Dr., I Thought I was the Patient?
June 27, 2007 by Kristina Chew, PhD
Filed under Health
Doctors who talk about their own lives with their patients neither establish rapport with their patients; nor do the doctors’ references to their personal live help their patients, according to a study published yesterday in the Archives of Internal Medicine. Today’s New York Times reports:
As part of a study on patient care and outcomes, the doctors agreed to allow two people trained to act as patients come to their offices sometime over the course of a year. The test patients would surreptitiously make an audio recording of the encounter. The investigators analyzed recordings of 113 of those office visits, excluding situations when the doctors figured out that the patient was fake.
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.
One reason that we have had a good experience with Charlie’s pediatric neurologist—and why we drive to Pennsylvania with Charlie to see him—is because the doctor long ago shared that one of his two children has ADHD. Jim and I often have to remind ourselves not to talk too much…….. But Jim and me talking to the neurologist is not the same as a patient (Charlie, in this case) talking to a doctor himself and getting accounts (as the New York Times notes) about building furniture.
It reminds me, that when visiting doctors with Charlie, we all need to listen to what he has to say, however he “says” it.
That’s interesting. I can think of two times my PCP has shared things from his personal life with me, and both were helpful. They were also both relevant to the healthcare I was receiving, not just a random tidbit of personal information. And I’m sure it also helps that my doctor and I already have an established relationship. In other words, it wasn’t an attempt to build rapport, but a natural result of the rapport that was already there.
What this study confirms is a truth that many should, and do, know: the physician community is a cross section of society. There are kind docs, and jerks; there are smart docs, and (shock!) not so smart docs; there are considerate and selfless docs, and there are self absorbed blow-hards. Some doctors think that once a medical school acceptance shows up in the mail box, Jesus Christ comes down through the roof and lands in said-recipient’s chromosomes. That actually happens only rarely
If you take a look around, you see that some folks just like to talk about themselves, some are easily set off on tangents, and some are just clueless and prattle on aimlessly. Put them in a white coat and, voila, above study findings. After all, docs are only human. As an aside, I love the story on the pediatric neurologist link above. Mexican food and Jimmy Hendrix – who could argue with that?
Charlie kept on saying “guacamole” throughout his appointment and the neurologist said,
“Charlie, I love guacamole too!”
And then he sighed, glanced at his middle, and reminisced about going out and eating bowls of chips and guacamoles, but no more……