Video study of physician selection: Preferences in the face of diversity

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Original Research

Video study of physician selection: Preferences in the face of diversity

J Fam Pract. 2003 July;52(7):552-559

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References

1. US Census Bureau Detailed occupation by race, Hispanic origin and sex: 1990. Available at: http://censtats.census.gov/ cgi-bin/eeo/eeojobs.pl. Accessed on June 9, 2003.

2. Johnson LMI ed. Minority Student Opportunities in United States Medical Schools. 15th ed. Washington, DC: Association of American Medical Colleges; 2000.

3. Ackerman-Ross SF, Sochat N. Close encounters of the medical kind: attitudes toward male and female physicians. Soc Sci Med 1980;14A:61-64.

4. Engleman E. Attitudes toward women physicians: a study of 500 clinic patients. West J Med 1974;120:95-100.

5. Challacombe C. Do women patients need women doctors? Practitioner 1983;227:848-850.

6. Fennema K, Meyer D, Owen N. Sex of physician: patients’ p and stereotypes. J Fam Pract 1990;30:441-446.

7. Weyrauch KF, Boiko PE, Alvin B. Patient sex role and preference for a male or female physician. J Fam Pract 1990;30:559-562.

8. Kerssens JJ, Bensing JM, Andela MG. Patient preference for genders of health professionals. Soc Sci Med 1997;44:1531-1540.

9. Graffy J. Patient choice in practice with men and women general practitioners. Br J Gen Pract 1990;40:13-15.

10. Elstad JI. Women’s priorities regarding physician behavior and their preference for a female physician. Women Health 1994;21(4):1-17.

11. Schmittdiel MA, Grumbach K, Selby JV, Quesenberry CP. Effect of physician and patient gender concordance on patient satisfaction and preventive care practices. J Gen Intern Med 2000;15:761-769.

12. Saha S, Taggart SH, Komaromy M, Bindman AB. Do patients choose physicians of their own race? Health Aff (Millwood). 2000;19(4):76-83.

13. Miller W, Sanchez V. Motivating young adults for treatment and lifestyle change. In: Howard G, ed. Issues in Alcohol Use and Misuse by Young Adults. Notre Dame, Ind: University of Notre Dame Press; 1994;55-82.

14. Jonas H, Etzel S, Baransky B. Educational programs in the US medical schools. JAMA 1992;268:1083-1090.

15. Rollnick S, Mason P, Butler C. Health Behavior Change: A Guide for Practitioners. Edinburgh: Churchill Livingstone; 1999.

16. Cooper-Patrick L, Gallo JJ, Gonzales JJ, Vu HT, Nelson C, Ford DE. Race, gender, and partnership in the patient–physician relationship. JAMA 1999;282:583-589.

17. Roter D, Hall J. Why physicians’ gender matters in the shaping of the patient-physician relationship. J Womens Health 1998;7:1093-1097.

18. Roter D, Lipkin M, Korsgaard A. Sex differences in patients’ and physicians’ communication during primary care medical visits. Med Care 1991;29:1083-1093.

19. Hall J, Irish J, Roter D, Ehrich C, Miller L. Gender in medical encounters: an analysis of physician and patient communication in a primary care setting. Health Psychol 1994;13:384-392.

20. Elderkin-Thompson V, Waitzkin H. Differences in clinical communication by gender. J Gen Intern Med 1999;14:112-121.

21. Miller WR, Rollnick S. Motivational Interviewing: Preparing People to Change Addictive Behaviors. New York: Guilford Press; 1991.

22. Stewart M. Effective physician–patient communication and health outcomes. CMAJ 1995;152:1423-1433.

23. Saha S, Komaromy M, Koepsell TD, Bindman AB. Patient–physician racial concordance and the perceived quality and use of health care. Arch Intern Med 1999;159:997-1004.

Strengths of the study

A major strength of our study was that participants represented both sexes and a range of ages, races, and education levels. In addition, the video technology allowed participants to select a video doctor based on a verisimilar experience and without the constraints of availability and access found in real-life choices. All our study participants accepted the survey questions and responded to the video doctor as a “real” physician.

Video doctor technology does allow for holding constant certain variables such as age, appearance, message content, and style of delivery, an advantage that cannot be achieved in real encounters between patients and physicians.

Challenges for the future

Some of our most crucial health care challenges are providing access to quality care and equal career opportunities for those who seek to practice medicine. Our results supported the growing diversity of the population of physicians, and emphasized that many patients will choose physicians, regardless of their sex and race, who appear professional, competent, and caring. Medical schools need to continue the trend toward teaching patient-centered, empathic care and recruiting and retaining minority physicians to rectify current imbalances. In addition, practicing physicians can take note that providing quality care for patients of all cultural backgrounds may be an easier task than they think—the common language of compassion may transcend our differences.

Future studies could use video doctor technology to confirm our findings and to further investigate patients’ preferences and attitudes about various dimensions of the relationship between patient and physician. As the patient population and the physician workforce diversify, and as managed care organizations continue to strive to increase patient satisfaction and retention, information about patient preferences could inform the future of health care delivery.

Acknowledgments

We thank Scott Ludwig for his excellent casting of actors, directing, and video production; and Annabelle Ison for designing subject recruitment materials. We also thank our video doctors, the staff of Tanforan Park Shopping Center in San Bruno, CA, and the mall visitors who volunteered to participate in the study.

Corresponding author
Barbara Gerbert, PhD, University of California at San Francisco, 350 Parnassus Avenue, Suite 905, San Francisco, CA 94117. E-mail: gerbert@itsa.ucsf.edu.