Addressing patient gender bias toward trainees in the field of andrology (original) (raw)
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BMC Family Practice, 2015
Background: Biological and sociocultural differences between men and women may play an important role in medical treatment. Little is known about the awareness of these differences among general practitioners (GPs) and if they consider such differences in their medical practice. The aim of this study was to explore GPs' perception of sex and gender aspects in medical treatment. Methods: We conducted five focus group discussions (FGDs) with 29 physicians (mainly GPs) in Sweden. A discussion guide with semi-structured questions was used. All FGDs were audio-recorded and transcribed word-byword. Data were analysed through inductive thematic analysis with no predetermined categories. Results: Three main categories emerged from the data. The first category emphasised GPs' experiences of sex and gender differences in diagnosing and assessment of clinical findings. Medical treatment in men and women was central in the second category. The third category emphasised GPs' knowledge of sex differences in drug therapy. Conclusions: The GPs stated they had little knowledge of sex and gender differences in drug treatment, but gave multiple examples of how the patient's sex affects the choice of treatment. Sex and gender aspects were considered in diagnosing and in the treatment decision. However, once the decision to treat was made the choice of drug followed recommendations by local Drug and Therapeutics Committee, which were perceived to be evidence-based. In the analysis we found a gap between perceived and expressed knowledge of sex and gender differences in drug treatment indicating a need of education about this to be included in the curriculum in medical school and in basic and specialist training for physicians. Education could also be a tool to avoid stereotypical thinking about male and female patients.
Sexual & Reproductive Healthcare, 2012
To gain a deeper understanding of how undergraduate male medical students experience a pelvic examination learning concept and performing the first pelvic examination (PE) on a professional patient. A qualitative study. In-depth interviews with 12 male medical students' after their involvement in a learning session about the PE, with professional patients and a supervising gynecologist as instructors. The interviews were analyzed according to the constant comparative method, a variety of content analysis, to acquire a deeper understanding of the students' experiences and the ongoing social processes. The essence of the entire analysis was "Unexpected enlightening of a 'female world'" and was identified from the three categories; "Not just any exam", "Professional supportive interaction" and "Humble awareness". The male students' most prominent concern was how to establish a professional rapport with the patient in the PE situation. Beneficial active support from the professional patient and the gynecologist assisted the students to overcome inherent barriers and facilitated the examination procedure. The informants gained "inside information" from the patients' perspective of being examined leading to a new awareness about an earlier unknown "female world" that is what women might go through before and during a PE and an humble understanding of how vulnerable it is to be placed in the examination position. The beneficial PE learning concept promoted an unexpected insight in what a woman might experience during a PE, creating a humble awareness of this vulnerable intimate situation and ideas for how to establish professional rapport.
Physician–patient interaction: a gynecology clinic in Turkey
Social Science & Medicine, 2003
Evidence for gender differences in physicians' communication with their patients comes primarily from Western countries. Little is known about whether these gender differences would also be observed in Turkey, where there are explicit rules about male-female conduct. The purpose of this study was to observe male and female gynecologists' communication with their patients in a gynecology clinic at a state hospital in Istanbul, Turkey. Four male and three female gynecologists were observed in their interaction with 70 patients over 10 days. The observations were conducted during both the history taking and the actual examination sessions by a woman researcher. The results reported in this paper are based on the extensive field notes taken during the observations. Important differences were revealed in interactions between male vs female gynecologists and their patients. Namely, interactions differed in terms of conversation initiation, communication style, use of technical and colloquial language, frequency of eye contact, patience, and provision of information. Communication characteristics specific to interactions between male gynecologists and their patients included a 'blaming the victim' approach, differential treatment of patients, and underestimation of patients' abilities. Environmental factors that affected physicians' interaction with their patients are reported in conjunction with physicians' use of these external factors to explain the problems they experienced in physician-patient interaction. The discussion focuses on alternative explanations for and future research implications of the observed differences between male and female gynecologists in this setting. r
WHAT ARE THE FACTORS AFFECTING THE INTERACTION BETWEEN THE PATIENT AND THE PHYSICIAN?
International Journal of Health Management and Tourism, 2019
In this review study, the factors affecting the interaction between the patient and the physician were investigated and the studies were taken into consideration for evaluation. The results of the investigations showed that the factors such as values, beliefs and opinions, gender of physicians, cognitive characteristics, behavior of physicians, race and ethnicity, social styles of patients, health status, informed consent, physician image, personal characteristics of patients and patient relatives have a significant effect in this regard. In the studies we reviewed, important findings were found to be highlighted under these headings. In particular, it was found that female physicians establish more empathy, that physicians with better cognitive characteristics are more effective in interaction, that well-informing the patient is beneficial, that nonverbal communication should be given importance in addition to verbal communication, that a good communication should be established with patient relatives, and that patient beliefs should be taken into consideration. In addition, elderly patients, patients with low literacy levels, and male patients were found to have more trouble in the interaction with physicians.
Patient preference for genders of health professionals
Social Science & Medicine, 1997
Preferences for physicians' gender is an obvious and well documented example of considerations of patients' attitudes. But research carried out in this field is rather limited to the domain of family medicine. This article describes preferences for 13 different health professions: surgeons, neurologists, anaesthetists, internists, general practitioners, psychiatrists, psychologists, social workers, hospital and district nurses, home helps, gynaecologists and midwives. Our investigation also concerns the reasons for people's preferences. In February 1993 a self-administered survey was completed and returned by 961 out of 1113 (response 86%) participants of the Dutch Health Care Consumers Panel, a panel resulting from a random sample of Dutch households. On a range of different health professions a varying minority of patients prefer a care provider of a particular gender. There are virtually no sex preferences for the more "instrumental" health professions (e.g. surgeons, anaesthetists). Gender preferences are stronger for those health professions more likely engaged in intimate and psychosocial health problems (e.g. gynaecologists and GPs). Preferences expressed do not relate to sex stereotypes of gender differences in instrumentality, expertise, efficiency, consultation length, and personal interest. The majority of persons who prefer female health professionals indicate that they talk more easily to females than to males, and feel more at ease during (internal) examination by females than by males. Persons who prefer male health professionals use the same reasons in favour of males. The discussion relates to gender differences in the communication style of male and female physicians. © 1997 Elsevier Science Ltd
The professional attitudes and clinical practices of men and women generalists
Canadian family physician Médecin de famille canadien, 1989
Data from a 1983-84 Quebec generalists' survey were used to compare the professional attitudes and clinical practices of women physicians with those of their male colleagues. The survey was conducted on a random sample of 736 Quebec generalists and achieved a 83.7% response rate. Analyses were performed separately for fee-for-service physicians and for salaried physicians working in local community health centers (CLSCS). Results showed more gender differences among fee-for-service physicians than among salaried physicians. Women in private practice were more likely than their male colleagues to value the multidisciplinary, social, and humanistic aspects of patient care. For their part, women salaried physicians reported being significantly more involved in the social and preventive dimensions of health care than their male colleagues. Important attitudinal differences were observed between fee-for-service and salaried generalists, regardless of gender. This study suggests that ...
Opinion and analysis : Accounting for physicians' gender expectations improves men's health medicine
Rev Panam Salud Publica, 2018
A tenet of the emerging field of men's health is that gender matters in health care. For example, while women have been socialized into seeking out preventative care through behavior change interventions such as the "pink" campaign for breast cancer awareness, men often avoid health care due to social expectations about male invulnerability. Men's health practitioners seek to address this gap. In this opinion and analysis piece, the authors argue that in addition to being aware of the effects of gender identity in their male patients' attitudes, lifestyle , and health, physicians must assess how their own ideas about masculinity influence their practice. To make this argument the authors 1) provide the social scientific definition of gender, 2) describe the limitations of considering the influence of patients' but not doctors' gender expectations in treatment interactions, and 3) draw on examples from their own research and practice to suggest remedies for such incomplete attention to gender in clinical practice. Social scientists define gender as a cultural practice rather than a biological construct. According to this definition, attitudes about gender are the product of cultural expectations about how men or women should be. While biological attributes such as hormone levels do mediate individual feelings and attributes, the fact that ideals of masculinity and femininity vary so widely across place and ABSTRACT The field of men's health seeks to improve men's health outcomes by accounting for the specific ways that gender influences male health behaviors. To meet this goal, physicians must also account for the ways that their own cultural assumptions about masculinity influence their clinical practice. Gender is not solely biological. It is a way of acting out masculinity or femininity that varies across individual and cultural contexts. Thus, doctors and patients might have different ideas about how a man should feel and act. These attitudes can influence whether men's bodily changes are viewed as pathological versus normal. Two simple interventions are proposed to enable physicians to identify their own assumptions about masculinity and differentiate these from their patients' in order to make more appropriate treatment decisions. The first is advocating for medical guidelines for their specialty that account for gender as context-specific rather than universal. The second is incorporating attention to gender into their daily clinical practice by asking rather than assuming what patients want in order to base treatment decisions on patients' rather than physicians' ideas of how men should feel and behave.