Journal of General Internal Medicine

, 23:1791

Physician Personality Characteristics and Inquiry About Mood Symptoms in Primary Care

  • Paul R. Duberstein
  • Benjamin P. Chapman
  • Ronald M. Epstein
  • Kelly R. McCollumn
  • Richard L. Kravitz
Original Article

DOI: 10.1007/s11606-008-0780-0

Cite this article as:
Duberstein, P.R., Chapman, B.P., Epstein, R.M. et al. J GEN INTERN MED (2008) 23: 1791. doi:10.1007/s11606-008-0780-0

ABSTRACT

BACKGROUND

Depression treatment is often initially sought from primary care physicians.

OBJECTIVE

To explore the influence of physician personality on depression assessments.

DESIGN

Secondary analysis of data collected in a randomized controlled trial.

SETTING

Offices of primary care physicians in Rochester, NY.

PARTICIPANTS

Forty-six physicians; six female actors.

Intervention

Eighty-six unannounced standardized patient (SPs) visits; physicians saw one SP with major depression and one with adjustment disorder.

MEASUREMENTS

SPs listened to audiotapes and completed a form on doctoring behaviors and symptom inquiry immediately following the visit. For the assessment of diagnostic documentation, SPs’ medical records were reviewed. Physician personality was assessed via items from the NEO-PI-R.

RESULTS

Physicians who are more dutiful and more vulnerable were more likely to document a diagnosis of depression; those who are more dutiful also asked fewer questions concerning mood symptoms.

LIMITATION

Roles portrayed by the SPs may not reflect the experience of a typical primary care patient. Most of the PCPs were white men. The sample of PCPs was limited to a single geographic location. Effect sizes were modest.

CONCLUSIONS

The clinical, educational, and translational, implications of research showing that physician personality traits could affect practice behaviors warrant consideration. Current models of treatment for depression in primary care could be engineered to accommodate the variability in physician personality. Given that there is no single “correct” way to ask about mood disorders or suicide, clinicians are encouraged to adopt an approach that fits their personal style and preferences.

KEY WORDS

mental healthprimary carephysician personalitysuicidedepression

Copyright information

© Society of General Internal Medicine 2008

Authors and Affiliations

  • Paul R. Duberstein
    • 1
  • Benjamin P. Chapman
    • 1
  • Ronald M. Epstein
    • 2
  • Kelly R. McCollumn
    • 1
  • Richard L. Kravitz
    • 3
  1. 1.Laboratory of Personality and Development, Department of PsychiatryUniversity of Rochester Medical CenterRochesterUSA
  2. 2.Rochester Center for the Improvement of Communication in Health Care, Department of Family MedicineUniversity of Rochester Medical CenterRochesterUSA
  3. 3.Center for Healthcare Policy and Research, Department of Internal MedicineUniversity of CaliforniaDavisUSA