An interesting study recently published in The Spine Journal examined what is important to patients as they seek care for their low back pain.1 The study included 419 patients who were surveyed, with each asked to rate (from 0 to 4) the importance of: "improvement in level of pain, improvement in ability to perform daily tasks, explanation of what is causing your problem, thorough physical examination, diagnostic testing, medication, physical therapy, surgery." The investigators also surveyed 198 medical physicians, asking them to rate what they thought would be most important to their patients.
What Patients Want
In descending order, the top three most important items for patients are:
1. Improvement in level of pain (3.48)
2. Improvement in ability to perform daily tasks (3.31)
3. Explanation of what is causing their problem (3.27)
And at the bottom of the list in terms of what patients consider important:
7. Medication
8. Surgery
A Disturbing Disparity
In comparing the ratings of the patient responses with those of the medical physicians, the investigators found statistically significant differences between the two. Specifically, physicians "underestimated the importance of an explanation of what is causing the problem" and overestimated the importance of diagnostic tests, medications and surgery.
What You Know Better Than Anyone
Knowing the cause and addressing it clearly matters to patients, much more than even a physical examination or diagnostic testing. This is why chiropractic continues to be appreciated and trusted by chiropractic patients.
The fact that back pain patients considered medications and surgery to be least important also points to their expectation and desire to see their condition cared for and resolved without the potential harm that many times accompanies drugs and surgery. This also underscores the importance of our chiropractic philosophy from the patient's perspective.
What is likely a surprise for medical doctors is their patients' lower regard for diagnostic testing. While this is certainly important from a pathology standpoint, it suggests many patients believe they know the problem(s) and that additional diagnostic tests do not play as prominent a role as MDs might expect.
At the end of the day, the majority of back pain patients want pain relief, improved function and a clear understanding of the cause of their back pain. They're not interested in surgery or medication, and are likely suspect of their potential side effects.
These patients want what chiropractic offers ... they just don't know enough about chiropractic (yet) to make a better choice in their health care.
Reference
- Smuck M, Barrette K, Martinez-Ith A, et al. What does the patient with back pain want? A comparison of patient preferences and physician assumptions. Spine J, 2022 Feb;22(2):207-213. Click here to read the free full text of this study.
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