Likeability and quality of care
Does your doctor like you? Does it matter? Well, it may influence the quality of care you receive.
A new study indicates that there could be a correlation between how much your doctor likes you and how seriously your pain symptoms are taken.
The research was conducted by researchers from the University of Ghent in Belgium and Dr. Ken Prkachin, from the University of Northern BC in Canada and was published in the latest volume of the journal Pain. Dr. Prkachin studies, among other things, pain expression and clinical psychology.
The study used photos and descriptions of personality traits to build up personas which were positive, neutral, or negative. Then videos were shown to observers who were asked to gauge the amount of pain the patient was experiencing. The results contributed to the teamGÃÍs theory that most people underestimate pain in someone they dislike, health professionals reduce its severity even further.
This is the opposite result than one might expect, where good clinical judgment and more experience should allow physicians to gauge pain more accurately.
“A good case can be made … that is going to demoralize patients and contribute to very testy patient-professional relationships,” Prkachin said. “What we’re trying to do is understand what’s going on there and how to change that.”– CTV News
Add this to the body of evidence that shows attractive people get preferential treatment and are perceived more positively through the “halo effect” in our psychology. Also add the studies that show the “big five” personality traits have effects on personal and professional success and you are left with a complex picture of the social dynamics at play during a patient / physician consult.
Update Oct 14, 2011
I reached out to Dr. Ken Prkachin to get his input on whether there was enough evidence to draw the conclusion that healthcare professionals (all of them, not just physicians) are affected by this “likeability” bias. Our email exchange resulted in the following clarifications:
- This study was conducted on non-HCPs
- There is independent evidence that even HCPs are affected by the “likeability” bias
- There is also some evidence that over exposure makes HCPs less sensitive to patients’ painSo, while the study was not conducted directly on HCPs I think the implications are that they are affected, perhaps strongly, and our recommendations are valid.
So, what does this mean for today’s e-Patients?
An e-patient has a fine line to navigate with their different healthcare providers. As an educated and knowledgeable contributor to the process the e-patient must bring forward what he or she knows, but it seems that it is important to do it in a collaborative and, for lack of a better term, friendly way.
Knowing this, how can e-patients improve their outcomes during those precious 5-15 minutes with the physician? Nancy Finn has some ideas on the e-Patient blog, and we can probably provide some general guidance:
Every e-patient’s condition is important, and each has an entire life entangled with it. Remember that the healthcare partners see something on the order of 300-500 patients every week. That doesn’t make each e-patient any less important, any less valuable, but it does give some insight into what the HCPs deal with every day. As the study at the beginning of this post shows, a smile and a friendly demeanor can go a long way to extracting the best care from the system.
This often means keeping a symptom journal or using some other tool to help you remember and communicate your progress (or lack thereof) efficiently. Charts and summaries are good, endless pages of notes aren’t. These tools are often available on association websites, condition-focused websites, or even branded pharmaceutical therapy websites.
It is easy for an engaged e-patient to dwell on problems and issues between physician consults, and to over-analyze the conversations. This is a trap to avoid, especially when you need to see the same physician many times and are having a hard time convincing him or her of your ability to accurately present your condition.
Listen as much as you talk
To be most effective the e-patient / physician partnership needs to be balanced. Typically the problems are seen to be unbalanced toward the physician, but e-patients need to assume responsibility and listen to what is being said and really consider the information before responding. Present your thoughts and opinions with the conviction that your own research has developed, but don’t be afraid to get the details and learn something new.
If necessary, take a stand
Sometimes, when you accurately present your condition, show your research, and provide your opinions physicians will still simply not agree. Sometimes they will be right, sometimes wrong, usually it will be impossible to tell until later when the e-patient has overcome the disease. An e-patient always has the right to take a stand, decide, and inform your healthcare partners what you want to do. They may not be able to help you, but in most cases professional standards will require them to point you in the direction of someone who can.
But before you get here, make sure you’ve at least tried to work the system.
What are your suggestions on how e-patients should deal with the medical systems and physicians to get the best benefit?
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