Physician resistance to the late whiplash syndrome

The biopsychosocial model of the late whiplash syndrome is based in part on the concept of symptom expectation--that the commonly held view of whiplash injury as a serious injury and anticipation of chronic pain and disability engenders a post-injury behavior that encourages chronic pain. We sought to determine if an unselected group of physicians (who might be expected to view whiplash as benign compared to most accident victims) would report a more benign outcome to their injuries than a group of nonphysicians.

This survey compares the self-reported outcome of whiplash-type injuries (neck sprain) in physicians and nonphysicians working at a university hospital. Subjects were asked to recall motor vehicle accident experiences, the presence of symptoms as a result, and the outcomes for those symptoms.

Seventy-one percent of physicians and 60% of nonphysicians recalled being in a motor vehicle accident. About 31% of physicians recalled acute symptoms, compared to 46% of nonphysicians. Symptoms tended to be short-lived for physicians (days to weeks) while nonphysicians more often had symptoms lasting over 6 months. Only 9% of physicians recalled symptoms lasting for more than one year compared to 32% of nonphysicians. Physicians took no more than one week off work, whereas among nonphysicians, it was common to take more than 6 months off.

Physicians appear to be in at least as many motor vehicle accidents as nonphysicians, and 33% suffered the acute whiplash syndrome. Physicians appear, however, to be more resistant than nonphysicians to the progression from acute pain to chronic pain and disability.