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Ideas and Opinions |2 December 2008

“Enough about Me, Let's Get Back to You”: Physician Self-disclosure during Primary Care Encounters

Diane S. Morse, MD; Susan H. McDaniel, PhD; Lucy M. Candib, MD; Mary Catherine Beach, MD

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
Acknowledgment: The authors thank Ronald Epstein, MD, and Janine Roberts, PhD, for their review of the manuscript.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Diane S. Morse, MD, University of Rochester Medical Center, Box Psych, 300 Crittenden Boulevard, Rochester, NY 14642; e-mail, diane_morse@urmc.rochester.edu.
Current Author Addresses: Dr. Morse: Departments of Internal Medicine and Psychiatry, University of Rochester Medical Center, Box Psych, 300 Crittenden Boulevard, Rochester, NY 14642.
Dr. McDaniel: Departments of Family Medicine and Psychiatry, University of Rochester, 777 South Clinton Avenue, Rochester, NY 14620.
Dr. Candib: Department of Family Medicine, Family Health Center of Worcester, 26 Queen Street, Worcester, MA 01610.
Dr. Beach: Department of Internal Medicine, Johns Hopkins University, 2024 East Monument Street, Baltimore, MD 21210.
  • From the University of Rochester School of Medicine and Dentistry, and Hebrew University of Jerusalem (Fulbright Program), Rochester, NY 14642; University of Rochester, Rochester, NY 14620; Family Health Center of Worcester and University of Massachusetts Medicine Center, Worcester, MA 01610; and Johns Hopkins University, Baltimore, MD 21210.
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Acknowledgment: The authors thank Ronald Epstein, MD, and Janine Roberts, PhD, for their review of the manuscript.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Diane S. Morse, MD, University of Rochester Medical Center, Box Psych, 300 Crittenden Boulevard, Rochester, NY 14642; e-mail, diane_morse@urmc.rochester.edu.
Current Author Addresses: Dr. Morse: Departments of Internal Medicine and Psychiatry, University of Rochester Medical Center, Box Psych, 300 Crittenden Boulevard, Rochester, NY 14642.
Dr. McDaniel: Departments of Family Medicine and Psychiatry, University of Rochester, 777 South Clinton Avenue, Rochester, NY 14620.
Dr. Candib: Department of Family Medicine, Family Health Center of Worcester, 26 Queen Street, Worcester, MA 01610.
Dr. Beach: Department of Internal Medicine, Johns Hopkins University, 2024 East Monument Street, Baltimore, MD 21210.
Patients want a relationship with a physician with whom they can talk freely, and physicians vary in how they engage with patients. One form of engagement is self-disclosure, in which the physician reveals something personal about himself or herself. Historically, self-disclosure has been considered unacceptable in both psychiatry and medicine. Freud advocated that psychotherapists act as blank slates, and Osler advised physicians to maintain aequanimitas or impartiality (1). Recent psychodynamic literature stresses boundaries, calling clinician self-disclosure risky, potentially motivated by projection, and distracting to patients (2–5).
Nevertheless, recent studies reveal that primary care physicians are talking about themselves to 25% to 30% of patients, and that these disclosures may not be effective in increasing rapport, conveying understanding, or helping patients engage in improved self-care (6–8)...
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Morse DS, McDaniel SH, Candib LM, Beach MC. “Enough about Me, Let's Get Back to You”: Physician Self-disclosure during Primary Care Encounters. Ann Intern Med. 2008;149:835–837. doi: 10.7326/0003-4819-149-11-200812020-00015

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Published: Ann Intern Med. 2008;149(11):835-837.

DOI: 10.7326/0003-4819-149-11-200812020-00015

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