Clinical Approach in Youth Sports Medicine

Patients' and Guardians' Desired Characteristics in Sports Medicine Surgeons

Jennifer J. Beck, MD; Martha M. Murray, MD; Melissa A. Christino, MD

Disclosures

J Am Acad Orthop Surg. 2019;27(13):479-485. 

In This Article

Abstract and Introduction

Abstract

Introduction: Adolescent athletes' and their guardians' preferences for sports medicine surgeon characteristics are unknown.

Methods: Unique, anonymous surveys regarding preferences in characteristics of sports medicine surgeons were given to both patients (aged 10 to 18 years) and their guardians before being seen by a sports medicine surgeon.

Results: Patients and their guardians reported shared decision making as the most important surgeon characteristic, followed by understanding patients' sports and goals. A higher percentage of male patients than female patients had a surgeon sex preference (P = 0.005); however, for both the groups, this ranked lower than other surgeon qualities. Nearly all respondents reported that the adolescent patient should be involved in medical decision making; yet, physician selection was determined by the guardian 65% of the time.

Conclusions: Both adolescent patients and their guardians reported shared decision making and understanding patients' sports and goals as surgeon qualities that were more important to them than surgeon sex.

Level of Evidence: Level IV, cross-sectional study

Introduction

Patient experiences and outcomes have become important metrics within the healthcare system and have become targets of healthcare improvement projects in recent years. With a plentiful number of Internet sites allowing patients to rate their physician and hospital experiences, little is known about what preferences patients have in regard to these entities, particularly with respect to physician characteristics. Previous studies have looked at the effects of physician sex[1–9] and attire[10] on patient satisfaction. These studies cross multiple surgical and medical specialties. The only study involving orthopaedic surgery is the survey of 500 adult patients in a large urban practice, showing no notable preferences toward surgeon sex, age, religion, or race, but those who had a preference tended to choose surgeons of the same demographic as themselves.[11]

In addition to patient preferences, the experience of medical decision making has evolved from being primarily physician driven to a shared decision-making model between the physician and the patient. This has been more extensively discussed within orthopaedic surgery literature,[12–14] with application to specific situations such as upper extremity traumatic versus nontraumatic conditions,[15] carpal tunnel syndrome management,[16,17] and stable ankle fractures.[18] Only one study evaluated differences in the preferences of patients and parents regarding adolescent idiopathic scoliosis surgery, which found that patients and parents often did not agree on reasons for surgery or on concerns or expectations after surgery.[19]

Sports participation and injury rates are increasing among adolescent athletes,[20] resulting in increased appointments with sports medicine surgeons. At a time when body self-image and independence are developing, adolescent athletes and their families are often faced with notable medical decisions that affect their quality of life and ability to participate in beloved activities. Very little is known about adolescent preferences for their care. A large study on adolescent preferences for healthcare providers, without reference to a specific medical specialty, showed that physician sex was a notable variable in adolescent preferences[21] and one in seven adolescents show fear and anxiety toward the physicians.[22]

Once an injury occurs, compliance and adherence to medical treatment can be affected by adolescent athletes' relationship with their sports medicine surgeons. To date, no study exists which has investigated adolescent athletes' and their guardians' sports medicine surgeon preferences, how they may differ from each other, and the role of the adolescent patient in shared decision making in these situations. In this study, we hypothesized that a higher percentage of patients would rank surgeon characteristics, including shared decision making, as very important than surgeon sex.

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