Huston S, Sleath B, Rubin R H
University of Michigan, College of Pharmacy, 428 Church Street, Ann Arbor, MI 48109-1065, USA.
J Womens Health Gend Based Med. 2001 Apr;10(3):279-87. doi: 10.1089/152460901300140031.
Hormone replacement therapy (HRT) is a major issue confronting millions of women today, and general internal medicine and family practice physicians are an important source of information and counseling on this issue. Previous studies have suggested that HRT discussion and prescribing are more frequent with female than with male physicians, but others have suggested age and practice setting may be the reason for observed differences. We attempted to determine if physician gender influenced HRT discussion frequency between physicians and their patients using cross-sectional, secondary analysis of data collected at general internal medicine and family practice clinics at the University of New Mexico Health Sciences Center. Twenty-seven family practice and internal medicine resident physicians (15 female, 12 male) participated. There were 127 female patients age 45 and older. Audio-taped observations of patient-physician visits collected during 1995 for a study on patient-physician communication and patient satisfaction were used. There was less frequent discussion with female than male physicians (OR = 0.42, p = 0.0014). HRT was discussed during 51 visits. Patients initiated HRT discussion in 39.2% of visits in which it was discussed. Patients with diabetes were less likely to discuss HRT (OR = 0.25, p = 0.0122). Increasing year of physician residency was associated with decreased discussion of HRT (OR = 0.51, p < 0.0001). In this health sciences center, with physicians similar in age and training, male physicians discussed HRT significantly more often than did female physicians.
激素替代疗法(HRT)是当今数百万女性面临的一个主要问题,普通内科和家庭医生是关于这个问题的重要信息和咨询来源。先前的研究表明,女性医生比男性医生更频繁地讨论和开HRT的处方,但也有人认为年龄和执业环境可能是观察到的差异的原因。我们试图通过对新墨西哥大学健康科学中心普通内科和家庭诊所收集的数据进行横断面二次分析,来确定医生性别是否会影响医生与患者之间HRT的讨论频率。27名家庭医生和内科住院医生(15名女性,12名男性)参与了研究。有127名45岁及以上的女性患者。使用了1995年为一项关于医患沟通和患者满意度的研究而收集的医患就诊录音观察资料。与男性医生相比,与女性医生的讨论频率较低(比值比=0.42,p=0.0014)。在51次就诊中讨论了HRT。在讨论HRT的就诊中,患者发起讨论的占39.2%。糖尿病患者讨论HRT的可能性较小(比值比=0.25,p=0.0122)。医生住院年限的增加与HRT讨论的减少相关(比值比=0.51,p<0.0001)。在这个健康科学中心,年龄和培训相似的医生中,男性医生讨论HRT的频率明显高于女性医生。