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Sunday, August 12, 2007

It worked great until she wasn’t doing so well: Physician/patient rapport

Yesterday’s post discussed a recent study of the usually ineffective attempts by doctors to build rapport with patients through self-disclosure.

Internist Howard Berkman, a co-author, ruefully disclosed his own story. He used to try to inspire older patients by telling them about his active mother, who walked two miles a day in her late eighties.

"It worked great until she wasn’t doing so well," he said. His mother is now 94. "By then, people got used to asking, 'How’s your mother?' I’d have to say, 'Well, she’s struggling.'"

Patients began worrying about his mother, and they wondered how good a doctor he was if he couldn't even keep his own mother healthy.

He had thought that talking about himself and his family strengthened his connection with patients, but he came to realize it wasn't such a good thing. "It created a complex set of issues, totally unnecessary in caring for these people."

Empathy, understanding and compassion work better than self-disclosure, the researchers found. Personal conversation is important, but doctors need to find time for it outside of patient visits.

Advice: If this is a problem, ask the office manager to mention it discreetly to the doctor.

Read Rita Rubin’s story in the June 26 USA Today.

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