Exploring the Relationship of Three Medical Entitlement Beliefs and Psychiatric/Psychological Variables for Acute and Chronic Pain Patients.
OBJECTIVE
The belief in medical care entitlement has recently resulted in major changes in the medical system in the United States. The objectives of this study were the following: to compare endorsement of three medical entitlement beliefs (I deserve the best medical care no matter what the cost [BMC], I am entitled to all of the medical care I want at no charge [NC], I shouldn't have to wait to see my doctors [W]) in community nonpatients without pain (CNPWP), acute pain patients (APPs), and chronic pain patients (CPPs) and to develop predictor models for these beliefs in APPs and CPPs.


METHODS
CNPWP, APPs, and CPPs were compared statistically for frequency of endorsement of each belief. All available variables were utilized in logistic regression models to predict each belief in APPs and CPPs. Those affirming/nonaffirming each belief were compared by t-test for affirmation of narcissism, dependency, and antisocial practices on three scales from established inventories.


RESULTS
CPPs were significantly more likely than APPs to endorse BMC. No other comparisons were significant. The logistic regression models identified variables that related to narcissism, anger, doctor dissatisfaction, depression, and anxiety, which entered the models for both APPs and CPPs for some beliefs. Those APPs and CPPs who affirmed the beliefs of NC and W were more likely than their counterparts to affirm antisocial practices, but not narcissism or dependency.


CONCLUSIONS
Patient medical entitlement beliefs may be related to some psychiatric/psychological issues.
Departments of Psychiatry, Neurological Surgery, and Anesthesiology, Miller School of Medicine at University of Miami, Miami Veterans Administration Hospital, Miami, Florida, U.S.A.
David A
DA
Fishbain
Health Psychology Associates, Greeley, Colorado, U.S.A.|Integrated Therapies, Lakewood, Colorado, U.S.A.
Daniel
D
Bruns
Graduate School of Professional Psychology, University of Denver, Denver, Colorado, U.S.A.
Laura J
LJ
Meyer
Department of Psychiatry, Miller School of Medicine at University of Miami, Miami, Florida, U.S.A.
John E
JE
Lewis
American International Group, New York, New York, U.S.A.
Jinrun
J
Gao
Health Psychology Associates, Greeley, Colorado, U.S.A.|Integrated Therapies, Lakewood, Colorado, U.S.A.
John Mark
JM
Disorbio
D059787:Acute Pain / Q000523:psychology*; D000328:Adult; D059350:Chronic Pain / Q000523:psychology*; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008483:Medical Assistance; D008875:Middle Aged; D010551:Personality; D012111:Residence Characteristics; D014481:United States
acute pain; battery of health improvement (BHI 2); chronic pain; community nonpatients without pain; entitlement; medical entitlement; narcissism; sociopathy