Department of Academic Affairs, Touro University College of Osteopathic Medicine, Vallejo, CA, USA.
Senior Associate Dean, Touro University College of Osteopathic Medicine, Vallejo, CA, USA.
J Osteopath Med. 2023 May 16;123(8):371-378. doi: 10.1515/jom-2023-0038. eCollection 2023 Aug 1.
Previous studies document that both osteopathic physicians and third-party observers identify an approach to the patient that is consistent with the philosophy and tenets of osteopathic medicine, often without investigating whether patients identify or are satisfied with it. Osteopathic physicians and the medical education community understand the distinctiveness of an osteopathic approach to the patient. Understanding the outcomes of an osteopathic approach to patient care includes confirming whether patients experience the tenets of osteopathic medicine in physician visits and, if so, how it relates to their experience of physician empathy and satisfaction with the visit.
The objectives of this study were to assess patient experience of the tenets of osteopathic medicine, physician empathy, and satisfaction with the visit and to compare the results for patients who saw DOs with those who saw MD physicians.
More than 2000 patients at four outpatient clinic facilities were surveyed after a clinical visit on 22 prompts regarding their experiences of physician behaviors, physician empathy, and their own satisfaction with the encounter. Adult patients who were treated by an osteopathic or allopathic physician for a nonemergency encounter and who were not pregnant were included in the analysis. Survey results for 1,330 patient-physician encounters were analyzed utilizing linear regression models comparing constructs representing patient experiences of the tenets of osteopathic medicine (Tenets), physician empathy (Physician Empathy), satisfaction (Satisfaction) with the encounter, as well as additional demographic and encounter variables.
Approximately 23.8 % of patients approached during the study period completed a survey (n=2,793), and among those, 54.7 % of patients who consented to the study and who saw a physician provider (n=1,330/2,431) were included. Significant (p≤0.01), positive associations among patient experiences of Satisfaction with the visit and Physician Empathy were observed among those who saw both DO and MD physicians. Patients experienced the Tenets during encounters with both DO and MD physicians, but linear regression showed that their experience of the Tenets was significantly (p≤0.01) and positively explained by their experience of Physician Empathy (β=0.332, p=0.00, se=0.052) and Satisfaction with the visit (β=0.209, p=0.01, se=0.081) only when the physician was a DO.
Patients identified physician behaviors consistent with the Tenets and positively associated their experiences of Physician Empathy and Satisfaction with the visit regardless of physician training background. Patient experience of the Tenets significantly explained their experiences of Physician Empathy and Satisfaction after visits with a DO but not after visits with an MD.
先前的研究记录表明，整骨疗法医师和第三方观察者都能识别出一种符合整骨医学理念和原则的患者就诊方式，而无需调查患者是否认同或满意这种方式。整骨疗法医师和医学教育界都了解整骨疗法医师对患者的独特治疗方法。了解整骨疗法对患者护理的效果包括确认患者在就诊过程中是否体验到整骨医学的原则，如果有，那么这与他们对医师同理心的体验以及对就诊的满意度有何关联。
本研究的目的是评估患者对整骨医学原则、医师同理心和就诊满意度的体验，并比较接受整骨疗法医师和全科学科医师治疗的患者的结果。
在 22 个提示下，对四家门诊诊所的 2000 多名患者进行了临床就诊后的调查，内容涉及患者对医生行为、医师同理心以及对就诊体验的自身满意度的体验。分析纳入了接受整骨或全科学科医师治疗、非紧急就诊且未怀孕的成年患者。利用线性回归模型比较了代表患者对整骨医学原则（原则）、医师同理心（医师同理心）、就诊满意度（满意度）体验的结构，以及其他人口统计学和就诊变量，分析了 1330 名患者-医生就诊的调查结果。
在研究期间，约有 23.8%的就诊患者完成了调查（n=2793），其中，同意研究并接受医生治疗的患者中，有 54.7%（n=1330/2431）被纳入分析。在接受整骨和全科学科医师治疗的患者中，观察到就诊满意度与医师同理心之间存在显著（p≤0.01）、积极的关联。患者在与整骨和全科学科医师的就诊过程中都体验到了这些原则，但线性回归显示，当医生是整骨疗法医师时，他们对这些原则的体验与医师同理心（β=0.332，p=0.00，se=0.052）和就诊满意度（β=0.209，p=0.01，se=0.081）的体验显著（p≤0.01）呈正相关。
无论医生的培训背景如何，患者都能识别出符合原则的医生行为，并将其与医师同理心和就诊满意度积极关联起来。在接受整骨疗法医师治疗后，患者对原则的体验显著解释了他们对医师同理心和就诊满意度的体验，但在接受全科学科医师治疗后则不然。
