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Journal of General Internal Medicine

, Volume 19, Issue 9, pp 905–910 | Cite as

Is physician self-disclosure related to patient evaluation of office visits?

  • Mary Catherine Beach
  • Debra Roter
  • Haya Rubin
  • Richard Frankel
  • Wendy Levinson
  • Daniel E. Ford
Original Articles

Abstract

CONTEXT: Physician self-disclosure has been viewed either positively or negatively, but little is known about how patients respond to physician self-disclosure.

OBJECTIVE: To explore the possible relationship of physician self-disclosure to patient satisfaction.

DESIGN: Routine office visits were audiotaped and coded for physician self-disclosure using the Roter Interaction Analysis System (RIAS). Physician self-disclosure was defined as a statement describing the physician’s personal experience that has medical and/or emotional relevance for the patient. We stratified our analysis by physician specialty and compared patient satisfaction following visits in which physician self-disclosure did or did not occur.

PARTICIPANTS: Patients (N=1,265) who visited 59 primary care physicians and 65 surgeons.

MAIN OUTCOME MEASURE: Patient satisfaction following the visit.

RESULTS: Physician self-disclosure occurred in 17% (102/589) of primary care visits and 14% (93/676) of surgical visits. Following visits in which a primary care physician self-disclosed, fewer patients reported feelings of warmth/friendliness (37% vs 52%; P=.008) and reassurance/comfort (42% vs 55%; P=.027), and fewer reported being very satisfied with the visit (74% vs 83%; P=.031). Following visits in which a surgeon self-disclosed, more patients reported feelings of warmth/friendliness (60% vs 45%; P=.009) and reassurance/comfort (59% vs 47%; P=.044), and more reported being very satisfied with the visit (88% vs 75%; P=.007). After adjustment for patient characteristics, length of the visit, and other physician communication behaviors, primary care patients remained less satisfied (adjusted odds ratio [AOR], 0.45; 95% confidence interval [CI], 0.24 to 0.81) and surgical patients more satisfied (AOR, 2.22; 95% CI, 1.12 to 4.50) after visits in which the physician self-disclosed.

CONCLUSIONS: Physician self-disclosure is significantly associated with higher patient satisfaction ratings for surgical visits and lower patient satisfaction ratings for primary care visits. Further study is needed to explore these intriguing findings and to define the circumstances under which physician self-disclosure is either well or poorly received.

Key words

patient-physician communication physician self-disclosure patient-physician relationship patient satisfaction professionalism 

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Copyright information

© Society of General Internal Medicine 2004

Authors and Affiliations

  • Mary Catherine Beach
    • 1
    • 2
  • Debra Roter
    • 2
  • Haya Rubin
    • 1
    • 2
  • Richard Frankel
    • 3
    • 4
  • Wendy Levinson
    • 5
  • Daniel E. Ford
    • 1
    • 2
  1. 1.the Division of General Internal Medicine, Department of MedicineThe Johns Hopkins School of MedicineUSA
  2. 2.Department of Health Policy and ManagementThe Johns Hopkins Bloomberg School of Public HealthBaltimore
  3. 3.Regenstrief InstituteIndiana University School of MedicineUSA
  4. 4.Roudebush Veteran’s Administration Medical CenterSt. Michael’s Hospital, University of TorontoTorontoCanada
  5. 5.Indianapolis, Ind; and Department of MedicineSt. Michael’s Hospital, University of TorontoTorontoCanada

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