Bertakis Klea D, Franks Peter, Azari Rahman
Department of Family and Community Medicine, Center for Health Services Research in Primary Care, University of California, Davis, USA.
J Am Med Womens Assoc (1972). 2003 Spring;58(2):69-75.
To measure the impact of physician gender on patient satisfaction, controlling for confounding patient variables, and to examine the extent to which differences in satisfaction with male and female physicians can be explained by physician practice styles.
New adult patients (n=509) were randomized to see male and female primary care physicians at a university medical center outpatient facility. Patient sociodemographics and self-reported health status (using the Medical Outcomes Study Short Form-36) were measured before the initial visit, and satisfaction with the physician was measured immediately following the visit. The entire medical encounter was videotaped and physician practice style was later analyzed using the Davis Observation Code.
Female physicians spent a significantly greater proportion of the visit on preventive services and counseling than male physicians did, and male physicians devoted more time to technical practice behaviors and discussions of substance abuse. Visit length was not significantly different for male and female physicians. Patients of female physicians were more satisfied than were those of male physicians, even after adjusting for patient characteristics, visit length, and physician practice style behaviors.
Patient satisfaction with primary care physicians appears to be influenced not only by patient characteristics and physician behaviors, but also by the gender of the provider. Possible explanations for this may be that psychosocial aspects of the physician-patient interaction are different for male and female physicians. Patients may also bring expectations about female physicians to the encounter, presuming them to be more empathetic, nurturing, and responsive.
在控制患者混杂变量的情况下，衡量医生性别对患者满意度的影响，并考察医患互动中男性和女性医生在满意度上的差异能在多大程度上由医生的执业风格来解释。
509名成年新患者被随机分配到一所大学医疗中心门诊去看男性和女性初级保健医生。在初次就诊前测量患者的社会人口统计学特征和自我报告的健康状况（使用医学结局研究简表36），并在就诊结束后立即测量患者对医生的满意度。整个医疗问诊过程都进行了录像，之后使用戴维斯观察代码对医生的执业风格进行分析。
与男性医生相比，女性医生在预防服务和咨询上花费的就诊时间比例显著更高，而男性医生则将更多时间用于技术执业行为和药物滥用讨论。男性和女性医生的就诊时长没有显著差异。即使在对患者特征、就诊时长和医生执业风格行为进行调整之后，女性医生的患者比男性医生的患者更满意。
患者对初级保健医生的满意度似乎不仅受患者特征和医生行为的影响，还受医疗服务提供者性别的影响。对此的可能解释是，男性和女性医生在医患互动中的心理社会方面存在差异。患者在就诊时可能也会对女性医生抱有期望，认为她们更具同理心、更有亲和力且反应更积极。
