The Lack of Patient Credibility

Swathi Mettela

MHC Science Forward

Professor Kowach

24 October 2016

The Lack of Patient Credibility

It is well established in academia that pain is one of the most difficult phenomena to communicate via language. When this idea is brought into a hospital setting, it poses a serious issue concerning efficiency of modern medicine.

Not only is communicating pain difficult, but it is even more tricky for females and minorities. A 2013 qualitative study examined what females suffering from chronic muscular pain face when trying to communicate with their physicians. Ten women of different ages and ethnicities were interviewed about their experiences having a “medically unexplained disorder.” For some physicians, seeing truly is believing. Unfortunately, not all pain is not visible whether it be through the naked eye or through a microscope. The study portrayed themes of trying to seem “normal.” The women reported that they tried not to come off as too weak or too healthy so as to comply with the expectations in clinical medicine. They also noted problems with credibility, assertiveness, appearance, and dignity. Trying to communicate a subjectively painful, but otherwise undetectable problem with their bodies left these women powerless and unsatisfied with their care. (Werner)

In 2009, the United Kingdom received 5.5 million responses to the English GP Patient Survey. The purpose of the study was to find ways to make medical care more patient-centered. However, a research study in 2013 uncovered that one some physicians made changes to their approach after seeing the results of the survey. Many expressed doubts regarding credibility of the responses. Physicians feared that some people may have political influences or ulterior motives reflected in their responses, disregarding that the sole purpose of the survey was to improve care in the medical facilities. While this caution is within reason, it nearly impossible to develop a truly patient-centered medical environment if a physician does not trust patient feedback. (Asprey)

Systematic differences such as economic status, upbringing, and ethnicity all play a role in how questionnaires like the English GP Patient Survey are completed. Some people have higher expectations for medical care than others. It was reported that medical practices with a higher number of young patients, ethnic minorities, and lower class families had more negative responses in patient surveys (Ahmed). Although there are studies supporting that patients can complete health related surveys without expectations of care influencing their responses, systematic differences such as class and ethnicity are difficult to address with objectivity (Weinick).

 

Citations:

Ahmed, F., Burt, J., & Roland, M. (2014). Measuring patient experience: concepts and

methods. The Patient-Patient-Centered Outcomes Research,7(3), 235-241.

 

Asprey, A., Campbell, J. L., Newbould, J., Cohn, S., Carter, M., Davey, A., & Roland, M.

(2013). Challenges to the credibility of patient feedback in primary healthcare settings: a

qualitative study. Br J Gen Pract, 63(608), e200-e208.

 

Gee, G. C., Ryan, A., Laflamme, D. J., & Holt, J. (2006). Self-reported discrimination and

mental health status among African descendants, Mexican Americans, and other Latinos in the New Hampshire REACH 2010 Initiative: the added dimension of immigration. American Journal of Public Health,96(10), 1821-1828.

 

Weinick, R. M., Elliott, M. N., Volandes, A. E., Lopez, L., Burkhart, Q., & Schlesinger, M.

(2011). Using standardized encounters to understand reported racial/ethnic disparities in patient experiences with care. Health services research, 46(2), 491-509.

 

Werner, A., & Malterud, K. (2003). It is hard work behaving as a credible patient: encounters

between women with chronic pain and their doctors.Social science & medicine, 57(8), 1409-1419.