Physician gender and psychosocial care for children: attitudes, practice characteristics, identification, and treatment.
OBJECTIVE
To examine differences by physician gender in the identification and treatment of childhood psychosocial problems.


METHODS
Survey of patients (n = 19,963) and physicians (n = 366) in primary care offices in 2 large, practice-based research networks. Multivariate regressions were used to control for patient, physician, and visit characteristics, with a correction for the clustered sample.


METHODS
Children ages 4 to 15 years seen consecutively for nonemergent care.


METHODS
Physician report of attitudes, training, practice factors, and identification and treatment of psychosocial problems. Parental report of demographics and behavioral symptoms.


RESULTS
Compared with male physicians, female physicians were less likely to view care for psychosocial problems as burdensome. They were more likely to see children who were female, younger, black or Hispanic, in single-parent households, enrolled in public or managed health plans, and with physical health limitations. Children seen by male physicians had higher symptom counts. Male physicians were more likely to report having primary care responsibility for their patient and that parents agree with their care plan. Female physicians spent more time with patients. After controlling for these differences, female physicians did not differ from male physicians in identification or treatment of childhood psychosocial problems.


CONCLUSIONS
Male and female physicians see different kinds of children for different visit purposes and have different kinds of relationships with their patients. After controlling for these factors, management of childhood psychosocial problems does not differ by physician gender. Improving management of psychosocial conditions depends on identifying modifiable factors that affect diagnosis and treatment; our work suggests that characteristics of the practice environment, physician-patient relationship, and patient self-selection deserve more research.
Scholle
S H
SH
Department of Psychiatry, University of Pittsburgh, Pennsylvania 15213, USA. schollesh@msx.upmc.edu
Gardner
W
W
Harman
J
J
Madlon-Kay
D J
DJ
Pascoe
J
J
Kelleher
K
K
D000293:Adolescent; D001291:Attitude of Health Personnel; D002170:Canada; D002648:Child; D002653:Child Behavior Disorders / Q000175:diagnosis / Q000628:therapy; D002675:Child, Preschool; D016000:Cluster Analysis; D005194:Family Practice; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000175:diagnosis / Q000628:therapy; D009819:Office Visits / Q000706:statistics & numerical data; D010822:Physicians, Women; D010818:Practice Patterns, Physicians'; D011647:Puerto Rico; D012044:Regression Analysis; D012737:Sex Factors; D014481:United States