Are patients of women physicians screened more aggressively? A prospective study of physician gender and screening.

OBJECTIVE

To determine the effects of physician gender on rates of Pap testing, mammography, and cholesterol testing when identifying and adjusting for demographic, psychosocial, and other patient variables known to influence screening rates.

DESIGN

A prospective design with baseline and six-month follow-up assessments of patients' screening status.

SETTING

Twelve community-based group family practice medicine offices in North Carolina.

PARTICIPANTS

1,850 adult patients, aged 18-75 years (six-month response rate, 83%), each of whom identified one of 37 physicians as being his or her regular care provider.

MAIN RESULTS

Where screening was indicated at baseline, the patients of the women physicians were 47% more likely to get a Pap test [odds ratio (OR) = 1.47, 95% confidence interval (CI) = 1.05, 2.04] and 56% more likely to get a cholesterol test (OR = 1.56, 95% CI = 1.08, 2.24) during the study period than were the patients of the men physicians. For mammography, the younger patients (aged 35-39 years) of the women physicians were screened at a much higher rate than were the younger patients of the men physicians (OR = 2.69, 95% CI = 0.98, 7.34); however, at older ages, the patients of the women and the men physicians had similar rates of screening.

CONCLUSIONS

In general, the patients of the women physicians were screened at a higher rate than were the patients of the men physicians, even after adjusting for important patient variables. These findings were not limited to gender-specific screening activities (e.g., Pap testing), as in some previous studies. However, the patients of the women physicians were aggressively screened for breast cancer at the youngest ages, where there is little evidence of benefit from mammography. Larger studies are needed to determine whether this pattern of effects reflects a broader phenomenon in primary care.