Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Physician self-disclosure about illness

Daniel Sands, MD, MPH
Physician
January 18, 2014
Share
Tweet
Share

I recently struggled with an interesting patient care issue related to my illness. I had to cancel several weeks of clinical sessions, which I realize is a hardship for my patients.

A few weeks ago, when seeing a long-time patient of mine — a warm woman with several chronic conditions — I apologized that we had cancelled her previously scheduled appointment on short notice. I paused a beat and quietly said that I had been hospitalized. She was genuinely concerned. She was anxious to know more information and if  I was going okay. I waved it off and said that I was getting better. But as I attended to her needs I could not help thinking whether I should share more information with her.

There is a growing literature about physicians sharing personal information with their patients, something known as “physician self-disclosure” or “physician personal disclosure” In one study, investigators examining audio recordings of patient visits found that when general internists self-disclose patients report lower satisfaction, but when surgeons self-disclose patients report higher satisfaction. An accompanying editorial suggested that some forms of self-disclosure may be useful while others may violate patient-provider boundaries.

Another paper in which investigators observed physicians interacting with standardized patients concluded that there was no evidence of a positive effect of physician self-disclosure, that it could be disruptive, and that physicians should consider avoiding it. Physicians Danielle Ofri and Juliet Mavromatis explored their experiences with personal disclosures to patients in their recent blog posts.

I considered the pros and cons of disclosing details of my illness to my patient. On the one hand, I didn’t wish to violate boundaries or to have my patient worry about me. On the other hand I did not believe that boundaries were absolute and impermeable, and I was comfortable being seen as human and subject to the same frailties as all human beings. I even have patients with whom I’ve shared meals and some with whom I connect on social media. So I’m comfortable selectively breaching what some would consider to be inviolable boundaries. After all, if I practiced and lived in a small town it’s likely my patients would know almost as much about my life as I knew about theirs. It’s only the big city in which I practice that makes it less likely I will accidentally connect with patients in a non-clinical context.

As we often do in primary care, I asked myself what was the worse thing that could happen if I disclosed? After all, I had already made a conscious decision to disclose my condition to the world through my blog post. And I knew this patient for so many years — what was I afraid of?

Just before I left, I scrawled the link to my story on a pad of paper in the exam room and handed it to the patient. Later that night, I found that she left a nice comment.

Would I have done this for all my patients? I doubt it. Did I do the right thing? I think so. But I suspect my views on this will continue to evolve over time.

Let me know your thoughts.

Daniel Sands is an internal medicine physician and co-founder, Society for Participatory Medicine.  He blogs at Connecting.

Prev

Speaking on behalf of patients is not the same as speaking as a patient

January 18, 2014 Kevin 3
…
Next

Finding the right EMR vendor can help navigate mandates

January 18, 2014 Kevin 10
…

Tagged as: Primary Care

Post navigation

< Previous Post
Speaking on behalf of patients is not the same as speaking as a patient
Next Post >
Finding the right EMR vendor can help navigate mandates

ADVERTISEMENT

More by Daniel Sands, MD, MPH

  • On the ultimate loss of control, living with uncertainty, reflecting on the future, and being a patient

    Daniel Sands, MD, MPH

More in Physician

  • Preserving your sense of self as a doctor

    Camille C. Imbo, MD
  • The geometry of communication in medicine

    Patrick Hudson, MD
  • Why I became a pediatrician: a doctor’s story

    Jamie S. Hutton, MD
  • Is trauma surgery a dying field?

    Farshad Farnejad, MD
  • Why we fund unproven autism therapies

    Ronald L. Lindsay, MD
  • How your past shapes the way you lead

    Brooke Buckley, MD, MBA
  • Most Popular

  • Past Week

    • Direct primary care in low-income markets

      Dana Y. Lujan, MBA | Policy
    • The burnout crisis in long-term care

      Carole A. Estabrooks, PhD, RN and Janice M. Keefe, PhD | Conditions
    • Why the media ignores healing and science

      Ronald L. Lindsay, MD | Physician
    • The ethical conflict of the Charlie Gard case

      Timothy Lesaca, MD | Conditions
    • How to reduce unnecessary medications

      Donald J. Murphy, MD | Physician
    • Why patients delay seeking care

      Rida Ghani | Conditions
  • Past 6 Months

    • Why you should get your Lp(a) tested

      Monzur Morshed, MD and Kaysan Morshed | Conditions
    • Rebuilding the backbone of health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The dismantling of public health infrastructure

      Ronald L. Lindsay, MD | Physician
    • The flaw in the ACA’s physician ownership ban

      Luis Tumialán, MD | Policy
    • The decline of the doctor-patient relationship

      William Lynes, MD | Physician
    • Silicon Valley’s primary care doctor shortage

      George F. Smith, MD | Physician
  • Recent Posts

    • The ethical conflict of the Charlie Gard case

      Timothy Lesaca, MD | Conditions
    • Preserving your sense of self as a doctor

      Camille C. Imbo, MD | Physician
    • Understanding the hidden weight bias that harms patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The ethics of mandatory Tay-Sachs testing

      Sheryl J. Nicholson | Conditions
    • The geometry of communication in medicine

      Patrick Hudson, MD | Physician
    • Why I became a pediatrician: a doctor’s story

      Jamie S. Hutton, MD | Physician

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

View 7 Comments >

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

ADVERTISEMENT

ADVERTISEMENT

  • Most Popular

  • Past Week

    • Direct primary care in low-income markets

      Dana Y. Lujan, MBA | Policy
    • The burnout crisis in long-term care

      Carole A. Estabrooks, PhD, RN and Janice M. Keefe, PhD | Conditions
    • Why the media ignores healing and science

      Ronald L. Lindsay, MD | Physician
    • The ethical conflict of the Charlie Gard case

      Timothy Lesaca, MD | Conditions
    • How to reduce unnecessary medications

      Donald J. Murphy, MD | Physician
    • Why patients delay seeking care

      Rida Ghani | Conditions
  • Past 6 Months

    • Why you should get your Lp(a) tested

      Monzur Morshed, MD and Kaysan Morshed | Conditions
    • Rebuilding the backbone of health care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The dismantling of public health infrastructure

      Ronald L. Lindsay, MD | Physician
    • The flaw in the ACA’s physician ownership ban

      Luis Tumialán, MD | Policy
    • The decline of the doctor-patient relationship

      William Lynes, MD | Physician
    • Silicon Valley’s primary care doctor shortage

      George F. Smith, MD | Physician
  • Recent Posts

    • The ethical conflict of the Charlie Gard case

      Timothy Lesaca, MD | Conditions
    • Preserving your sense of self as a doctor

      Camille C. Imbo, MD | Physician
    • Understanding the hidden weight bias that harms patient care [PODCAST]

      The Podcast by KevinMD | Podcast
    • The ethics of mandatory Tay-Sachs testing

      Sheryl J. Nicholson | Conditions
    • The geometry of communication in medicine

      Patrick Hudson, MD | Physician
    • Why I became a pediatrician: a doctor’s story

      Jamie S. Hutton, MD | Physician

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Physician self-disclosure about illness
7 comments

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...