Thursday, May 21, 2015

How Much Do You Share With Your Patients?

Genmedmom here.

In my practice, there are two kinds of doctors. There are those who don't display even one personal photo in their exam rooms, and then, there are those that do. Me? I proudly display a collage of recent kids' photos. Occasionally, a photo will include me and/or Hubby, or our cats.

I've found that the photos can "break the ice", meaning serve as benign fodder for a softer, friendlier discussion in an otherwise sterile, somewhat scary environment.

Let's face it: a bleachy-smelling standard-hospital-grade exam room, where the cold speculum and bristly Pap brushes are laid right out on the chux, is not a fun place to be sitting twiddling your thumbs. No People magazine can change that.

How do I know this? Hey, I have a doctor, too.

What I've personally experienced is that decorations or photos can help to create a warmer, more inviting environment. I'll immediately feel like this provider is confident enough to share of themselves; that they're open to connect with me as a fellow human being.

The exam rooms that don't feature any kind of personal touch may as well be alien spaceship exam rooms: What part of me is going to get probed?

The worst exam rooms I've encountered are at my GYN's office: almost completely tiled without any objects left out in view whatsoever. I feel like a lobster in a pound. They may get high marks from OSHA and The Joint Commission, but I sit there increasingly uneasy, freezing in my flimsy paper gown. Even our dentist does better job with environmental emotional regulation.

Our pediatrician wins the prize for personal adornments. He's got family photos, his kids' artwork, obviously his choice of decorations (all sports-themed), and entertaining items like books and toys strewn all about. Not only am I made to feel more at ease, but my kids are, as well.

Of course, items and photos invite questions and conversation. I think this is good, and I tend to be very open and honest with my patients. Hey, I'm querying them deeply about their relationships, jobs, bad habits, fertility plans, and private parts. These are all topics that are socially prohibited in usual, out-of-the-doctor's-office conversation. I can at least share that my kids are in preschool and my husband works for the Patriots.

Some patients ask more, and I have real conversations with these folks. My general rules of thumb are: no personal chit-chat until the patient's issues and concerns are addressed. No shooting the breeze when I'm running behind. No sharing of my own medical issues. (Well, I'll sometimes share that I used to smoke cigarettes and that it was hard for me to quit, too.)

In seven years of practicing in this style, I haven't had anyone complain that I waste their time or overshare. My colleagues can tell you that I run on time, more or less. (More than most.) At this point, my regular patients excitedly ask for updates as soon as I walk in the door. How are the kids, how old are they now? Still have those huge cats? What does your husband thank about Deflategate?

Obviously, I'm all for sharing. heck, I blog.

What do other docs think?


  1. i have pictures of my kids displayed in my rooms (they do need to be updated, however). I'm in family medicine and I think it makes people more comfortable and does give an opening for conversation. I think the fact that I have kids gives me some credibility as far as taking care of kids as well. I will sometimes share things about parenting that I've learned. I will also sometimes share some of my own medical history if is pertinent, particularly the fact that I had two C-sections. I do OB and I think it helps when someone is looking at having a C-section when I share that I didn't want to have one either, but it was what needed to happen. I think some degree of self disclosure is fine as long as you keep it professional.

  2. Working in a hospital clinic, I have no say over how the rooms are decorated (they aren't), but I tend to be pretty open talking about my family and other interests. I try to take the parents' lead---I usually won't bring it up if they don't. My long term patients remember my pregnancies and always ask about my kids. The newer ones don't necessarily know if I have kids, so I may throw it in there (I'm in peds, so its relevant). I also think it makes me seem more human and fosters a deeper connection. I disagree that doctors should never reveal anything personal. Sure, you shouldn't go on and on & waste time, nor should you hijack the visit and not let the patient get their issues addressed, but a minute or two while you print scripts and labs makes the day more pleasant.

  3. I completely agree with you. As a blogger, I have few secrets. Being an anesthesiologists, I don't have longitudinal contact with most of my patients, but when I do meet them I use personal information all the time to establish a connection. It is very effective with most people when you basically have 10-15 minutes to assure someone that you are trustworthy with their lives! I have a picture of my husband and dog on the back of my nametag, and when it turns around (often), people always ask about it. And if it seems appropriate, I tell patients about how I had brain surgery and I was very scared, but all went well, etc. People seem to respond very well to these things.

  4. First of all, I think your children (assuming that's them!) are absolutely adorable!!

    As a military doc I am not allowed pers items in my exam room, but I agree with what was said above - a bit of self disclosure (I have three kids, etc) can be pleasant and helpful and good for the patient, within certain limits.

    However, I have a paranoia: sometimes, I fear that if I put up pictures of my family, some angry patient (of which I have very very few) might decide to hurt my kids because I didn't give them narcotics or something. Is that totally weird? Does anyone else ever think that? I also refused to park in my designated physician parking spot b/c I didn't want my car to be identified as mine (it's an old domestic, not worried it'll be stolen!). I knew an ER doc who had a patient ram her car in the parking lot after she took away his license following a seizure.

    Anyway.... A bit off topic.... I think that if I had the freedom, I would definitely put my children's art work up in my exam room, but owing to my paranoia, I probably wouldn't do photos. I'd still have the aesthetic pleasure of their art along with the conversation starter, while soothing my anxiety at the same time. It's win-win:-)

    Great post. I'm curious what others think. And just to be clear - me saying I wouldn't put up photos is not a judgement of those who do!!!!! Not at all!!! Just my own mind at work:-)

  5. I never put photos in my exam rooms because they were never "my" exam rooms, and now I'm a hospice doc so I don't have exam rooms at all. I love that my own doc has photos in her exam rooms, and the first time I saw the photos I realized we were both adoptive moms in multiracial families. I loved that. I have pictures and artwork up in my office at the inpatient hospice unit. The door is adorned with a big curly-lettered MOMMY in multicolors, with my full name written in parentheses underneath.

    I did talk to my patients about my daughter and I sometimes share more than the very superficial cute baby stories. If I'm telling the story in the interest of the relationship or for the benefit of the patient, then I share. If I'm talking to meet my own needs, then I don't.

  6. Yes, I have lots a pictures of my kids. It actually never occurred to me that people wouldn't put personal pictures up. I also put fun travel posters above my exam tables on the ceiling (I'm a gyn). I love to travel/ talk about travel so that opens up a lot of conversations.

  7. I'm an oversharer! I can't stop talking about my daughter, but I feel like it just makes things more real and personal!

  8. Great post and such a relevant topic to explore! You are the type of physician I would want to see. As a physician blogger like Dawn (Practice Balance), I publically share some aspects of my life. When I am with a patient one on one, depending on the circumstance and where appropriate, I share personal anecdotes to bring out the humanistic quality of physician-patient relationships that for me is the essential in medicine. There are some cautionary tails about self-disclosure to patients but I think that applies to situations where you work in high risk settings or boundaries are clearly overstepped.

    Great conversation generator!


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