Women in general practice

Patient preference for genders of health professionals

Preferences for physicians' gender is an obvious and well documented example of considerations of patients' attitudes. But research carried out in this field is rather limited to the domain of family medicine. This article describes preferences for 13 different health professions: surgeons, neurologists, anaesthetists, internists, general practitioners, psychiatrists, psychologists, social workers, hospital and district nurses, home helps, gynaecologists and midwives. Our investigation also concerns the reasons for people's preferences. In February 1993 a self-administered survey was completed and returned by 961 out of 1113 (response 86%) participants of the Dutch Health Care Consumers Panel, a panel resulting from a random sample of Dutch households. On a range of different health professions a varying minority of patients prefer a care provider of a particular gender. There are virtually no sex preferences for the more "instrumental" health professions (e.g. surgeons, anaesthetists). Gender preferences are stronger for those health professions more likely engaged in intimate and psychosocial health problems (e.g. gynaecologists and GPs). Preferences expressed do not relate to sex stereotypes of gender differences in instrumentality, expertise, efficiency, consultation length, and personal interest. The majority of persons who prefer female health professionals indicate that they talk more easily to females than to males, and feel more at ease during (internal) examination by females than by males. Persons who prefer male health professionals use the same reasons in favour of males. The discussion relates to gender differences in the communication style of male and female physicians.

Women's health care: for whom and why?

Differences are investigated between female practice populations of female general practitioners providing women's health care and of women and men general practitioners providing regular health care. Women's health care in the Netherlands is provided in the general practice "Aletta" and is based on the following principles: (1) consideration of the patient's gender identity and gender roles; (2) consideration of the patient's personal and social situation; (3) treating the patient respectfully; (4) encouraging the patient to cope with health problems and stimulating self-responsibility; and (5) avoidance of medicalization. Data were derived from an extensive health interview with 253 women Aletta patients (15 years or older) about socio-demographic characteristics, gender role, attitudes, somatic and mental health status, and medical consumption. The Aletta patients were also asked about their motives in choosing women's health care. Reference groups were comprised of 391 and 628 women patients of women and men general practitioners, respectively, providing regular health care. Logistic regression analyses were performed to explain differences between the three groups. "The Aletta patient" can be characterized as a young, urban, single, highly educated, working, and childless woman, who deliberately chooses women's health care. She is more androgynous than women of other doctors, less inclined to seek help with the GP, she suffers more from psychosomatic and psychosocial problems, and she has poorer mental health. It results in a higher use of mental health care, and also of alternative health care. Women patients of women and men doctors providing regular health care hardly differ between each other in the characteristics described above. Health policy makers should take into consideration that in the future possibly more women will prefer health care in which the ideas of women's health care are being applied. The integration of some important aspects of women's health care into regular health care is recommended.