Patient-centered communication in primary care: physician and patient gender and gender concordance.
BACKGROUND
Physicians' use of patient-centered communication (PCC) affects important outcomes of care. Although there is evidence that both patient and physician gender affect the process of care, there is limited information about their impact on PCC. Our objective was to investigate the influence of patient and physician gender, as well as gender concordance between patient and physician, on the patient centeredness of primary care visits.


METHODS
Participating primary care physicians (100 family physicians and internists) with clinical practices in the Rochester, New York area, had two unannounced covertly audiorecorded standardized patients' visits. Encounters were analyzed using the Measure of Patient-Centered Communication (MPCC), which measures three aspects of physician communication: Component 1 (Exploring both the disease and illness experience), Component 2 (Understanding the whole person), and Component 3 (Finding common ground).


RESULTS
Compared with male patients, females had interactions characterized by greater PCC (total and Component 2 scores). Whereas female physicians exhibited higher Component 1 scores, male physicians had higher Component 2 scores, and gender-concordant visits also exhibited higher Component 2 scores. However, there were no significant differences in total MPCC scores for encounters of female vs. male physicians or for gender-concordant compared with discordant patient-physician dyads.


CONCLUSIONS
These findings add further evidence that patient gender can affect the interactions between physicians and patients. More research is needed to understand why male patients are less likely to have medical encounters in which their physicians employ a patient-centered practice style.
Department of Family and Community Medicine and Center for Healthcare Policy and Research, University of California, Davis, Sacramento, California 95817, USA. kdbertakis@ucdavis.edu
Klea D
KD
Bertakis
Peter
P
Franks
Ronald M
RM
Epstein
D000328:Adult; D000368:Aged; D003142:Communication; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009518:New York; D018802:Patient-Centered Care; D010817:Physician-Patient Relations; D011320:Primary Health Care; D012737:Sex Factors