now, did they give you an appointment for the stress test?

Nick Zwar, professor of general practice at the University of NSW, said doctors may confide in their patients as they often had no other outlet, such as a doctor of their own.

Chief Executive of the Australian General Practice Network, Kate Carnell, said doctors needed strong communication skills and should look at each situtation on a case-by-case basis to determine what was appropriate. "It is a good message to GPs that it is really important to stay focussed on the job rather than off loading on your patients."

In some settings, such as small communities or country towns, it would be unnatural for a doctor not to discuss their personal life, she said.