Empirical Review

Physician Gender and Patient Centered Communication

Objective

  • This study synthesizes the results of two meta-analytic reviews on the effects of physician gender on communication in medical visits.
  • A communication framework that reflects patient-centeredness and the functions of the medical visit were used.

Methods

  • Online database searches of English-language abstracts between 1967 to 2001
  • Searched database included:
    • MEDLINE, AIDSLINE, PsycINFO, and BIOETHICS
  • Hand search of reprint files and the reference sections of review articles and other publications also performed.
  • Studies using a communication data source such as audiotape, videotape, or direct observation were identified through bibliographic and computerized searches.

Results

  • Over 150 different variables from 23 studies were sorted into independent categories that later allowed for summarization.
  • Some categories included:
    • data gathering and facilitation of patient disclosure
    • patient education and counseling
    • emotional responsiveness
    • partnership building
  • Medical visits with female physicians were, on average, two minutes (10%) longer than those of male physicians.
  • During these longer visits, female physicians engaged in significantly more communication that was considered patient-centered.
    • They engaged in more active partnership behaviors, positive talk, psychosocial counseling, psychosocial question asking, and emotionally focused talk.
  • Female physicians asked more psychosocial questions than male physicians
    • Three of six studies reported significant results indicating higher levels of psychosocial questioning for female physicians, while none reported higher levels of psychosocial questioning by male physicians.
  • Patients of female physicians spoke more overall, disclosed more biomedical and psychosocial information, and made more positive statements to their physicians than did the patients of male physicians.
  • Male physicians demonstrated higher levels of emotionally focused talk than their female colleagues.
  • Female primary care physicians and their patients engaged in more communication that can be considered patient-centered and had longer visits than did their male colleagues.