Patient gender preferences in a large military teaching hospital

Responding to patient requests for women obstetrician-gynecologists

Patients may request care from a woman obstetrician-gynecologist for various reasons, including privacy concerns, religious or cultural reasons, and in some cases, a history of abuse. They should be given the opportunity to voice their reasons for requesting a woman obstetrician-gynecologist but should not be compelled to do so. Respect for patient autonomy is a compelling reason to consider honoring a patient's gender-based request. When a patient requests a woman obstetrician-gynecologist, efforts should be made to accommodate the request if possible. However, medical professionals and institutions are not ethically obligated to have a woman obstetrician-gynecologist on call or to make one available at all times. If it is not feasible for a woman obstetrician-gynecologist to provide care because of staffing or other system constraints or patient safety concerns, accommodation is not required, and physicians do not have an overriding responsibility to ensure that patients receive gender-concordant care. Patients have the right to decline care and may choose to seek care elsewhere if their requested healthcare provider type is not available. Institutions and medical clinics should have policies and procedures in place for managing patient requests for women obstetrician-gynecologists, and patients should be made aware of these policies preemptively. These policies and procedures should include information about whom to contact for assistance and how to document the encounter. They should also be accessible and familiar to physicians and trainees. Care should be taken to ensure that adequate educational opportunities in obstetrics and gynecology are available for all medical trainees, regardless of gender.

Altered patient perceptions and preferences regarding male and female gynecologists: a comparison between 1997 and 2018

PURPOSE

The purpose of this investigation was to explore changes in patient preference regarding gynecologist's gender.

METHODS

Using a standardized questionnaire, distributed in 1997 and 2018, a total of 1000 women were interviewed about preferences in terms of their choice of gynecologist and perceptions regarding gender-dependency of gynecologist's qualifications, strengths and weaknesses. Data was correlated with sociodemographics and possible influencing factors.

RESULTS

Based on their own experience, an increasing majority did not express a preference for their gynecologist's gender (58-71%). However, the minority that still favors one gender demonstrated a significant decrease in preference of male gynecologists (14-5%), while about a quarter still generally prefer treatment by female physicians. Sub-analyses of emotional and technical treatment aspects generally confirm these trends in that more of today's patients are indifferent to their gynecologist's sex and that the remaining minority shifts towards favoring female doctors. If asked to definitely choose between female and male physicians based solely on the aspect of trust a significant change can be noted (69-30%) in favor of female doctors in 2018 as opposed to 1997 when patients were split in this regard (52%/48%). Overall bad personal experience regarding gynecological treatment has significantly decreased (36% reduction).

CONCLUSION

Over the last decades, patient preference and perception of the importance of their gynecologist's gender has changed. While an increasing majority attributes equal competence in emotional, professional and interpersonal aspects to both genders, the remaining proportion of patients demonstrates a significant shift towards favoring female doctors.

Patient satisfaction and gender composition of physicians - a cross-sectional study of community health services in Hubei, China

BACKGROUND

Patient satisfaction is associated with both individual (patients and health workers) and organizational (health facilities) characteristics. This study aimed to establish a link between patient satisfaction and gender composition of physicians in community health service (CHS) organizations.

METHODS

Participants were selected through multistage stratified random sampling: 36 CHS centers were selected from six municipalities in Hubei, China. All physicians on duty and patients visiting the CHS during the study period (from April to October in 2015) were invited to participate in this study: 324 physicians and 865 patients completed a questionnaire survey. Multilevel linear regression analyses were performed to determine the associations of patient satisfaction (scored from 1 to 5) with patient characteristics (gender, age, education, income, medical expense, frequency of visits to the CHS) and organizational features of the CHS (sex ratio of physicians, and gender differences of physicians in education and job satisfaction).

RESULTS

Older patients and those with a higher medical bill had a lower degree of satisfaction (p < 0.05). At the organizational level: a higher proportion of male physicians weakened the negative association between patient age and patient satisfaction (p < 0.05); a larger gap in university qualifications between male and female physicians exacerbated the negative association between patient age and patient satisfaction (p < 0.05).

CONCLUSIONS

The gender composition of physicians in CHSs is associated with patient satisfaction in the Chinese context: a larger gap (in number and qualifications) between male and female physicians is associated with higher patient satisfaction. Further studies are needed to explore the cultural roots of such an association.

Patient preferences for technical skills versus interpersonal skills in chiropractors and physiotherapists treating low back pain

BACKGROUND

Little is known about which characteristics of chiropractors and physiotherapists matter to patients and influence their preferences when seeking care.

OBJECTIVE

To examine the impact of four factors (patient gender, practitioner gender, practitioner specialty-chiropractor or physiotherapist and practitioner reputation-technical ability or interpersonal skills) on patients' choice of therapist to treat low back pain.

METHODS

Questionnaire-based vignette study in which participants sampled from the general population rated the likelihood of consulting eight fictional therapists. Each fictional therapist represented a different combination of the three practitioner factors (e.g. male chiropractor with reputation for good technical ability). The study was administered as a postal survey to a simple random sample of residences in one postal town in England.

RESULTS

Respondents (n = 657) consistently reported that they considered a practitioner's qualifications and technical skills important when choosing either a physiotherapist or a chiropractor; and just less than a third thought it was important that a practitioner was a good listener. As hypothesized, female respondents preferred female practitioners and respondents had a general preference for physiotherapists over chiropractors. Contrary to our hypothesis, the practitioner's reputation had the largest effect on respondents' preferences and all practitioners with a reputation for technical ability were preferred over those with a reputation for interpersonal skills.

CONCLUSION

Similar factors are important to patients whether they are choosing an individual chiropractor or physiotherapist; patients particularly value information about technical competence. An awareness of these factors should help primary care providers to direct patients to relevant information and support their decision-making.

Physician's gender, communication style, patient preferences and patient satisfaction in gynecology and obstetrics: a systematic review

OBJECTIVE

Review of studies published in the last 10 years about women seeking gynecological- or obstetrical care and physician's gender in relation to patient preferences, differences in communication style and patient satisfaction.

METHODS

Studies were identified by searching the online databases PubMed, PsycINFO, Embase and the Cochrane Library. The search strategies 'gender'; 'obstetrics' and 'gynecology' were combined with 'communication'; 'physician-patient relations'; 'patient preference' and 'patient satisfaction'.

RESULTS

After screening title and abstract, evaluating full text and quality assessment, 9 articles were included in this review. Most patients preferred a female rather than a male gynecologist-obstetrician. This was partly explained by a more patient-centered communication style used by female gynecologists-obstetricians. Also experience and clinical competence were important factors in choosing a gynecologist-obstetrician. It was not clear whether patient's age or ethnicity influenced patients gender preference. Patient satisfaction increased when gynecologists-obstetricians used a patient-centered communication style.

CONCLUSION

Preference for a female gynecologist-obstetrician might be explained by a more patient-centered communication style used by female gynecologists-obstetricians. Using a patient-centered communication style increases patient satisfaction.

PRACTICE IMPLICATIONS

To increase patient satisfaction, gynecologists-obstetricians should learn to integrate patient-centered communication style into the consultation.

The effect of student gender on the obstetrics and gynecology clerkship experience

OBJECTIVES

To explore the effects of the students' gender on their perception of quality and quantity of teaching, the amount of experiential learning, and their interest in obstetrics and gynecology.

METHODS

Anonymous, self-administered surveys to third-year medical students rotating on the obstetrics and gynecology clerkship.

RESULTS

Eighty-one of 91 students participated (89% response rate): 33 men, 46 women, 2 declined to reveal their gender. No significant gender differences existed regarding number of interactions with residents and faculty; number of deliveries, surgeries, or examinations performed; perceived quality of teaching; or feeling included as part of the clinical team. Male students were more likely to report performing specific surgical procedures, such as operating the bovie cautery during gynecological surgeries (p = 0.005). More men experienced patients refusing to allow them to participate in the clinical interview (p < 0.0001) and physical examination (p < 0.0001). Male students were also more likely to report feeling that their gender negatively impacted their clerkship experience (p < 0.0001). Although less likely to report preclerkship and postclerkship career interest in obstetrics and gynecology, male students were more likely to report that their interest increased at the end of the clerkship.

CONCLUSIONS

Male students were more likely to experience gender bias from patients on the obstetrics and gynecology service. Male students also described feeling socially excluded from female-dominated clinical teams. Obstetrics and gynecology educators need to consider methods of encouraging patients to accept medical student participation regardless of gender. Obstetrics and gynecology faculty and residents need to be sensitive to subtle forms of gender bias and ensure equal inclusion for both male and female medical students.

How patients choose acupuncturists: a mixed-methods project

OBJECTIVES

Patients can have difficulties choosing acupuncturists in the United Kingdom because acupuncturists are not all subject to statutory regulation. Research has identified factors that influence patients' choice of general practitioner. However, how patients choose acupuncturists has not been studied. The aim was to investigate how patients choose acupuncturists and to identify which factors might influence this choice.

DESIGN

A mixed-methods design used an exploratory qualitative study followed by a quantitative study. The qualitative study explored patients' experiences of acupuncture. The quantitative vignette study investigated the impact of patient gender and practitioner factors (gender, training location, and qualifications) on choice of acupuncturist.

METHODS

In the qualitative study, 35 acupuncture patients (recruited through maximum variation sampling from seven clinics and the community) participated in semistructured interviews about their acupuncture experiences. In the quantitative study, 73 participants imagined wanting to consult an acupuncturist for back pain. They rated 8 fictional acupuncturists; ratings were analyzed using analysis of covariance.

RESULTS

Patients wanted qualified, personable acupuncturists and valued recommendations from trusted others. Without such recommendations, potential patients preferred female acupuncturists (F(1,69)=4.504, p<0.05) and those with medical qualifications (F(1,69)=44.832, p<0.01).

CONCLUSIONS

The decision to consult a particular acupuncturist is not straightforward. Acupuncturists' trustworthiness and technical competence are important to (potential) patients; practitioner gender also influenced preferences. Patients need to be informed about proposals concerning statutory regulation in CAM and its implications; conventional practitioners might be able to better support their patients wanting to consult acupuncturists.

Patient attitudes toward the use of surgical scrubs in a military hospital clinic

OBJECTIVE

To determine whether obstetrics and gynecology (ob/gyn) patients in a large military teaching hospital have a negative attitude toward the wearing of surgical scrubs by ob/gyn providers.

METHODS

A convenience sample questionnaire on patient preferences, including two questions relating independently to military and civilian staff attire, was offered to clinic patients over a 2 month period. Univariate and multiple logistic regression analyses were used to identify patient groups less accepting of the surgical scrubs in clinics.

RESULTS

Over ninety-one percent of respondents viewed surgical scrubs with a white coat to be acceptable clinical attire for military or civilian providers. Eight percent preferred the more formal uniform or business dress. Non-white and Hispanic patients had higher rates of preference for more formal dress.

CONCLUSIONS

The majority of ob/gyn patients surveyed did not view the use of surgical scrubs with a white coat negatively.