The researchers compared patient satisfaction and pain management for those visiting osteopaths and medical doctors.
Fundamental tenets in osteopathic medicine, including whole-person treatments and an emphasis on physician empathy, could improve patient satisfaction with care, support pain management, and boost clinical outcomes, according to researchers from the University of North Texas Health Science Center (UNTHSC).
As the nation faces an opioid epidemic, medical industry leaders are looking for strategies to promote pain management and patient satisfaction while also cutting down on the number of medications used to treat pain. Calls for patient-centered care abound, leaving providers consulting strategies that put emphasize the whole patient.
The study, which compared patient perceptions of care for both doctors of osteopathy (DOs) and medical doctors (MDs), revealed that patients visiting DOs may experience better care outcomes for chronic pain, and especially for lower back pain.
Looking at data for patients in the PRECISION Pain Research Registry in the Texas area, researchers also found that osteopathic care led to more patient satisfaction and perceptions of physician empathy.
“The greater levels of physician empathy and the better interpersonal manner reported by patients who were treated by osteopathic physicians may be important mediators of clinical outcomes in people with chronic pain,” said John Licciardone, DO, MS, MBA, of UNTHSC Texas College of Osteopathic Medicine. “That patients of osteopathic physicians reported lower levels of pain catastrophizing and were more resilient and better able to cope with their pain may explain their lower levels of disability.”
Osteopathy is different from allopathy, or traditional medicine, the researchers said. The practice is rooted in the philosophy that “(1) the human being is a dynamic unit of function; (2) the body possesses self-regulatory mechanisms that are self-healing in nature; (3) structure and function are interrelated at all levels; and (4) rational treatment is based on these principles,” the team wrote in their study.
And because of those fundamental differences, the researchers hypothesized that patient perceptions of care quality would be different.
“Such interpersonal factors as physician empathy and communication style may be important determinants in seeking and retaining osteopathic medical care,” they said. “Empathy and communication style also represent 2 aspects of the medical encounter that may contribute to patient satisfaction.”
Overall, patients receiving pain management treatment from DOs reported better care outcomes. These patients were less likely to be taking an NSAID or opioid to manage their pain. Twenty-one patients visiting an osteopath said they took an opioid to manage pain, compared to 81 patients visiting an MD. Fifty-one patients seeing an osteopath took an NSAID for pain, while 159 of those visiting an MD said the same.
And despite using fewer medications, patients visiting DOs reported better pain control. These patients were less likely to report pain catastrophizing and had better pain self-efficacy, or the ability to manage their own pain and the negative emotions that come with it.
Patients seeing an osteopath likewise reported better patient satisfaction scores and rated their patient-provider communications better. Specifically, patients visiting a DO were more likely to say their provider’s interpersonal skills and empathy levels were high.
This study was limited because of its design, the researchers said. Because only patients visiting DOs gave reviews of their DOs, and vice versa for those visiting MDs, it is impossible to truly compare the two, the team acknowledged. In other words, the researchers have no way of knowing if an individual patient would have rated an MD the same as a DO because that patient did not visit an MD.
There may be temporal variables, such as pain flare-ups at the time of patient surveying, that also could have impacted results.
“Although a causal relationship between these physician characteristics and their patient’s reported low back pain treatments and clinical status measures cannot be established because of the cross-sectional design used in this study, the findings suggest several questions about osteopathic medical care that warrant further investigation,” they wrote.
The team did note that this data could point to a path forward in managing pain during the opioid crisis. Recommendations from the CDC and the American College of Physicians state that providers should first use nonpharmacologic methods to treat chronic pain.
“However, successful implementation of such recommendations may depend on the relationship between the physician and patient during medical encounters for low back pain,” the researchers concluded. “The findings of our study suggest that an ‘osteopathic practice style’ (corroborated by such empirical findings as more favorable patient perceptions of interpersonal manner and empathy) may facilitate implementing the recommended treatment guidelines for low back pain.”
Date: August 23, 2019
Source: Patient Engagement Hit