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Views of Physicians, Patients Differ on Spinal Surgery

Family physicians found to favor surgery more than surgeons do

THURSDAY, Feb. 4 (HealthDay News) -- Surgeons, family physicians, and their patients have different perceptions of what constitutes good grounds for spinal surgery, according to a study in the Jan. 1 issue of Spine.

S. Samuel Bederman, M.D., of the University of California in San Francisco, and colleagues conducted a survey of 131 surgeons, 202 family physicians and 164 patients, and used conjoint analysis to elicit their preferences for lumbar spinal surgery. The survey presented participants with scenarios based on clinical factors, including walking tolerance, pain duration and severity, and neurologic symptoms.

When the researchers analyzed the data they found that family physicians had the highest preference for surgery, while surgeons had the lowest. Whereas surgeons believed that the most important factor was location of pain, for family physicians, walking tolerance, pain severity and neurologic symptoms were all given similar weight. For patients, the main deciding factors for surgery were severity and duration of pain, as well as walking tolerance.

"Aligning opinions of patients and physicians would improve the shared decision-making process itself and patients' expectations about surgery would be more accurate. This can directly result in a significant improvement in patient satisfaction with the health care process and even overall health status following treatment," the authors write. "Future research will need to test strategies to align preferences particularly between family physicians and surgeons."

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