title: Do gender differences affect the doctor-patient interaction during consultations in general practice? Results from the INTERMEDE study.
abstract: OBJECTIVE
  The aim of the study was to ascertain whether disagreement between GPs and patients on advice given on nutrition, exercise and weight loss is related to patient-doctor gender discordance. Our hypothesis is that a patient interacting with a physician of the same gender may perceive more social proximity, notably on health care beliefs and may be more inclined to trust them.
  
  
  METHODS
  The analysis used the Intermede project's quantitative data collected via mirrored questionnaires at the end of the consultation. Multilevel logistic regressions were carried out to explore associations between patient-doctor gender discordance and their disagreement on advice given during the consultation adjusted on patients' and physicians' characteristics. The sample consists of 585 eligible patients and 27 GPs.
  
  
  RESULTS
  Disagreement on advice given on nutrition was observed less often for female concordant dyads: OR = 0.25 (95% CI = 0.08-0.78), and for female doctors-male patients dyads: OR = 0.24 (95% CI = 0.07-0.84), taking the male concordant dyads as reference. For advice given on exercise, disagreement was found less often for female concordant dyads OR = 0.38 (95% CI = 0.15-0.98) and an interdoctor effect was found (P < 0.05). For advice given on weight loss, the probability of disagreement was significantly increased (OR: 2.87 95% CI = 1.29-6.41) when consultations consisted of female patient and male GP.
  
  
  CONCLUSIONS
  Patient-doctor gender concordance/discordance is associated with their agreement/disagreement on advice given during the consultation. Physicians need to be conscious that their own demographic characteristics and perceptions might influence the quality of prevention counseling delivered to their patients.
authors.affiliation: INSERM UMR 1027, Toulouse, France, Université Toulouse III, UMR1027, Toulouse, France, CHU Toulouse, Service d'Epidémiologie, Toulouse, France, annececile.schieber@gmail.com.
authors.forename: Anne-Cécile
authors.initials: AC
authors.lastname: Schieber
authors.affiliation: INSERM UMR 1027, Toulouse, France.
authors.forename: Cyrille
authors.initials: C
authors.lastname: Delpierre
authors.affiliation: INSERM UMR 1027, Toulouse, France, Université Toulouse III, UMR1027, Toulouse, France.
authors.forename: Benoît
authors.initials: B
authors.lastname: Lepage
authors.affiliation: IRDES, Paris, France.
authors.forename: Anissa
authors.initials: A
authors.lastname: Afrite
authors.affiliation: CHU Toulouse, Service d'Epidémiologie, Toulouse, France, CHU Toulouse, Département d'Information Médicale, Toulouse, France.
authors.forename: Jean
authors.initials: J
authors.lastname: Pascal
authors.affiliation: INED, Paris, France.
authors.forename: Chantal
authors.initials: C
authors.lastname: Cases
authors.affiliation: UPRES EA3412, Université Paris 13, Bobigny, France and AP-HP Hôpital Avicenne, Bobigny, France.
authors.forename: Pierre
authors.initials: P
authors.lastname: Lombrail
authors.affiliation: INSERM UMR 1027, Toulouse, France, Université Toulouse III, UMR1027, Toulouse, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Lang
authors.affiliation: INSERM UMR 1027, Toulouse, France.
authors.forename: Michelle
authors.initials: M
authors.lastname: Kelly-Irving
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000209:etiology / Q000517:prevention & control*; D003142:Communication; D004032:Diet / Q000523:psychology / Q000592:standards; D015444:Exercise / Q000502:physiology; D005260:Female; D058006:General Practice / Q000379:methods / Q000592:standards*; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007398:Interpersonal Relations; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D010817:Physician-Patient Relations; D012737:Sex Factors; D015431:Weight Loss / Q000502:physiology; D055815:Young Adult
keywords: Cardiovascular diseases; counselling; gender identity; healthcare disparities; physicians; physician–patient relation; primary care