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Patient Perceptions of Osteopathic Treatment Distinction
Hartwig, W. [3]
Davis, G. E. [5]
McTighe, A. J. [4]
Riemer, R. B. [2]

Journal: Journal of Osteopathic Medicine Date: 2019/12, 119(12):Pages: e117-e118. doi: Subito , type of study: cross sectional study

Full text    (https://www.degruyter.com/document/doi/10.7556/jaoa.2019.128/html)

Keywords:

cross sectional study [597]
empathy [50]
patients [80]
perception [89]
satisfaction [52]
USA [1086]

Abstract:

Statement of Significance: Patients can and do identify a distinctive experience of osteopathic philosophy following a clinic appointment. A framework of osteopathic distinction centered on patient experience of osteopathic philosophy and further comprising satisfaction with the visit and experience of physician empathy could be used in future studies of patient compliance and health outcomes. Demonstrating positive patient outcomes directly associated with an osteopathic approach to their care establishes a tangible distinction of osteopathic principles and practices in the training of physicians. Methods: Between 2017-2018 patients in 4 outpatient primary care clinics in California and Nevada were surveyed after a physician encounter. Over 2400 patients participated in the live, self-directed, anonymous and confidential survey consisting of 24 items validated to measure physician adherence to osteopathic philosophy, patient satisfaction, and physician empathy, as well as demographic information. The survey language was calibrated for a patient community readership and free of jargon. Patients participated in the survey voluntarily, affirmed a statement of informed consent, and were not compensated. Survey project managers followed a script for engaging with participants, did not assist participants in answering any of the questions, and were not given incentives to secure participants. Patients were treated by osteopathic physicians, allopathic physicians and mid-level providers at the clinic sites. Inclusion criteria included patient age of 18-80 and non-pediatric purpose of visit. The survey instrument and research grant proposal were approved by the Touro University California Institutional Research Board. Data Analysis: Data were analyzed using Multiple Analysis of Variance (MANOVA),Multiple Analysis of Covariance (MANCOVA), correlation, and tabulation. Relationships among dependent variables were assessed using MANOVA. A threshold of P<.01 was used to establish statistical significance. Partial eta squared (partial η2) was calculated to indicate the effect size of group differences, accounting for error variance. Values of partial η2 between 0.06 and 0.14 were considered to indicate medium effect sizes while those >=0.14 were considered to indicate large effects. The directions of relationships among dependent variables were studied using Pearson correlations. The relationships among dependent variables controlling for the effects of co-variables were studied using MANCOVA. Statistical significance and effect sizes were evaluated as in MANOVA. Results: Patients who experienced greater adherence to osteopathic philosophy by their physician reported higher levels of satisfaction and experiences of physician empathy compared with those who experienced lesser adherence to osteopathic philosophy. Most respondents were aged 41 to 70 [1425/2432, 59%], were female [1572/2432, 65%], and were seeing their doctor for the third time or more [1479/2432, 61%]. There was a statistically significant difference in empathy and satisfaction ratings based on experience of osteopathic philosophy. A between-subjects test showed a statistically significant difference with large effect size in experience of physician empathy based on experience of osteopathic philosophy. A second between-subjects test showed a statistically significant difference with medium effect size in satisfaction ratings based on experience of osteopathic philosophy during the visit. Positive correlations were demonstrated between patient satisfaction and experience of osteopathic philosophy, between patient satisfaction and experience of physician empathy, and between experiences of physician empathy and osteopathic philosophy. There was a statistically significant difference with small effect size in empathy ratings based on age, and no significant difference in empathy ratings based on gender. A borderline statistically significant difference with small effect size was also found in satisfaction ratings based on age but not based on gender. Conclusion: The survey results indicate greater patient experience of osteopathic philosophy is associated with greater patient perception of physician empathy and satisfaction with the visit. Correlation analysis confirmed the relationships are statistically significant and positive. Further analysis confirmed that the effect of experiencing osteopathic philosophy on both experience of physician empathy and satisfaction with the visit is statistically significant, even when controlling for age, gender, and visit history of the respondent. These results suggest patients in the study perceive a distinctive experience of physician empathy and satisfaction with their visit based on the experience of osteopathic philosophy, that satisfaction with their visit increases with greater experience of osteopathic philosophy and physician empathy, and that increased experience of osteopathic philosophy is related to increased experience of physician empathy.

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