Physician self-disclosure in primary care: a mixed methods study of GPs' attitudes, skills, and behaviour.
BACKGROUND
There is a debate in medicine about the use and value of self-disclosure by the physician as a communication tool. There is little empirical evidence about GPs and self-disclosure.


OBJECTIVE
To explore what GPs' attitudes, skills, and behaviour are with regard to self-disclosure during a clinical consultation and whether there is a need for the development of training resources.


METHODS
Mixed methods using open-ended and semi-structured interviews in Auckland, New Zealand, and the surrounding districts.


METHODS
Sixteen GPs were interviewed on the issue of self-disclosure in clinical practice. A general inductive approach was used for data analysis.


RESULTS
Self-disclosure was common in this group of GPs, contrary to training in some of the groups, and was seen as a potentially positive activity. Family and physical topics were most common, yet psychological and relationship issues were also discussed. Knowing patients made self-disclosure more likely, but a GP's intuition played the main role in determining when to self-disclose, and to whom. GPs have developed their own guidelines, shaped by years of experience; however, there was a consensus that training would be helpful.


CONCLUSIONS
Self-disclosure is common and, in general, seen as positive. Major personal issues were acceptable for some GPs to self-disclose, especially to known patients. Although participants had developed their own guidelines, exposure of trainees to the issue of self-disclosure would be of value to prevent future mistakes and to protect both doctor and patient from any unintended harm, for example, developing a dependent relationship.
Department of General Practice and Primary Health Care, University of Auckland, New Zealand.
Emily-Charlotte Frances
EC
Allen
Director of the Goodfellow Unit, Department of General Practice and Primary Health Care, University of Auckland, New Zealand.
Bruce
B
Arroll
D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003858:Dependency, Psychological; D030881:Disclosure / Q000941:ethics*; D005260:Female; D058005:General Practitioners / Q000193:education / Q000941:ethics / Q000523:psychology; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009520:New Zealand; D010817:Physician-Patient Relations / Q000941:ethics*; D036301:Qualitative Research; D013192:Staff Development
education; general practice; physician–patient relations; self disclosure