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WASHINGTON - Too much personal talk by doctors can be bad medicine, according to a study published yesterday in which US researchers sent actors posing as new patients to see doctors in secretly recorded visits.
Doctors often wasted time in what already may have been short visits and stifled the flow of information from patients by gabbing about themselves, their own health problems, their families and their political beliefs, the study found.
The doctors engaged in such "personal disclosures" in 34 per cent of visits tracked by the researchers.
The personal talk may have been well-intentioned - to deepen a doctor-patient relationship - but yielded little of value to patients and sometimes was counterproductive, the researchers said.
"We found that physician self-disclosures were often non sequiturs, unattached to any discussion in the visit, and focused more on the physician's than the patient's needs," they wrote in the journal Archives of Internal Medicine.
Dr Howard Beckman, a medical professor at the University of Rochester in Rochester, New York, said he used to engage in this type of talk in his own practice.
"I've changed my thinking," Beckman, who worked on the study, said in a telephone interview.
"What I've learned is when I'm thinking of talking about myself, I probably need to ask the person (patient) more about their experience."
A hundred experienced, primary-care doctors in the Rochester region agreed to take part in a study of patient care and outcomes, consenting to two unannounced, audio-recorded patient visits in 2000 and 2001.
Actors portrayed first-time patients professing to have common medical problems.
Some of the recorded visits were thrown out because the doctor figured out the actor was not a real patient, leaving 113 visits for the researchers to analyse.
Eighty-five per cent of the personal disclosures by the doctors were deemed by the researchers to be useless to the patient - not providing, for example, education, support or explanation or prompting helpful patient information.
In 79 per cent of instances when the doctor engaged in this personal talk, the conversation never returned to the topic the patient was discussing before the doctor began yakking.
Eleven percent of the time, what the doctor said was considered disruptive, including times saying things that seemed to compete with the patient or expressing personal political views.
"The health care system now requires doctors to see many patients," lead researcher Susan McDaniel of the University of Rochester said in a statement.
"Visits to the doctor often are short and anything that is a waste of time takes away from getting to what the patient needs."
Beckman gave an example of when his own personal talk with patients backfired.
He said he would talk to his patients using his mother, who is 94, as an example that exercise can be a good thing for the elderly.
"That worked great until she stopped doing well," Beckman said.
When his mother ended up in bad shape after breaking a bone, he said, his patients may have thought, "Well, if you can't take care of your mother, how can you take care of me?"
"For me, I'm worried that people are going to say that the physicians are somehow bad people," Beckman said.
"These are good people doing things unknowingly."
- REUTERS
