title: Patient-centered care: the influence of patient and resident physician gender and gender concordance in primary care.
abstract: BACKGROUND
  Patient-centered care (PCC) is thought to significantly influence the process of care and its outcomes and has been identified as part of a comprehensive strategy for improving our nation's healthcare delivery system. Patient and physician gender, as well as gender concordance, may influence the provision of PCC.
  
  
  METHODS
  Patients (315 women, 194 men) were randomized to care by primary care resident physicians (48 women, 57 men). Sociodemographic information, history of health risk behaviors (tobacco use, alcoholism, and obesity), and self-reported global pain and health status were collected before the first visit. That visit and subsequent patient visits to the primary care physician (PCP) were videotaped during the year-long study period. PCC was measured by coding all videotapes using a modified version of the Davis Observation Code.
  
  
  RESULTS
  No significant gender differences in PCC were found between the male and female patients; however, female physicians provided increased PCC to their patients. The greatest amount of PCC was seen in the female patient-female physician gender dyad. Regression analyses, controlling for other patient variables, confirmed that female concordant dyads were associated with a greater amount of PCC. There was no significant relationship for the male patient-male physician concordance (vs. disconcordance).
  
  
  CONCLUSIONS
  These findings highlight the influence of gender in the process of care and provision of PCC. Gender concordance in female patient-female physician dyads demonstrated significantly more PCC. Further research in other clinical settings using other measures of PCC is needed. A public mandate to provide care that is patient-centered has implications for medical education.
authors.affiliation: Department of Family and Community Medicine, University of California School of Medicine, Davis, Sacramento, California 95817, USA. kdbertakis@ucdavis.edu
authors.forename: Klea D
authors.initials: KD
authors.lastname: Bertakis
authors.forename: Rahman
authors.initials: R
authors.lastname: Azari
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D018802:Patient-Centered Care; D010820:Physicians / Q000706:statistics & numerical data*; D011320:Primary Health Care; D012737:Sex Factors