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Patients who choose doctors of the opposite sex generally are more satisfied with their care

Patients who chose doctors of the opposite sex in a large group-model health maintenance organization (HMO) in California generally were more satisfied with their physicians than patients who selected doctors of the same sex. In fact, women who chose female physicians were the least satisfied with their physician (74 percent), while male patients who chose female physicians were the most satisfied (85 percent). About 79 percent of female patients of male doctors and male patients of male doctors were satisfied.

This male-female phenomenon was not seen among patients who were assigned to their physicians, according to a study supported by the Agency for Healthcare Research and Quality (HS08269). The researchers analyzed patient-primary care doctor dyads by sex in a random sample of HMO members aged 35 to 85 years.

Patients who choose their own doctors may have higher expectations for certain physician qualities, which affects their care satisfaction. In fact, Joe V. Selby, M.D., M.P.H., of the Kaiser Permanente Medical Care Program of Northern California, and his colleagues found that female patients placed a higher value than male patients on a physician's communication skills and personal manner. Female patients also appeared to value technical skills more highly than male patients in this sample.

The female doctors selected by women in this study may not have achieved certain care ideals, such as better communication on social, lifestyle, prevention, and emotional concerns. On the other hand, the productivity demands of physicians in HMOs may make it difficult for female physicians to spend more time with their patients despite patient expectations. For example, female doctors in this study, as in many settings, were more likely to work part-time (60 to 90 percent of the time). Accounting for this part-time status, their workload was larger than that of their male counterparts (i.e., they had larger effective panels of primary care patients, 1,552 vs. 1,388 for male doctors), which may have compounded problems related to heightened patient expectations. However, this does not explain why male patients of these same female doctors were so satisfied, note the researchers.

For more details, see "Effect of physician and patient gender concordance on patient satisfaction and preventive care practices," by Julie Schmittdiel, M.A., Kevin Grumbach, M.D., Dr. Selby, and Charles P. Quesenberry, Jr., Ph.D., in the November 2000 Journal of General Internal Medicine 15, pp. 761-769.

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