Physician and patient gender concordance and the delivery of comprehensive clinical preventive services.
BACKGROUND
Understanding the role of patient- and physician-gender on delivery of preventive services has important implications for identifying strategies to increase preventive service delivery. We attempt to overcome methodological limitations of previous studies in examining the association of the patient-physician gender interaction on the delivery of preventive screening, counseling, and immunization services.


METHODS
In this cross-sectional study, research nurses directly observed 3256 consecutive adult patient visits to 138 family physicians. Delivery of gender neutral US Preventive Services Task Force (USPSTF) recommended screening, health behavior counseling, and immunization services was assessed by direct observation and medical record review. Multilevel regression analyses were used to test the interaction effect of physician and patient gender with preventive service delivery, controlling for patient age, insurance type, number of office visits in the past 2 years and physician age.


RESULTS
The interaction effect of physician and patient gender was not significantly associated with delivery of gender neutral screening, counseling, or immunizations. Patients of female physicians were more up-to-date on counseling services (P < 0.01) and immunizations (P < 0.05) than patients of male physicians. Male patients, independent of physician gender, were more up-to-date on counseling and immunizations (P < 0.01).


CONCLUSIONS
Physician-patient gender concordance is not associated with delivery of more preventive services. Rather, female physicians provide more counseling and immunization services to all of their patients. Previous research showing higher rates of gender-specific screening achieved by women physicians may have been an indication of an overall greater prevention orientation among women physicians rather than a specific benefit of gender concordance.
Flocke
Susan A
SA
Department of Family Medicine and Epidemiology and Biostatistics, Case Western Reserve University, Cleveland, Ohio 44106-7136, USA. susan.flocke@case.edu
Gilchrist
Valerie
V
D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis; D003376:Counseling / Q000706:statistics & numerical data*; D003430:Cross-Sectional Studies; D005194:Family Practice / Q000592:standards*; D005260:Female; D005783:Gender Identity; D015438:Health Behavior; D006801:Humans; D007114:Immunization / Q000706:statistics & numerical data*; D008297:Male; D008327:Mammography / Q000706:statistics & numerical data; D008403:Mass Screening / Q000706:statistics & numerical data*; D008875:Middle Aged; D009820:Ohio; D010808:Physical Examination / Q000706:statistics & numerical data; D010817:Physician-Patient Relations; D011314:Preventive Health Services / Q000706:statistics & numerical data*; D012737:Sex Factors; D014626:Vaginal Smears / Q000706:statistics & numerical data