Patient gender and physician practice style.

Background: Patient and physician gender may impact the process of medical care and its outcomes. Our objective was to investigate the influence of patient gender on what takes place during initial primary care visits while controlling for other variables previously demonstrated to affect the physician-patient interaction, such as physician gender and specialty, patient health status, pain, depression, obesity, age, education, and income.

Methods: New patients (315 women, 194 men) were randomized for care by 105 primary care physicians. Sociodemographic information, self-reported health status and pain measures, a depression evaluation, screening for alcoholism, history of tobacco use, and measured body mass index (BMI) were collected during a previsit interview. The entire medical visit was videotaped, and then analyzed using the Davis Observation Code (DOC) system.

Results: There was no significant difference in the visit length or work intensity (number of behavioral codes) for female patients compared with male patients; however, women's visits had more discussions regarding the results of the therapeutic interventions, more preventive services, less physical examination, and fewer discussions about tobacco, alcohol, and other substance abuse.

Conclusions: There are significant differences in the process of care between female and male patients. Physicians may be making medical decisions based on gender-related considerations. Strategies for implementing knowledge about these gender differences are crucial for the delivery of gender-sensitive care.