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Boundary Issues: A Doctor With MS Confides In Her Patient

Anne Brewster, a Boston internist, has multiple sclerosis, an autoimmune disease of the central nervous system. One day, she decided to risk disclosing something about herself to a patient:  “I have the same disease,” I told my patient over the telephone. There was a pause, and then a sigh. “That makes me feel so much better,” she said.

Boston’s NPR station, WBUR, did a story on Dr. Brewster and the question of whether physicians should disclose to their patients information about their own health.  Dr. Brewster said, “In revealing personal information, physician to patient, I had crossed a line. I did so intentionally, in an effort to bring compassion to our exchange, but still today, I cannot shake the slightly uneasy feeling that I have somehow breached medical etiquette.”

“As physicians, our duty is to bring self-awareness to our patient-doctor encounters. We cannot let feelings impair our judgment. We must be cognizant of what we bring to the relationships, and avoid over-identification with patients. Our values are not necessarily their values. Patient best interest must always come first. At the same time, we must honor our humanness, trust our emotions and have the courage to expose our vulnerabilities when it feels right. In some instances, this may be the most therapeutic and compassionate thing we can do,” said Dr. Brewster.

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