Frank E, Harvey L K
Department of Family and Preventive Medicine, Emory University School of Medicine, Atlanta, Ga, USA.
Arch Fam Med. 1996 Apr;5(4):215-9. doi: 10.1001/archfami.5.4.215.
As the number of women in medicine and the emphasis on prevention and primary care increase in the United States, it is important to know the extent to which female and male physicians advise patients about prevention. It is also important to know whether any gender-based differences are attributable to women's higher rates of choosing primary care specialties. Prior studies have examined only small populations of physicians, limited physician specialties, or few prevention-related outcomes.
Telephone survey from a systematic random sample of the Physician Masterfile maintained by the American Medical Association. One thousand US physicians (167 women and 833 men); a 48% response rate. Self-reported frequency with which physicians review patients' health behaviors and initiate counseling about unhealthy behaviors.
Of the surveyed physicians, 44% stated that they always reviewed the patient health behaviors in question, and 36% usually systematically counseled patients when unhealthy behaviors were known. Female physicians were significantly more likely than were male physicians to report systematic counseling about unhealthy behaviors (52% vs 37.8%, P < .001, chi 2). We also analyzed our data by adjusting for age and including only family and general physicians and internists. After these adjustments, gender-based differences remained in the direction of female physicians being more likely than male physicians to report reviewing patients' health practices and providing systematic counseling, although these differences no longer reached statistical significance. Gender-related differences were greatest for more sensitive behaviors (ie, drug use and sexual behaviors). Primary care physicians were more likely than other physicians to review and counsel patients about health behaviors. This specialty-based difference was more significant among male than among female physicians.
In this random sample, although all physicians counseled patients inconsistently about prevention, female physicians reported systematically counseling patients more than did male physicians, and primary care physicians reviewed and counseled more often than did physicians in other specialties.
在美国，随着医学界女性人数的增加以及对预防和初级保健的重视程度提高，了解男女医生就预防问题向患者提供建议的程度非常重要。了解是否存在任何基于性别的差异可归因于女性选择初级保健专科的比例较高也很重要。先前的研究仅调查了少量医生群体、有限的医生专科或很少的与预防相关的结果。
对美国医学协会维护的医师主档案进行系统随机抽样的电话调查。1000名美国医生（167名女性和833名男性）；回复率为48%。自我报告医生审查患者健康行为并就不健康行为开展咨询的频率。
在接受调查的医生中，44%表示他们总是审查相关患者的健康行为，36%在知晓患者存在不健康行为时通常会系统地为患者提供咨询。女医生比男医生更有可能报告就不健康行为进行系统咨询（52%对37.8%，P<.001，卡方检验）。我们还通过调整年龄并仅纳入家庭医生、普通内科医生和内科专科医生来分析数据。经过这些调整后，基于性别的差异仍然存在，女医生比男医生更有可能报告审查患者的健康行为并提供系统咨询，尽管这些差异不再具有统计学意义。对于更敏感的行为（即药物使用和性行为），与性别相关的差异最大。初级保健医生比其他医生更有可能审查和咨询患者的健康行为。这种基于专科的差异在男性医生中比在女性医生中更显著。
在这个随机样本中，尽管所有医生在预防问题上对患者的咨询都不一致，但女医生报告系统咨询患者的情况比男医生更多，并且初级保健医生比其他专科的医生审查和咨询的频率更高。
