Empathy, understanding and compassion from physicians are more effective than self-disclosure in personal conversations with patients, according to a study published Tuesday in the Archives of Internal Medicine, USA Today reports. The study, conducted by University of Rochester School of Medicine and Dentistry researchers, involved 100 internists and family doctors who agreed to have two unannounced "standardized patient" visits in 2000 or 2001.

The patients were middle-aged white actors trained to play patients with either gastrointestinal reflux disease or medically unexplained symptoms. Audio recordings of patients' office visits were analyzed for content and intonation, and cases where a physician suspected the patient was an actor were not used. According to researchers, physicians in 38 of 113 visits talked about themselves and those conversations seldom were prompted by a patient's question (Rubin, USA Today, 6/26).

The study found that self-disclosure by doctors wastes patients' time and causes physicians to lose focus during office visits. Researchers said that there was no evidence that self-disclosure by physicians helped patients or developed rapport. In addition, four out of five times when a doctor interjected personal information, the physician never returned to the topic being discussed before the interruption.

Howard Beckman, medical director at the Rochester Individual Practice Association and an author of the report, said, "We found that the longer the disclosures went on, the less functional they were."

Psychologist Susan McDaniel, associate chair of the department of family medicine at the University of Rochester and lead author of the study, said, "I think all of us on the team thought self-disclosure is a potentially positive aspect to building a doctor-patient relationship and that we ourselves were quite good at it," adding, "We were quite shocked" by the study results. "We realized that maybe not 100% of the time, but most of the time, self-disclosure had more to do with us than with the patients," McDaniel said (Kolata,