Patient pain: its influence on primary care physician-patient interaction.
OBJECTIVE
Heightened awareness of the importance of appropriate pain management in health care delivery has stimulated researchers to examine the impact of patient pain on medical encounters. In this study, we explored how patient pain might influence the physician-patient interaction during medical visits.


METHODS
New adult patients (n = 509) were randomized to see primary care physicians in videotaped visits at a university medical center Self-reported patient pain was measured before the visit using the Visual Analog Scale and the Medical Outcomes Study Short Form-36 (MOS SF-36) pain scale; patient sociodemographics were also measured. Physician practice style during the visit was analyzed with the Davis Observation Code (DOC).


RESULTS
Regression analyses revealed that patient pain during the medical visit was associated with the physician spending a greater portion of the visit on technical tasks and a smaller portion on preventive services and other activities designed to encourage the patients' active participation in their own health care.


CONCLUSIONS
Patient pain may influence the physician-patient interaction and its outcomes. Primary care physicians should be aware that there may be less focus on patients' active involvement in their own care and less emphasis on providing disease prevention when treating patients who are experiencing pain.
Bertakis
Klea D
KD
Department of Family and Community Medicine, University of Califomia, Davis, Sacramento 95817, USA. kdbertakis@ucdavis.edu
Azari
Rahman
R
Callahan
Edward J
EJ
D000328:Adult; D017677:Age Distribution; D000368:Aged; D001291:Attitude of Health Personnel; D005194:Family Practice / Q000379:methods; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000175:diagnosis / Q000453:epidemiology; D059408:Pain Management; D010147:Pain Measurement; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000379:methods; D011336:Probability; D011379:Prognosis; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D012959:Socioeconomic Factors