SAN DIEGO -- Patients were significantly less likely to recommend a female gynecologist than a male gynecologist, according to a small survey presented here.
When asked about their likelihood to recommend their gynecologist, patients were 37% less likely to recommend a female gynecologist (OR 0.63, 95% CI 0.48-0.83). After adjusting for healthcare environment, they were 47% less likely to do so (adjusted OR 0.53, 95% CI 0.37-0.58), reported Carolyn Haunschild, MD, of Stanford University, and colleagues.
Action Points
- Note that this study was published as an abstract and presented at a conference. These data and conclusions should be considered to be preliminary until published in a peer-reviewed journal.
At a poster presentation at the American College of Obstetricians and Gynecologists annual meeting, Haunschild said the impetus for this study originally came from a female colleague in the emergency department, who felt that her gender was impacting her patient encounters and her patient satisfaction scores.
Haunschild said that her group wanted to look at this particular issue in ob/gyn because they wanted to see if males were discriminated against in the field.
"Male medical students feel like they're discriminated against in a way because the residents or faculty won't allow them into these patient encounters, when it's really the patient saying 'I don't know if I want a man in there,'" she told 51˶. "And when patients are choosing a provider, they're probably going to say they want a woman to do that exam."
But she added that she was not surprised with these results because of "gender bias in general."
Haunschild's group examined Press-Ganey patient satisfaction surveys from 909 patients at outpatient ob/gyn visits at a single hospital-based clinic at an academic medical center. Patients had a mean age of 49, with about 60% over the age of 40 and 60% were white. They were mostly married, English-speaking, and about half had a history with their physician of less than 6 months.
Two-thirds of physicians were women, who also had a mean age of 49. The large majority were white and most were at least age 40.
Haunschild said they focused specifically on receiving a top likelihood to recommend score (which was reported on a Likert scale from 1 to 5), because of the trend toward medical reimbursement going towards patient satisfaction. She added that she wanted to examine what that might mean for female physicians given that a wage gap already exists.
"Eighty-three percent of ob/gyn residents in the last survey are female, so it's becoming female-dominated, but they're not in the top leadership positions, they earn about $20,000 less than their male counterparts," Haunschild explained.
Overall, a significantly lower portion of patients were likely to recommend a female gynecologist (78.1% versus 83.1%, P<0.05), but a significantly higher portion were likely to recommend a clinician around the same age versus a different age (82.5% versus 76.4%, P<0.05), or the same race versus a different race (85.6% versus 74.6%, P<0.0001).
Patients were more than twice as likely to recommend a provider who spoke English (OR 2.19, 95% CI 1.11-4.33) or one they had been seeing for over 3 years (OR 2.25, 95% CI 1.33-3.81).
Haunschild said that these results beg the question about whether patient satisfaction should be factored into reimbursement "because there's so much bias that you can't account for" and that nothing other than being a woman is going to get you a lower score.
"The thought was if there was a field that you should have an advantage being a female, gynecology should be it," she said.
Primary Source
American College of Obstetricians and Gynecologists
Haunschild C, et al "Sex differences in patient satisfaction with outpatient obstetrics and gynecology care" ACOG 2017; Abstract 14G.