Workers Perceptions of Care for Low Back Pain Based on Type of Provider

In this study, workers with occupational back pain are asked to rate their satisfaction with care based on who provided that care. Health care providers included surgeons, medical doctors, osteopathic physicians, chiropractors, and physical therapists.

The workers involved in the study were all at least 18 years old. Each one had filed a workers' compensation claim for occupational back pain. Satisfaction with care was assessed by survey. The same survey was filled out before care, one month later, six months later, and after one year.

The researchers were interested in finding out if health-care satisfaction differed based on provider type (who provided the care). They also looked at the effect of patient satisfaction on workers' rates of return-to-work.

Overall satisfaction was based on answers to questions about the provider's bedside manner and effectiveness of care. Bedside manner was described as consisting of listening, being courteous, offering good explanations, and taking the patient's pain seriously. Effectiveness of care referred to getting a good diagnosis and thorough treatment that improved patient pain and function.

Analysis of the data showed that workers tend to be more satisfied with active treatment. This refers to interventions offered by chiropractors, physical therapists, and surgeons. Patients receiving passive care by physicians were less likely to be satisfied with the results.

Previous studies have shown that satisfaction with back care also depends on workers' socioeconomic status, work environment, and severity of injury. This study now adds type of provider as another important factor. Patients return to work more often when satisfied with provider care.

The results also showed that effectiveness of care was more important than bedside manner. The authors pointed out that bedside manner may be easier to evaluate for patients. It's obvious when a health care provider is rude, not listening, or appears uninterested in a patient. It's less clear what makes for optimal care.



References: Richard J. Butler, PhD, and William G. Johnson, PhD. Satisfaction with Low Back Pain Care. In The Spine Journal. May 2008. Vol. 8. No. 3. Pp. 510-521.