...That, a group of researchers say, is part of an actual conversation they recorded in the course of a study that showed that many doctors waste patients’ time and lose their focus in office visits by interjecting irrelevant information about themselves. ...
To their surprise, the researchers discovered that doctors talked about themselves in a third of the audio recordings and that there was no evidence that any of the doctors’ disclosures about themselves helped patients or established rapport.
Nor, in the vast majority of cases, did the doctors circle back to the personal conversation or try to build upon it.
“I think all of us on the team thought self-disclosure is a potentially positive aspect to building a doctor-patient relationship and that we ourselves were quite good at it,” said Susan H. McDaniel, a psychologist who is associate chairwoman of the department of family medicine at the University of Rochester and lead author of the study.
“We were quite shocked,” Dr. McDaniel added. “We realized that maybe not 100 percent of the time, but most of the time self-disclosure had more to do with us than with the patients.” ...
“I’d been saying for many years that disclosure was a form of patient support,” Dr. Beckman said. “If someone says, ‘I have a problem,’ and you say, ‘I understand because I have it, too,’ that would be comforting.” But, he added, “in truth that never happens.”
Patients were not comforted, he said, and conversations got off track. Four out of five times when a doctor interjected personal information, the doctor never returned to the topic under discussion before the interruption.
“We found that the longer the disclosures went on, the less functional they were,” Dr. Beckman said. “Then the patient ends up having to take care of the doctor and then the question is who should be paying whom.” ...
“We looked for any statement of comfort, any statement of appreciation, any deepening of the conversation,” Dr. Beckman said.
They found none.
This deserves a fuller discussion after I get hold of the full research report. I do worry that it will be over-read to support robot-like interactions with patients, already a problem in many settings.
It is peculiar to read of doctors wasting time on "irrelevant personal narratives" when there are so many credible reports of pressure on primary care docs to increase patient throughput (that is, see as many patients as quickly as possible), and when calls for improved informed consent and shared decision making are rejected on grounds that there is no time for such conversations. Very mysterious to me.
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