| According to
statistics released by the American Medical Associaton recently, it is
increasingly likely that the doctor you see for routine care will be a
woman. The AMA data indicate that while about only 20% of physicians are
currently women, female students make up 40% of enrollment in medical
schools. Moreover, a higher proportion of women than men are entering
internal medicine, the principal primary-care specialty. This trend,
along with interest in quality of care, has prompted research into the
effects of gender on the doctor/patient relationship. While no
investigations have indicated that either men or women do a better job
of keeping their patients alive and in good health, a few studies have
turned up subtle differences in the way male and female primary-care
doctors respond to female patients.
These studies, most of which have been conducted in the last 10-15
years, are generally small, and their findings can in no way be
extrapolated to every doctor-- either male or female. As we all know
well, interpersonal relationaships are so complex that many of the
contributing factors can't be adequately measured or even described.
Yet, this research to date has produced several interesting
observations, which seem to bode well for the relationship between women
patients and their female physicians.
Tests prescribed. A 1993 study from the University of Minnesota of
almost 25,000 women in a large health plan determined that those who had
a female primary-care physician were twice as likely to have an annual
Pap smear as those whose interists were men. They were also 41% more
likey to have a mammogram than those with male doctors. However, ther is
no evidence that male gynecologists order fewer such tests.
Length of visit. As a rule, female doctors seem to spend more time with
their patients during office visits. In one of the latest studies, which
involved 25 male and 25 female physicians at Massachusetts General
Hospital in Boston, researchers videotaped office visits of both male
and female patients. They found that the male doctors spent an average
of 22.4 minutes with women patients, and women doctors spent an average
of 29.9 minutes.
Interpersonal dynamics. Many studies have hinted that female doctors are
more likely to treat patients as equals. The Boston study bore this out,
finding that conversations were most balanced when both doctor and
patient were female. On average, female doctors made 261 utterances
(defined as meaningful string of words) during a visit, and women
patients spoke 254 times. In comparison, male doctors spoke 208 times
and their female patients, 175..
The tenor of the conversations between doctor and patient more
frequently indicated a partnership, rather than a paternalistic
relationship, when both parties were women. The Boston group found that
the word "we" was exchanged most frequently between female
patients and doctors, and that supportive gestures, including nods,
smiles, and responses of agreement, were also the most frequent in this
setting.
Information exchange. Most studies have found that women patients
volunteer more information to women doctors. However, the Boston
researchers noted that women provided - and received - the same amount
of information from physicians of both sexes.
The patient's responsibility. If there's a message in these studies, it
may be that many of us feel more comfortable discussing the most
intimate details of our lives with another woman. However, we can't
expect any doctor - male or female - to be a mind reader. To ease the
flow of information during your next visit, do some advance preparation.
Jot down your symptoms and the drugs you are taking. If you are seeing a
new doctor, bring your medical history, as well as your concerns and
questions.
Reprinted:
Harvard Women's Health Watch. Volume II, Number 9
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