Doctors are more extroverted, but also more neurotic and less open than patients, says study by British Medical Journal

Doctors are more extroverted, agreeable, and conscientious, but also more neurotic and less open than their patients, finds an analysis of responses to two nationally representative Australian surveys, published online in the open access journal BMJ Open.

These character trait differences might have clinical implications for the doctor-patient relationship, suggest the researchers.

The selection and training of doctors may accentuate personality characteristics that differ from their patients, say the researchers, adding that in turn, these differences may create a mismatch between how doctors deliver information and how patients receive it.

The available body of research on doctors' personalities is dominated by convenience samples, low sample sizes and response rates; and limited by a focus on specific types of doctors, medical schools, or geographic areas, point out the researchers.

To avoid these issues, the researchers drew on two nationally representative Australian surveys, in which respondents were asked to assess their own personality traits.

The Household, Income and Labour Dynamics in Australia (HILDA) survey of 25,358 members of the general public aged 20-85 included 18,705 patients, 1,261 highly educated people, and 5,814 professional caregivers.

The Medicine in Australia: Balancing Employment and Life (MABEL) survey of 19,351 doctors included 5,844 general practitioners, 1,776 patient-oriented specialists, and 3,245 "technique-oriented" specialists.

The researchers wanted to find out whether there were personality trait differences between doctors and all the other groups, and whether there might be equivalent differences between the two groups of medical specialists.

They focused on the "big 5" personality traits of conscientiousness, agreeableness, extroversion, neuroticism, and openness as well as locus of control—belief in personal agency (internal) rather than external forces, such as fate, a higher power, or powerful others (external).

Agreeableness encapsulates empathy, kindness, cooperation, and warmth; conscientiousness includes the descriptors orderly, systematic, efficient, careful, and organized; extroverts are talkative, confident, loud, bold and lively; neurotics describe themselves as envious, moody, touchy, jealous, temperamental and fretful; while the descriptors philosophical, creative, intellectual, complex, and imaginative apply to openness.

Not unexpectedly, doctors were more agreeable and extroverted than all the other groups, but they were also more neurotic. And both doctors and caring professionals were more agreeable than patients. But doctors were significantly more agreeable than caring professionals.

Somewhat unexpectedly, doctors more strongly believed themselves subject to external forces beyond their control than the general public.

Although significant, this difference was relatively small, and there were no significant differences between doctors and patients, caring professionals, or the highly educated, caution the researchers.

Finally, differences among doctors across medical specialties were, overall, smaller than those between doctors and patients and the public, with family doctors (GPs) standing out for their higher level of agreeableness.

Women doctors seemed to differ more strongly from the other groups relative to men, the survey responses suggested. This was particularly noticeable for neuroticism, with women doctors scoring significantly higher on this trait than female members of the general public.

The researchers acknowledge certain limitations to their findings. Although based on well-known and validated instruments, the scales used to assess personality traits were self-rated. And the "big 5" descriptors differed slightly between the two surveys.

Nevertheless, the researchers suggest that these personality differences might have implications for the doctor-patient relationship and ultimately the success of treatment.

"For example, being more conscientious has implications for treatment adherence, as conscientious doctors may overestimate their patients' ability to follow recommendations. Higher doctor neuroticism, which is related to stress, could lead doctors to see stress as a normal part of life, and thus, underestimate the impact of [it] on patient well-being," they write.

"Doctor agreeableness and conscientiousness increase patient satisfaction with care, but could potentially lead doctors to view patients—in contrast to themselves—as more confrontational and less conscientious than patients actually are, causing an asymmetry in doctor and patient judgements of one another, which could impact outcomes," the researchers add.

"By taking into account these differences, doctors can better calibrate their judgments of patients and gain insight into factors that influence their patient interactions," they suggest.

A range of different personalities is also likely to be better for clinical team performance, they add, "The lack of personality difference we found between doctor specialties suggests that adding more doctors to a team will not increase diversity of personality-base perspectives. However, the differences found between doctors and those in other caring professions suggest that including non-doctor caring professionals in clinical teams will increase personality diversity, and thus, team performance."

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