Dr. Strange: Doctors are more extroverted, but also more neurotic than their patients

QUEENSLAND, Australia — The relationship between doctor and patient should be a sacred one, but it doesn’t always feel that way. Doctors often don’t click with their patients when it comes to personality, and that can make all the difference when discussing medical matters. Now, a fascinating new study out of Australia is shedding further light on this complex topic. Scientists report doctors are more extroverted, agreeable, and conscientious, but also more neurotic and less open than their patients.

Study authors say their findings, based on an analysis of responses to two nationally representative Australian surveys, may hold clinical implications for the doctor-patient relationship. More specifically, the very selection and training of doctors may accentuate personality characteristics that differ from their patients, researchers explain. In turn, these differences can lead to a mismatch between how doctors deliver information and how patients receive it.

Up until now, prior studies conducted focusing on doctors’ personalities were 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.

To avoid such limitations with this project, researchers utilized two nationally representative Australian surveys. Across both, respondents assessed their own personality traits. The Household, Income and Labour Dynamics in Australia (HILDA) survey included 25,358 members of the general public (ages 20-85), encompassing 18,705 patients, 1,261 highly educated people, and 5,814 professional caregivers. Meanwhile, The Medicine in Australia: Balancing Employment and Life (MABEL) survey featured 19,351 doctors — 5,844 general practitioners, 1,776 patient-oriented specialists, and 3,245 “technique-oriented” specialists.

Doctors think they have less control than patients

Study authors set out to determine if there were specific personality trait differences apparent between doctors and all the other cohorts, as well as if there could be any equivalent differences between the two groups of medical specialists. The research team chose to place a particular focus on the “big 5” personality traits: conscientiousness, agreeableness, extroversion, neuroticism, and openness, in addition to locus of control — a belief in personal control over one’s life as opposed to external factors such as fate, a higher being, and powerful people.

The team used the term “agreeableness” to encapsulate empathy, kindness, cooperation, and warmth; conscientious covered the descriptors orderly, systematic, efficient, careful, and organized. They defined extroverts as talkative, confident, loud, bold and lively.

Meanwhile, neurotics described themselves as envious, moody, touchy, jealous, temperamental and fretful; and openness applied to characteristics such as philosophical, creative, intellectual, complex, and imaginative.

Doctors were more agreeable and extroverted than all other cohorts, but study authors also found them to be more neurotic. Both doctors and caring professionals were more agreeable than patients, yet doctors were significantly more agreeable than caring professionals.

To the researchers’ surprise, doctors more strongly believed they were being subjected to external forces beyond their control than the general public. While significant, this difference was relatively small, and study authors note there were no notable differences between doctors and patients, caring professionals, or the highly educated. Fluctuations between doctors across medical specialties were, overall, smaller than those between doctors and patients and the public; family doctors (GPs) displayed the highest level of agreeableness.

Women in medicine appeared to be more neurotic

Female doctors appeared to differ to a stronger degree from the other groups relative to men. This was especially apparent for neuroticism, with women doctors scoring significantly higher for this trait than female members of the general public.

Study authors acknowledge a number of limitations to this work. While it was based on well-known and validated instruments, the scales used to assess personality traits were also self-rated. It’s also worth noting the “big 5” descriptors differed slightly between the two surveys. However, researchers still assert that these personality differences could hold important implications for the doctor-patient relationship and ultimately the success of medical treatments.

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“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 wellbeing,” the team writes in a media release.

“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,” they 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,” the study authors suggest. “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.”

The study is published in BMJ Open.