Self-Disclosure

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When I get together with other practitioners to discuss best practices and challenges, a topic that frequently arises is self-disclosure.  In other words, to what extent do we share personal information with our patients, and what do we keep to ourselves?  Patients often want to learn about the person treating them, while sharing information can sometimes unexpectedly garner a negative reaction.  It’s a tough call and there is not necessarily a right answer.

Joanne and I have our autobiographies on our website.  Last week, a new patient said to me, “I almost didn’t come today after reading what a great athlete you are,” as she explained her intimidation.  While her “great athlete” categorization was flattering, I disagree that the label fits me, as would the thousands of athletes who have beaten me in races and tennis matches over the years.  I doubt those who watched me finish in 86th place at last weekend’s Loon Mountain Race, or who witnessed my trademarked swing-and-miss overhead during my years as a competitive tennis player, said to themselves, “Now, there’s a great athlete.”

Issues of perspective and comparison aside, the way I look at it – and I have held this opinion for years, even before I became a practitioner myself – the question is not what the practitioner does in his or her own life, but rather whether or not said practitioner can help the patient.  I never asked my neurosurgeon if he had undergone back surgery himself; I just wanted to know that he would perform the operation successfully on me.  Similarly, the patient I mentioned was overemphasizing the relevance of my own athletic background when the real question should have been whether or not I could help her towards her own goals.

Consider the classic example of a doctor who tells his patient not to smoke, then steps outside and has a cigarette himself.  People call him a hypocrite, but does his behavior really have an impact on patient care?  In other words, does the doctor being a smoker suddenly make it more or less healthy for his patients to smoke?  Of course not; they are independent.  All it means is that the doctor is human too and is dealing with his own stuff, just like we all are.

Last month, I went out to dinner with some of my friends to celebrate one of them just having finished her master’s program.  I ordered a root beer, to which one of my friends reacted, “So you don’t practice what you preach.”  I explained that in fact I do, that I encourage people to find balance, the middle ground that is right for each of them, because all-or-nothing dietary approaches fail nearly 100% of the time.  I love soda, I think it tastes great, and I would be sad to never have it.  If I tried to cut it out entirely, I would probably snap back like an elastic band and drink a two-liter bottle.  At the same time, I understand it is not the healthiest beverage for me and drinking it all the time would be detrimental to both my health and goals.  So, I save it for occasions when I feel like it will really hit the spot.

That example really illustrates what I hope people gain from my use of self-disclosure.  I would never tell anybody to exercise or eat specifically the way that I do.  Why would I advise someone else to live his or her life the way that I lead mine when the reality is that we are all unique individuals with our own goals, needs, priorities, and constraints?  What I hope people take away from my self-disclosure is that I am a guy who is working through his personal challenges to maintain balance and achieve his goals, and hopefully my patients find some inspiration in that as they strive to do the same in their own lives.

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