Determinants of women's choice of obstetrician/gynecologist.
J Womens Health Gend Based Med 2002 Mar;11(2):175-80 (ISSN: 1524-6094)
Zuckerman M; Navizedeh N; Feldman J; McCalla S; Minkoff H
Department of Obstetrics and Gynecology, Maimonides Medical Center, Brooklyn, New York, USA.
INTRODUCTION: There has been a reported increase in women's desires to have female medical providers. It is unclear if this finding extends to obstetrician/gynecologists or how important gender is relative to other factors in choosing a provider. This study seeks to address these issues. METHODS AND MATERIALS: In community locations in Brooklyn, New York, 537 women completed a questionnaire regarding demographics, gender of their current provider, and whether they considered age, gender, experience, location, or cost to be the most important factor in choosing an obstetrician/gynecologist. They rated their current experience and the importance of gender using a 10-point Likert scale. RESULTS: Overall, 61% of participants preferred a female provider. The proportion did not vary with gender of the interviewer or participants' age. A female provider was preferred by 56% of Protestants, 58% of Catholics, and 58% of Jews and by 74% of Hindus and 89% of Muslims (p = 0.02). Regardless of whether a woman preferred a male or a female provider, 38% of participants felt strongly (7-10 on Likert scale) that gender was important. There was no difference in satisfaction with current provider between women who preferred a male or female provider. Gender was as important in choosing an obstetrician as experience or cost. Almost as many women with a female provider indicated a preference for a male (46%) as women with a male provider who preferred a female provider (54%). CONCLUSIONS: A slight majority of these women, particularly those who are Hindu or Moslem or currently use a female, prefer female providers. Only a minority of these women feel strongly about their preference, and women with male providers are as satisfied as are women with female providers. Gender of provider was about as important as a physician's experience in choice of clinician.
Women's provider preferences for basic gynecology care in a large health maintenance organization.
J Womens Health Gend Based Med 1999 Jul-Aug;8(6):825-33 (ISSN: 1524-6094)
Schmittdiel J; Selby JV; Grumbach K; Quesenberry CP
Division of Research, Kaiser Permanente Medical Care Program (Northern California Region), Oakland, USA.
To examine women's preferences for the type and sex of the provider of basic gynecological services and the correlates of these preferences, we mailed a cross-sectional survey to 8406 women in a large group model health maintenance organization (HMO) in northern California, with a response rate of 73.6%. Four questions asked women the type (obstetrician/gynecologist, nurse practitioner, or primary care physician) and sex of provider who performed their last pelvic examination and their preferences in type and sex of provider for these examinations. This was a random sample of female HMO members 35-85 years of age who were empaneled with a primary care physician from one of three categories: family practitioner, general internist, or subspecialist. Of the 5164 respondents who received their last pelvic examination at Kaiser Permanente, 56% had seen a gynecologist, 26% a nurse practitioner, and only 18% their own primary care physician for the examination. Of these women, 60.3% reported preferring a gynecologist for basic gynecology care, 12.6% preferred a nurse practitioner, 13.3% preferred their own primary care physician, and 13.8% had no preference. Patients of family practitioners were more likely to prefer their own primary care practitioner than patients of other types of doctors. The strongest independent predictor of preferring a gynecologist over the primary care physician was having seen a gynecologist for the last pelvic examination (OR = 28.3, p < 0.0001). Other independent predictors of preferring a gynecologist were younger age, higher education and income, and having a male primary care physician. Of respondents, 52.2% preferred a female provider for basic gynecological care, and 42.0% had no preference for the sex of the provider. Preferring a female provider was strongly and independently associated with lower income, higher education, nonwhite race, having a male primary care physician, having an older primary care, physician, and having seen a female provider at the last pelvic examination. In this HMO, a majority of women reported a preference for seeing an obstetrician/gynecologist for their routine gynecological care, despite having a primary care physician. This most likely reflects the strong influence of previous patient experience and that familiarity with a particular type of provider leads to preferences for that type. This medical group's structure probably also affects preferences, as in this HMO, primary care physicians can be discouraged from performing pelvic examinations. Many women do prefer female providers for pelvic examinations, but a large percentage have no preference. These women often see male providers for basic gynecological care. As managed care places increasing emphasis on providing integrated, comprehensive primary care, this apparent preference for specialty gynecological care will require further study.
It ain't necessarily so: most women do not strongly prefer female obstetrician-gynaecologists.
J Obstet Gynaecol Can 2002 Nov;24(11):885-8 (ISSN: 1701-2163)
Fisher WA; Bryan A; Dervaitis KL; Silcox J; Kohn H
Department of Obstetrics and Gynaecology, University of Western Ontario, London, ON, Canada.
OBJECTIVE: To examine whether Canadian women seeking care from obstetrician-gynaecologists prefer to see female or male physicians or have no strong preference in this regard. METHODS: A self-administered questionnaire assessing women's "strong preference" for female or male obstetrician-gynaecologists, or their lack of a strong preference in this area, was completed by 409 women (93.8% response rate) attending two hospital-based obstetrics and gynaecology outpatient clinics in London, Ontario. RESULTS: Overall, 75% of women stated that they had no strong preference concerning the gender of their obstetrician-gynaecologist; 21% strongly preferred a female obstetrician-gynaecologist; and 4% strongly preferred a male obstetrician-gynaecologist. Women who were single, pregnant, or had a history of abortion, sexual coercion, relationship violence, sexual dysfunction, or sexually transmitted disease were no more likely to prefer to see a female obstetrician-gynaecologist than were women without these characteristics. CONCLUSION: A clear majority of women expressed no strong preference for the gender of their obstetrician-gynaecologist, and preference for a female obstetrician-gynaecologist was not associated with a history of sensitive gender-related medical concerns. Nationally representative research is needed to clarify women's preferences in this domain across the regions of Canada and to determine the strength and correlates of any such preferences. Patient care and human rights implications of women's preference for the gender of their obstetrician-gynaecologist will need to be carefully considered as well.
The importance of physician gender in the selection of an obstetrician or a gynecologist.
Am J Obstet Gynecol 2002 May;186(5):926-8 (ISSN: 0002-9378)
Plunkett BA; Kohli P; Milad MP
Department of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, Ill 60611, USA.
[email protected].
OBJECTIVE: The purpose of this study was to determine the importance of gender in the selection of an obstetrician or a gynecologist. STUDY DESIGN: At a university-based hospital, 46 patients after delivery and 79 patients after gynecologic surgery who had selected their physician within the previous year were interviewed to determine the importance of physician gender in the selection of an obstetrician or gynecologist. Chi-square test, Fisher exact test, and the Student t test were used for statistical analysis. RESULTS: Of the 125 women who were surveyed, 52.8% of the women preferred a female physician, 9.6% of the women preferred a male physician, and 37.6% of the women stated no gender preference, with no significant difference between the obstetric and gynecologic groups. The groups were similar with respect to ranking the importance of gender; 24.8% of the women who were interviewed considered gender to be one of the 3 most important factors in the selection of a physician. When participants were asked to choose gender over physician experience, bedside manner, or competency, gender was selected by 12%, 10.4%, and 0.8%, respectively, with no significant differences between the groups. CONCLUSION: For most women, physician gender is not of primary importance in the selection of an obstetrician or gynecologist
