Differences in medical care satisfaction of patients with “functional” vs “organic” esophageal diseases... 2025 Soldaini et al

Full title: Differences in medical care satisfaction of patients with “functional” vs “organic” esophageal diseases, Italian validation of the PPRS SF questionnaire

Abstract

Patient-physician relationship (PPR) plays a key role in modern healthcare, especially within gastrointestinal medical practice. In 2017 Kurlander et al. developed a Patient-Physician-Relationship-Scale (PPRS), a questionnaire used to assess the patients’ medical care-satisfaction. The PPRS was later simplified by Drossman et al. in 2021 by creating a PPRS-SF (short form).

This study aimed to validate the PPRS-SF in Italian and to administer it to patients with “functional” and “organic” esophageal diseases, to highlight the differences in the PPR between the two categories. The process of validation was carried out following a standardized forward-backward procedure and each step was overseen by a Rome foundation independent clinical monitor. The Italian version of the PPRS-SF was then administered to 50 Eosinophilic Esophagitis (EoE), 53 Achalasia, 48 Gastroesophageal Reflux Disease (GERD) and 44 esophageal disorders of gut brain interaction (eDGBI) patients.

In eDGBI and GERD, the degree of patients’ satisfaction was significantly lower. Between a score of -36 and + 36, the mean score for patients with EoE was 30.20 (± 9.78), for Achalasia 23.78 (± 19.9); for GERD 20.46 (± 16.03) and for esophageal DGBI 17.91 (± 18.41). Moreover, there was a negative significant correlation between the PPR and age (R=- 0.208).

This study validated the Italian version of the PPRS-SF questionnaire and showed that the patients’ diagnosis together with other factors such as their age, can affect the PPR. In particular, patients with DGBI and older patients reported lower scores than the ones with organic diseases and the younger ones, respectively.

Open access

 

There was no correlation between symptoms and satisfaction.

They did not control for all common demographics.

I’m not surprised if people are less satisfied with gaslighting..

 

I'm not motivated enough to look into the illnesses they are comparing, but the only fair comparison here would be between "organic"/acknowledged illnesses that can be treated, ones that can't because no treatments exist, and "functional" ones, which obviously can't be treated, but also can improve or even fully recover spontaneously, with all the fake patient satisfaction this can bring.

Because the difference in satisfaction between "organic" illnesses that can't be treated (yet) and ones that are dismissed as "functional", and thus aren't treated, won't be significant, as there is an odd baseline of patient satisfaction that creates an artificial floor, where anything but being told you're stupid and to get the hell out of here will get 3/5 from almost anyone. They won't get the bump of improving outcomes, but they still get the free participation tokens.

Unless of course they explicitly assess satisfaction based on treatment efficacy alone, but since many diseases can't be treated, this rarely happens. And it makes sense, except where psychosomatic beliefs dominate. But that baseline passing grade (60%) is simply not valid. They actually have to be offensive jerks in order to drop below it. A sack of potato could get that 3 star rating in most cases. Everything is the margin where this bulk of participation trophies is ignored.

Also, I love how they show that their concepts are so completely fake and devoid of any meaningful substance that they use scare quotes. After all, that distinction has nothing at all to do with the illness or the patients, it's entirely a property of their perception. In just about the same as for most people who don't believe in a particular religion, they'd think of "miracles", and not miracles, whereas believers won't use scare quotes because they genuinely accept those "miracles" as real miracles.

Here they know their distinction is not real, that it's blatant bullshit. They're embarrassed by it. But they still go right ahead as if it were real, genuine miracles, and won't ever bother looking for the source of the "holy water", or care much once it's found that it was actually plumbing nearby that dripped on the statue. They'll keep telling people that there's nothing wrong with swallowing a bit of water leaking from toilet plumbing here and then.

 

[sarcasm on] I must add "organic" to my list of names doctors use when they mean "real". [sarcasm off]