An argument for getting personal with your patients

I was seeing a young female patient in my office who was inquiring about birth control. Because of her age, I recommended long-acting birth control and shared with her the different forms I had personally used and my experiences with each of these methods. I told her I was currently on the NuvaRing and was forthcoming about why I liked it and what to be aware of when using it. After a thorough conversation, she decided to go with my personal preference.

The benefits of self-disclosure

The beauty of communicating some of our personal information with our patients is that it allows them to connect to and see us in a different light—I’ve found that, as physicians, we are often viewed as professionals to put on a pedestal.

Physician self-disclosure is when we share private information about ourselves with our patients to create rapport.^[] It is often viewed as a patient-centered communication style that evokes compassion, empathy, and credibility. It can help empower patients to lead healthier lifestyles, help them be more honest with their physicians, and results in them being more compliant with their medication and screening tests. 

Physician self-disclosure can be helpful in normalizing the patient experience. It can enhance patient trust in their physician and treatment or care, increase their hope and motivation, and promote better understanding.

The risk of blurring professional boundaries

At the same time, self-disclosure can blur professional boundaries, shift focus from the patient to the physician, and potentially lead to a loss of trust in the physician. As a result, research is still unclear whether physician self-disclosure benefits the patient.

There are plenty of studies that support physician disclosure, and how it has positive effects on patient outcomes. However, other studies show that it can have neutral or even negative effects on patient outcomes.

These inconsistencies may be because self-disclosure is subjective to the physician and the patient. For example, was it the right time and place for the physician to self-disclose? Was the focus continually on the patient, or did it shift to the physician? Was this self-disclosure done prematurely before there was an established physician-patient relationship? 

• Your patient is nervous about undergoing their first colonoscopy. You ask about what they are afraid of and share your experience of your first colonoscopy with them, promoting understanding and a sense of ease. 

• You can find common ground about personal habits when talking to patients about exercise and nutrition; saying, for example, “I also find exercise difficult to fit into my schedule.”

• Your patient is about to start her chemotherapy journey, and you share about embarking on this journey with a family member following their diagnosis.

• When talking to patients about alcohol use, you can share how you cut down on alcohol after learning about how it contributed to cancer.

• You can share your journey with antidepressants with your patient, if they are grieving from the loss of a family member or close friend.

• For a patient who suffered a back injury, you can share your experience with a similar injury, and explain how long it took to regain strength to return to your favorite activities, such as playing golf.

What to avoid when self-disclosing

In one study of 73 deliberate self-disclosures by primary care doctors meeting new patients, researchers found that only 15% of self-disclosures were useful to the patient.^[] Reasons cited for the lack of relevance include that the self-disclosure was unrelated to the patient’s experience or the conversation changed course in an ineffective way, among others. 

• Make sure that sharing your story with your patient enhances their treatment in some way.

• Keep your disclosure brief, as you do not want to take up too much of your patient’s appointment time. 

• Self-disclose only when you have established a firm foundation with your patient.

• Consider your patient’s comfort level and how they might perceive this information. 

• Do not self-disclose for personal gratification or to please your patient’s loved ones.

• Do not self-disclose just because the patient asked you personal questions unrelated to the visit's scope. 

• Be intentional and keep professional boundaries intact.

• Remember that your self-disclosure is not confidential, and your patient may share your story with others. 

Best practices for patient care

It is uncommon for patients to ask about their physician’s personal lives. Innocent questions such as “What are you kids doing this summer?” or “How is your new baby?” should be answered authentically but carefully without spinning an irrelevant yarn and wasting your patient’s time.

Providing short, simple, and polite answers to questions like this can help you connect with your patient. Just don’t forget to get the conversation back on track regarding their treatment plan.