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The Effect of Medical Authoritarianism on Physicians' Treatment Decisions and Attitudes Regarding Chronic Pain

Authors

  • DIANA J. BURGESS,

    Corresponding author
    1. Center for Chronic Disease Outcomes Research, (a VA HSR&D Center of Excellence), Department of Veterans Affairs Medical Center, Minneapolis, MN Minneapolis VA Medical Center, and Department of Medicine, University of Minnesota–Minneapolis
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  • JOHN DOVIDIO,

    1. Yale University
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  • SEAN PHELAN,

    1. Division of Epidemiology, University of Minnesota–Minneapolis Department of Family Medicine and Community Health, University of Minnesota-Minneapolis
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  • MICHELLE VAN RYN

    1. Division of Epidemiology, University of Minnesota–Minneapolis, and Department of Family Medicine and Community Health, University of Minnesota–Minneapolis
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  • The views expressed in this article are those of the authors and do not necessarily reflect the position or policy of the Department of Veterans Affairs or the United States government.

  • This project was supported by a Merit Review Entry Program (MREP) award to Diana Burgess from the VA Health Services Research & Development (HSR&D) and a Locally Initiated Project (LIP) award from the Center for Chronic Disease Outcomes Research.

Diana Burgess, VA Medical Center 152/2, One Veterans Drive, Minneapolis, MN 55417. E-mail: Diana.Burgess@va.gov

Abstract

This study examined the influence of medical authoritarianism (MA) on physicians' treatment decisions and attitudes regarding chronic pain among a randomly selected sample of primary care physicians (N = 382) who responded to a mail survey. As hypothesized, high-MA physicians had more negative attitudes toward chronic pain patients, greater concerns about prescription drug abuse, and more negative attitudes toward the use of opioids to treat chronic pain than did low-MA physicians. Despite these negative attitudes, high-MA physicians were more likely than were low-MA physicians to recommend the aggressive use of opioids. The results point to the complex relationship between MA and physician attitudes and decisions, and provide insights into how political ideology might influence physician behavior.

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