title: What do physicians tell patients about themselves? A qualitative analysis of physician self-disclosure.
abstract: OBJECTIVE
  Physician self-disclosure (PSD) has been alternatively described as a boundary violation or a means to foster trust and rapport with patients. We analyzed a series of physician self-disclosure statements to inform the current controversy.
  
  
  METHODS
  Qualitative analysis of all PSD statements identified using the Roter Interaction Analysis System (RIAS) during 1,265 audiotaped office visits.
  
  
  METHODS
  One hundred twenty-four physicians and 1,265 of their patients.
  
  
  RESULTS
  Some form of PSD occurred in 195/1,265 (15.4%) of routine office visits. In some visits, disclosure occurred more than once; thus, there were 242 PSD statements available for analysis. PSD statements fell into the following categories: reassurance (n = 71), counseling (n = 60), rapport building (n = 55), casual (n = 31), intimate (n = 14), and extended narratives (n = 11). Reassurance disclosures indicated the physician had the same experience as the patient ("I've used quite a bit of that medicine myself"). Counseling disclosures seemed intended to guide action ("I just got my flu shot"). Rapport-building disclosures were either humorous anecdotes or statements of empathy ("I know I'd be nervous, too"). Casual disclosures were short statements that had little obvious connection to the patient's condition ("I wish I could sleep sitting up"). Intimate disclosures refer to private revelations ("I cried a lot with my divorce, too") and extended narratives were extremely long and had no relation to the patient's condition.
  
  
  CONCLUSIONS
  Physician self-disclosure encompasses complex and varied communication behaviors. Self-disclosing statements that are self-preoccupied or intimate are rare. When debating whether physicians ought to reveal their personal experiences to patients, it is important for researchers to be more specific about the types of statements physicians should or should not make.
authors.affiliation: Division of General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA. mcbeach@jhmi.edu
authors.forename: Mary Catherine
authors.initials: MC
authors.lastname: Beach
authors.forename: Debra
authors.initials: D
authors.lastname: Roter
authors.forename: Susan
authors.initials: S
authors.lastname: Larson
authors.forename: Wendy
authors.initials: W
authors.lastname: Levinson
authors.forename: Daniel E
authors.initials: DE
authors.lastname: Ford
authors.forename: Richard
authors.initials: R
authors.lastname: Frankel
mesh_terms: D003376:Counseling; D030881:Disclosure; D004243:Divorce; D013502:General Surgery; D006801:Humans; D010817:Physician-Patient Relations; D011320:Primary Health Care