TY - JOUR
T1 - Empathy in medicine
T2 - Osteopathic and allopathic physician interpersonal manner, empathy, and communication style and clinical status of their patients: A pain registry–based study
AU - Licciardone, John C.
AU - Schmitt, Monika E.
AU - Aryal, Subhash
N1 - Funding Information:
Support: The study was supported in part by grants to Dr Licciardone from the Osteopathic Heritage Foundation and the American Osteopathic Association.
Publisher Copyright:
© 2019 American Osteopathic Association.
PY - 2019/8
Y1 - 2019/8
N2 - Context: Comparisons of osteopathic physicians (ie, DOs) and allopathic physicians (ie, MDs) on interpersonal manner, including empathy and communication style, have been limited by such methodologic issues as self-assessment and a focus on medical students rather than practicing physicians. Objective: To compare perceptions of the interpersonal manner, empathy, and communication style of DOs and MDs and corresponding clinical measures reported by their patients. Methods: A cross-sectional study of adults with subacute or chronic low back pain was conducted within the PRECISION Pain Research Registry from April 2016 through December 2018. A total of 313 patients having their physician for 1 year or longer reported sociodemographic and clinical characteristics, including use of nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids for low back pain. Using validated research instruments, they also reported perceptions of their physician’s interpersonal manner, empathy, and communication style and clinical measures of pain catastrophizing, pain self-efficacy, low back pain intensity, back-related disability, and deficits in quality of life relating to sleep disturbance, pain interference with activities, anxiety, depression, and low energy/fatigue. Results: Patients treated by DOs were less likely to be using NSAIDs (odds ratio [OR], 0.60; 95% CI, 0.36-0.997) or opioids (OR, 0.57; 95% CI, 0.32-0.998) than patients treated by MDs. Patients treated by DOs reported lesser pain catastrophizing (mean, 12.5; 95% CI, 10.1-15.0 for DOs vs 18.1; 95% CI, 16.3-19.9 for MDs; P<.001) and greater pain self-efficacy (mean, 39.5; 95% CI, 36.3-42.8 for DOs vs 35.3; 95% CI, 33.4-37.3 for MDs; P=.03). Correspondingly, patients treated by DOs reported lesser back-related disability (mean, 11.2; 95% CI, 9.9-12.5 for DOs vs 13.5; 95% CI, 12.8-14.3 for MDs; P=.002) and a trend toward lesser deficits in quality of life. Patients reported more favorable perceptions of DOs on interpersonal manner (mean, 4.3; 95% CI, 4.2-4.5 for DOs vs 4.0; 95% CI, 3.9-4.2 for MDs; P=.01) and empathy (mean, 41.2; 95% CI, 39.1-43.3 for DOs vs 38.0; 95% CI, 36.5-39.5 for MDs; P=.02). Conclusion: The mechanisms underlying lesser use of NSAIDs and opioids, superior clinical status measures, and more favorable perceptions of physician interpersonal manner and empathy reported by patients treated by DOs warrant further investigation.
AB - Context: Comparisons of osteopathic physicians (ie, DOs) and allopathic physicians (ie, MDs) on interpersonal manner, including empathy and communication style, have been limited by such methodologic issues as self-assessment and a focus on medical students rather than practicing physicians. Objective: To compare perceptions of the interpersonal manner, empathy, and communication style of DOs and MDs and corresponding clinical measures reported by their patients. Methods: A cross-sectional study of adults with subacute or chronic low back pain was conducted within the PRECISION Pain Research Registry from April 2016 through December 2018. A total of 313 patients having their physician for 1 year or longer reported sociodemographic and clinical characteristics, including use of nonsteroidal anti-inflammatory drugs (NSAIDs) and opioids for low back pain. Using validated research instruments, they also reported perceptions of their physician’s interpersonal manner, empathy, and communication style and clinical measures of pain catastrophizing, pain self-efficacy, low back pain intensity, back-related disability, and deficits in quality of life relating to sleep disturbance, pain interference with activities, anxiety, depression, and low energy/fatigue. Results: Patients treated by DOs were less likely to be using NSAIDs (odds ratio [OR], 0.60; 95% CI, 0.36-0.997) or opioids (OR, 0.57; 95% CI, 0.32-0.998) than patients treated by MDs. Patients treated by DOs reported lesser pain catastrophizing (mean, 12.5; 95% CI, 10.1-15.0 for DOs vs 18.1; 95% CI, 16.3-19.9 for MDs; P<.001) and greater pain self-efficacy (mean, 39.5; 95% CI, 36.3-42.8 for DOs vs 35.3; 95% CI, 33.4-37.3 for MDs; P=.03). Correspondingly, patients treated by DOs reported lesser back-related disability (mean, 11.2; 95% CI, 9.9-12.5 for DOs vs 13.5; 95% CI, 12.8-14.3 for MDs; P=.002) and a trend toward lesser deficits in quality of life. Patients reported more favorable perceptions of DOs on interpersonal manner (mean, 4.3; 95% CI, 4.2-4.5 for DOs vs 4.0; 95% CI, 3.9-4.2 for MDs; P=.01) and empathy (mean, 41.2; 95% CI, 39.1-43.3 for DOs vs 38.0; 95% CI, 36.5-39.5 for MDs; P=.02). Conclusion: The mechanisms underlying lesser use of NSAIDs and opioids, superior clinical status measures, and more favorable perceptions of physician interpersonal manner and empathy reported by patients treated by DOs warrant further investigation.
KW - Low back pain
KW - Osteopathic manipulative treatment
KW - Pain research registry
KW - Physician empathy
UR - http://www.scopus.com/inward/record.url?scp=85071354749&partnerID=8YFLogxK
U2 - 10.7556/jaoa.2019.092
DO - 10.7556/jaoa.2019.092
M3 - Article
C2 - 31305871
AN - SCOPUS:85071354749
SN - 0098-6151
VL - 119
SP - 499
EP - 510
JO - Journal of the American Osteopathic Association
JF - Journal of the American Osteopathic Association
IS - 8
ER -