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Are patients more likely to see physicians of the same sex? Recent national trends in primary care medicine

https://doi.org/10.1016/j.amjmed.2004.03.043Get rights and content

Purpose

Women may prefer female physicians, particularly for preventive health services. We assessed national trends in the proportion of women among patients seeing female physicians, and compared visit characteristics and preventive services among visits to female and male primary care physicians.

Methods

We assessed the characteristics of 92,389 visits from the 1995–2000 National Ambulatory Medical Care Survey, a nationally representative survey of office-based physicians in the United States, using linear and logistic regression.

Results

Female physicians were more likely than male physicians to see female patients in the specialties of primary care (73% vs. 56%), psychiatry (72% vs. 54%), dermatology (67% vs. 56%), and pediatrics (52% vs. 46%; P <0.01 for all). In primary care, the difference increased over time, such that by 2000, 78% of visits to female primary care physicians were from women, compared with 56% for male primary care physicians (P <0.01). Female primary care physicians saw younger patients (mean age, 45 vs. 49 years, P = 0.04), reported longer visits (19 vs. 17 minutes, P <0.01), and reported performing more preventive services than did male primary care physicians when seeing female patients, including Papanicolaou testing (11% vs. 4.7%, P <0.01) and mammograms (9% vs. 4%, P <0.01).

Conclusion

The phenomenon of sex concordance between patient and physician has increased in recent years, particularly in primary care. Nearly four of five patient visits to female primary care physicians are from women, and female physicians report performing more preventive health services for their female patients.

Section snippets

Methods

We analyzed data from the 1995 to 2000 National Ambulatory Medical Care Survey (NAMCS), an annual survey of non–federally funded office-based physicians conducted by the National Center for Health Statistics (NCHS), Hyattsville, Maryland. The survey is based on a multistage probability sample design, and a sampling weight is calculated for each visit that can be used to extrapolate to national estimates. We had access to additional confidential data on physician age and sex that were not

Results

We analyzed 92,389 patient visits with available data on physician age and sex, representing an estimated 3 billion patient visits in the United States from 1995 to 2000. Within primary care, women comprised 59% of all visits and the proportion of visits by women did not change significantly over time (60% in 1995 and 59% in 2000, P = 0.64 for trend). The proportion of visits to female physicians varied by specialty: pediatrics (33%), dermatology (21%), psychiatry (20%), primary care (15%),

Discussion

We found that female primary care physicians in the United States were more likely than their male counterparts to see female patients, a difference that appeared to increase over time. By 2000, four of every five visits to female primary care physicians were from women. Further, female physicians were substantially more likely to report performing preventive health services when seeing female patients, particularly when the services were specific to women. Sex concordance between patients and

Acknowledgment

The authors are indebted to Negasi Beyene at the National Center for Health Statistics for his help with the data, and to Roger B. Davis, ScD, for his statistical expertise.

References (39)

  • P. Franks et al.

    Physician gender, patient gender, and primary care

    J Womens Health (Larchmt)

    (2003)
  • J. Bernzweig et al.

    Gender differences in physician-patient communication: evidence from pediatric visits

    Arch Pediatr Adolesc Med

    (1997)
  • L. Cooper-Patrick et al.

    Race, gender, and partnership in the patient-physician relationship

    JAMA

    (1999)
  • J.R. Meuleman et al.

    Assessing medical interview performance: effect of interns' gender and month of training

    Arch Intern Med

    (1992)
  • D.L. Roter et al.

    Physician gender effects in medical communication: a meta-analytic review

    JAMA

    (2002)
  • D.K. Cherry et al.

    National Ambulatory Medical Care Survey Summary

    (2003)
  • R.N. Anderson

    Deaths: Leading Causes for 2000

    (2002)
  • K.F. Weyrauch et al.

    Patient sex role and preference for a male or female physician

    J Fam Pract

    (1990)
  • C.J. Van Ness et al.

    Male adolescents and physician sex preference

    Arch Pediatr Adolesc Med

    (2000)
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