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

Results

In a 1 month study period, 280 adolescent athletes filled out anonymous paper surveys regarding preferences in sports medicine surgeons. Adolescent patients' average age was 14.7 ± 2.2 years (age groups: 10 to 14 years; N = 119 and 15 to 18 years; N = 161), with responses given by 105 male patients (38%) and 175 female patients (62%). No notable differences were observed when patients were divided into two age groups, so results represent entire patient participation population. In the same 1 month study period, 256 adult guardians filled out matched corresponding surveys regarding preferences in sports medicine surgeons. Based on the study protocol, only one guardian was allowed to complete the survey per adolescent patient. If more than one guardian was present, those guardians determined who completed the survey. Guardians' average age was 47.4 ± 5.5 years, with responses given by 46 male patients (18%) and 206 female patients (82%).

Characteristics other than surgeon sex were reported to be very important to adolescents, particularly for female patients (see Supplement 1, Supplemental Digital Content 1, http://links.lww.com/JAAOS/A222). A greater percentage of female patients than male patients reported that surgeon compassion (72% versus 47%; P < 0.001) and being a good listener (82% versus 61%; P < 0.001) were very important. Seventy percent of female patients reported that being treated as an individual was very important, whereas only 58% of male patients did so (P = 0.02). Forty-seven percent of female patients reported that surgeon assertiveness was very important, whereas only 34% of male patients did so (P = 0.03). Similarly, both female and male patients reported that hearing good things about the surgeon was very important (77% versus 65%); however, more female patients compared with male patients reported this attribute to be slightly more important (P = 0.045). Both female and male adolescent patients (85% versus 70%) reported surgeons involving them in decision making and the surgeon understanding their sports and goals as the top important characteristics.

Surgeon characteristics showed fewer notable differences between male and female guardians. Female guardians reported that hearing good things about the surgeon was very important, more so than male guardians (83% versus 57%; P < 0.001). More female guardians compared with male guardians reported that understanding their child's sports and goals was very important (86% versus 67%; P < 0.003). Similar to the adolescent patients, both male and female guardians reported that surgeons involving them in decision making and the surgeon understanding their sports and goals were the top important characteristics.

Comparing adolescent patient and guardian responses (see Supplement 2, Supplemental Digital Content 2, http://links.lww.com/JAAOS/A223), only fair to moderate agreement was seen in all eight categories involving the importance of surgeon characteristics between patients and guardians. Patient and guardian agreement ranged from poor to fair with responses to surgeon characteristics (intraclass correlation, 0.34 to 0.53). Patients and guardians both reported being involved in the decision-making process as the most important surgeon characteristic (34% versus 31%), followed by understanding patients' sports and goals (32% versus 28%). Patients reported hearing good things about the surgeon (10%) as the third most common and most important attribute, whereas guardians reported treating their child as a unique individual (15%) as the third most common and most important characteristic. Agreement was fair for the most important qualities of being involved in decision making and understanding their sports and goals (kappa: 0.236) and surgeon sex preference (kappa: 0.258).

In regard to surgeon sex, far fewer adolescents reported that surgeon sex was important than other characteristics, with male patients reporting a preference more frequently than female patients (26% versus 12%; P= 0.005). Among the male patients, 25% reported that they would prefer a male surgeon, less than 1% reported preference for a female surgeon, and 74% had no preference. Among the female patients, 8% reported preferring a female surgeon, 4% reported preference for a male surgeon, and 88% had no preference (see Supplement 1, Supplemental Digital Content 1, http://links.lww.com/JAAOS/A222). An even smaller percentage of guardians reported a surgeon sex preference, with only 3% preferring male surgeons, 3% preferring female surgeons, and 94% had no preference. A fair agreement existed between patients and their guardians on surgeon sex preference (see Supplement 2, Supplemental Digital Content 2, http://links.lww.com/JAAOS/A223).

Even though nearly all patients and guardians reported that the adolescent patient should be involved in their medical decision making (patients: 95%; guardians: 96%), physician selection was determined by the guardian 65% of the time and by the patient 2% of the time, whereas only 33% of the time did the adolescent patient and guardian chose the physician together (see Supplement 2, Supplemental Digital Content 2, http://links.lww.com/JAAOS/A223). Seventy-seven percent of patients aged 10 to 14 years reported that their guardians chose the doctor compared with 56% of patients aged 15 to 18 years who reported that their guardians chose the doctor (P < 0.001). When the guardians and patients decided the physician together, no statistical differences was found in their surgeon preferences. However, when guardians made the decision alone, the patients were more likely to have different surgeon preferences from their guardians, specifically on the issue of sex (P < 0.05).

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