Review
Physician's gender, communication style, patient preferences and patient satisfaction in gynecology and obstetrics: A systematic review

https://doi.org/10.1016/j.pec.2012.06.034Get rights and content

Abstract

Objective

Review of studies published in the last 10 years about women seeking gynecological- or obstetrical care and physician's gender in relation to patient preferences, differences in communication style and patient satisfaction.

Methods

Studies were identified by searching the online databases PubMed, PsycINFO, Embase and the Cochrane Library. The search strategies ‘gender’; ‘obstetrics’ and ‘gynecology’ were combined with ‘communication’; ‘physician–patient relations’; ‘patient preference’ and ‘patient satisfaction’.

Results

After screening title and abstract, evaluating full text and quality assessment, 9 articles were included in this review. Most patients preferred a female rather than a male gynecologist–obstetrician. This was partly explained by a more patient-centered communication style used by female gynecologists–obstetricians. Also experience and clinical competence were important factors in choosing a gynecologist–obstetrician. It was not clear whether patient's age or ethnicity influenced patients gender preference. Patient satisfaction increased when gynecologists–obstetricians used a patient-centered communication style.

Conclusion

Preference for a female gynecologist–obstetrician might be explained by a more patient-centered communication style used by female gynecologists–obstetricians. Using a patient-centered communication style increases patient satisfaction.

Practice implications

To increase patient satisfaction, gynecologists–obstetricians should learn to integrate patient-centered communication style into the consultation.

Introduction

Two studies in family practice showed that female patients preferred a female physician and that female general practitioners were more often consulted for women's health problems compared to male general practitioners [1], [2]. Especially when gynecological care is needed there is a preference for a female general practitioner [3], [4]. Gynecological and obstetrical consultations mostly include a pelvic exam so it is expected that female patients prefer a female gynecologist–obstetrician. Because nowadays more female- than male residents start working in gynecology and obstetrics there might become a hesitance for males to enter this specialization [5], [6]. This may lead to a shortage in gynecologists–obstetricians and to less diversity in the profession. Therefore it is necessary to get insight into gender preferences in gynecology and obstetrics.

Preferences for a female general practitioner were related to the use of a more patient-centered communication style, meaning female general practitioners were more attentive, gave more information and showed more sympathy [7]. Because gender preferences might be caused by differences in communication style between male and female physicians we searched for evidence concerning gender differences in communication style in gynecology and obstetrics. Patient-centered communication style might be of even more importance in gynecology–obstetrics when discussing the more delicate and intimate subjects of health and performing pelvic examinations. Therefore we need information about gynecologist's–obstetrician's gender differences in communication style.

Both female gender of the physician and communication style were found to be related to female patients satisfaction [8]. A study done in the emergency department also concluded that women trust female physicians more compared to male physicians and were more satisfied when seen by a female physician [9]. Because communication and patient satisfaction lead to better adherence to therapy and to better health outcomes, attention to patient satisfaction in relation with gynecologist's–obstetrician's gender is very important [10], [11], [12].

The aim of this review therefore is to give an overview of all studies published in the last 10 years about female patients seeking gynecological or obstetrical care and gynecologist's–obstetrician's gender in relation to patient gender preferences, differences in communication style and patient satisfaction. To date there have been no reviews published about these subjects.

Section snippets

Methods

Studies were identified by searching the online databases PubMed, PsycINFO and Embase. The literature search was setup with help from a medical librarian. The searches in these three databases were performed in January 2010 and repeated in January 2011 to identify relevant studies on gynecologist's gender in relation with gynecologist's communication style, patient preference and patient satisfaction. The initial search was exactly repeated in 2011 to be able to include the most recent

Results

The previously described search strategy resulted in 246 hits in PubMed, leaving 93 studies for screening after excluding studies published before 2000, not published in English, Dutch or German and after removing duplicates. Selection of studies was based on screening title and abstract followed by evaluating full text, resulting in 12 relevant studies (Fig. 1). The search strategies in PsycINFO and Embase resulted in 138 and 272 hits respectively, leaving 98 respectively 194 studies for

Discussion

The first finding of our study is that about half of the women did not have any gender preference. Those who did express a gender preference, preferred a female gynecologist–obstetrician. Preference for a female gynecologist–obstetrician increases when physical examination was performed during the consultation, resulting in half of the patients preferring a female physician [20], [24]. In gynecology and obstetrics most, if not all, consultations include a pelvic examination so we can conclude

Financial support

None.

Conflict of interest

None.

Disclosure

I confirm all patient/personal identifiers have been removed or disguised so the patient/person(s) described are not identifiable and cannot be identified through the details of the story.

Acknowledgement

Elmi Peters, medical librarian.

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