title: A study of physician recommendations for reversible contraceptive methods using standardized patients.
abstract: BACKGROUND
  Health care providers may influence patients' choice of contraceptive method, yet little is known about the recommendations they make to their patients.
  
  
  METHODS
  In 2007-2008, a total of 468 physicians at four family medicine and obstetrics and gynecology meetings were randomly assigned to view one of 18 videos of a patient seeking contraceptive advice; the patients were standardized for most relevant behaviors and characteristics, but differed by race and ethnicity, socioeconomic status and gynecologic history. Participants provided their demographic and practice characteristics and completed a survey about their contraceptive recommendations for the patient. Multivariate logistic regression analyses were conducted to identify associations between physician characteristics and recommendations for specific contraceptive methods.
  
  
  RESULTS
  The most frequently recommended methods were the pill (89%) and ring (80%), followed by the levonor-gestrel IUD (64%), patch (56%), injectable (49%) and copper IUD (45%). Oral contraceptives were more likely to be recommended by private practice physicians than by academic physicians (odds ratio, 2.9). Recommendations for the ring were less common among family physicians and those 56 or older than among obstetrician-gynecologists and those 35 or younger (0.6 and 0.3, respectively), and more common among physicians in private practice than among those in academia (2.4). The patch and injectable were more commonly recommended by family physicians than by obstetrician-gynecologists (2.6 and 2.5, respectively). Both IUD types were recommended less often by physicians 36 or older than by younger ones (0.2-0.5).
  
  
  CONCLUSIONS
  The advice women receive about contraception may vary according to the characteristics of their provider. Research on the reasons for these differences is needed.
authors.affiliation: Department of Family and Community Medicine, University of California, San Francisco, CA, USA. cdehlendorf@fcm.ucsf.edu
authors.forename: Christine
authors.initials: C
authors.lastname: Dehlendorf
authors.forename: Kevin
authors.initials: K
authors.lastname: Grumbach
authors.forename: Eric
authors.initials: E
authors.lastname: Vittinghoff
authors.forename: Rachel
authors.initials: R
authors.lastname: Ruskin
authors.forename: Jody
authors.initials: J
authors.lastname: Steinauer
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D003267:Contraception; D003657:Decision Making; D005194:Family Practice; D005260:Female; D006176:Gynecology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009774:Obstetrics; D010817:Physician-Patient Relations; D010820:Physicians; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*