Reciprocity in Low Back Pain Care and Its Role in Power Dynamics: A Give-and-Take Approach.
Karime Mescouto, Meris Tan, Jenny Setchell
PMID 36222160WHAT IT FOUND
Clinicians who accepted patients’ conversational leads, invited their input, and shared personal stories created more equal power dynamics.
Blocking these offers or staying strictly biomedical kept clinicians in control and discouraged patient participation.
Key findings
01Physical therapists who accepted patients' conversational offers, rather than blocking them, shared power in the interaction.
02Inviting patients to make offers, such as by asking open-ended questions about their context, allowed for more collaborative treatment planning.
03Reciprocating psychosocial offers by sharing personal stories helped both parties see each other as human beings, which reduced power differences.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
The study was conducted in a single fee-for-service private clinic in Australia, so the findings may not apply to publicly funded systems or different cultural contexts. The participant population was relatively homogeneous, with most clinicians and patients being White, middle-class, and female. As an observational study, it describes what happened in these specific interactions but does not prove that these communication techniques cause better clinical outcomes. The researchers acknowledged that their own perspectives as clinicians and observers influenced the data collection and analysis.
Declared interests
The study was funded by the University of Queensland and the National Health and Medical Research of Australia. The funders played no role in the design, conduct, or reporting of the study.
The easy way to misread this
Do not assume that sharing personal stories is a universal technique for building rapport. The authors note that therapists must be cautious not to shift the focus away from the patient, and that sharing may be challenging or inappropriate for clinicians who fear stigma regarding their own identities.