Knowledge is Power? Pap Testing Habits of Female OB/GYNs Compared To Other Female Physicians

Background. To investigate whether knowledge regarding cervical cancer risk factors and Pap testing influence OB/GYN physicians’ compliance to cervical cancer screening and prevention.Methods. Female physicians working in the Tel Aviv Sourasky Medical Center were asked to complete an anonymous questionnaire assessing their knowledge of cervical cancer related factors, Pap testing and compliance with screening guidelines. Reported data was compared between resident and senior OB/GYN physicians and physicians from non-OB/GYN specialties.Results. 42 female OB/GYNs ( residents – 18, seniors- 24) and 80 female physicians of other specialties (“non-OB/GYNs”, residents -48, seniors -32) volunteered to participate in our study, with similar proportions of resident and senior participents between the two groups (p=0.0865). Generally, OB/GYNs were more knowledgable about cervical cancer prevention and risk factors compared to non-OB/GYNs. OB/GYN residents knew less about world health organization (WHO) recommendations for age at last Pap compared to senior OB/GYNs (answered correctly – 50% vs. 83%, respectively, p=0.04). They also knew less about the upper age for vaccine administration (answered correctly – 11% vs 50%, respectively, p=0.01). Even so, the majority of physician recommended Human Papillomavirus vaccination, in all groups compared. A similar proportion of OB/GYNs and non-OB/GYNs had performed a Pap smear in the last 3 years (OB/GYN – 75% non-OB/GYN – 83%, p=0.3). Of note, a higher percentage of residents, both OB/GYNs and non- OBGYNs were vaccinated against Human Papillomavirus compared to their senior counterparts (OB/GYNs -38.89% vs. 4.17%, p=0.013, non-OB/GYNs 50% vs. 12.5%, p=0.0007). Only half of OB/GYNs (residents – 50%, seniors –66.67%, p>0.99) initiated their Pap testing, similar to non-OB/GYNs. Human Papillomavirus vaccination was more prevalent among residents than among seniors, regardless of their specialty (OB/GYNs – 38.89% vs. 4.17%, p=0.013, non OB/GYN – 50% vs. 12.5%, p=0.0007) with a trend toward higher porportions of vaccinated physicians in non-OBGYNs.Conclusion. Female OB/GYNs’ knowledge of the importance of Pap test and their accessibility to Pap smear services, do not improve their compliance for Pap smear performance or Human Papillomavirus vaccination. Residents tend to have better general personal health habits out of their field of specialty.

Comparison of inpatient spending and readmission rates for patients treated by male versus female physicians in China: An observational study

Objective To determine whether there are significant differences in costs of treatment and readmission rates for hospital consultations undertaken by female versus male physicians in China. Methods Using data from the Urban Employee Basic Medical Insurance program from January 2018 through October 2019, we investigated spending patterns and clinical outcomes for patients at tertiary hospitals in one of the largest cities in China by the gender of the attending physician. Our sample included 79,085 hospitalizations treated by 3993 physicians in internal medicine departments. We examined the association between physician gender and visit cost using a multivariable linear model. We examined the association between physician gender and 30-days readmission rates using a multivariable probability model. We adjusted for a rich set of patient characteristics, primary diagnosis fixed effects, and hospital fixed effects. In addition, we used patient fixed effects in a robustness analysis. Results Adjusting for primary diagnosis fixed effects, spending per visit was 4.1% higher for patients treated by male physicians than for those treated by female physicians, a statistically significant difference (95% CI [1.5%, 6.7%]). This pattern persisted after further adjusting for hospital fixed effects (3.2% [1.2%, 5.2%]), patient characteristics (3.2% [1.2%, 5.1%]), and patient fixed effects (4.2% [1.8%, 6.7%]). The difference is mainly driven by higher spending on drugs (8.7% [3.9%, 13.6%]) and out-of-pocket costs (3.9% [1.7%, 6.0%]). No statistically significant differences were observed in the readmission rates of patients treated by male and female physicians in any of our three model specifications. Conclusions Spending per visit was significantly higher among patients treated by male physicians than among those treated by female physicians, with the difference mainly driven by spending on drugs and out-of-pocket costs. No significant difference was observed in the hospital readmission rates of patients treated by male and female physicians. These findings have important implications for gender equality in medicine and health care quality and efficiency in developing countries.

Gender differences in the medical industries’ payments to physicians: a systematic review

Purpose This paper aims to explore gender differences in payments made to physicians by the pharmaceutical and medical device industries via the performance of a systematic review of articles based on the Open Payments Database (OPD). Design/methodology/approach Three databases (Scopus, Web of Science and PubMed) were searched for articles published from September 30, 2014 to May 10, 2019, using two search terms: “Sunshine Act” and “Open Payments.” The systematic review is reported according to preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. Findings The search identified 359 abstracts. Thirty-nine articles were selected for full review, and 17 of these met the inclusion criteria. Although the articles considered are based on the same database, they adopt diverse approaches and analyses are conducted in different ways. A substantial proportion of the studies show total payments from the two industries to be higher for male physicians than for female physicians. However, a few exceptions exist, higher female mean or median values occurring for payments involving research, ownership, honoraria, grants, royalties/licenses and travel/lodgings. Also, in the case of obstetric–gynecological specializations, a higher proportion of women than men are shown to cooperate with the industries. Originality/value There is gender inequality in terms of industries’ funding for doctors. While analyses of secondary OPD data show that a gender inequality exists, they do not provide an understanding of why this occurs. However, from the exceptions identified, it can be speculated that this phenomenon is connected with greater adherence to ethical standards on the part of female physicians and/or the likelihood that fewer opportunities for industrial cooperation are extended to them.

Gender Biases in Online Physician Ratings: Female Doctors Evaluated More Harshly by Patients (Preprint)

BACKGROUND Prior research has highlighted gender differences in online physician reviews, however, to date no research has linked online ratings with quality of care. OBJECTIVE To compare a consumer-generated measure of physician quality (online ratings) with a clinical quality outcome (sanctions for malpractice or improper behavior), to understand how patients’ perception and evaluation of doctors differ based on the physician’s gender and quality. METHODS We use data from a large online doctor reviews website and the Federation of State Medical Boards. We implement paragraph vector methods to identify words that are specific to and indicative of the separate groups of physicians. We then enrich these findings by utilizing the NRC word-emotion association lexicon to assign emotional scores to the various segments: gender, gender and sanction, and gender and rating. RESULTS We find significant differences in the sentiment and emotion of reviews for male and female physicians. We find that numerical ratings are lower and the sentiment in text reviews is more negative for women who will be sanctioned than for men who will be sanctioned; sanctioned male doctors are still associated with positive reviews. CONCLUSIONS Conclusions: Given the growing impact of online reviews on demand for physician services, understanding the different reviews faced by male and female physicians is important for consumers and for platform architects in order to revisit their platform design.

An Application of the Theory of Representative Bureaucracy, Gender Concordance, and Symbolic Representation in the Health Care Context

Although the United States spends more on health care than comparable nations, many Americans suffer from poor health. Many factors are emphasized as being important for improved health outcomes, including social and economic indicators, living and working conditions, and individual-level behavior. However, I argue the overwhelming attention to male health outcomes—compared to female health outcomes—and focus on factors that are “traditionally understood” as important in shaping health are two limitations of existing health-related research. I adopt an innovative approach that combines the theory of representative bureaucracy, gender concordance, and symbolic representation to argue that increase in female physicians contribute to improved female health outcomes. Using an originally collected dataset that contains information on female physicians, health outcomes, and state and individual-level factors, I study how female physicians influence the health outcomes of non-Hispanic White women, non-Hispanic Black women, and Latinas in the United States from 2000 to 2012. The findings suggest female physicians contribute to improved health outcomes for non-Hispanic White women and non-Hispanic Black women, but not Latinas. Supplemental Analysis bolsters confidence that the findings are not the result of increased access to health care professionals. This study highlights the importance of applying the theory of representative bureaucracy and symbolic representation to health care, the promise of greater female representation in health, and the insight gleaned from incorporating intersectionality in public administration research.

Dr. Olga Jonasson: A Pioneer for Women in Surgery

The advancement of women in surgery has seen tremendous progress over the past century. Among the many physicians who paved the way for women in surgery is Dr. Olga Jonasson, a Chicago-based transplant surgeon who performed the first kidney transplantation in the state of Illinois in 1969. Her passion for service and drive for greater female representation in medicine was massively influential to the field. Aspiring female physicians are forever indebted to the efforts of Dr. Jonasson and the bold women who came before us.

Association of clinical competence, specialty and physician country of origin with opioid prescribing for chronic pain: a cohort study

BackgroundAlthough little is known about why opioid prescribing practices differ between physicians, clinical competence, specialty training and country of origin may play a role. We hypothesised that physicians with stronger clinical competence and communication skills are less likely to prescribe opioids and prescribe lower doses, as do medical specialists and physicians from Asia.MethodsOpioid prescribing practices were examined among international medical graduates (IMGs) licensed to practise in the USA who evaluated Medicare patients for chronic pain problems in 2014–2015. Clinical competence was assessed by the Educational Commission for Foreign Medical Graduates (ECFMG) Clinical Skills Assessment. Physicians in the ECFMG database were linked to the American Medical Association Masterfile. Patients evaluated for chronic pain were obtained by linkage to Medicare outpatient and prescription files. Opioid prescribing was measured within 90 days of evaluation visits. Prescribed dose was measured using morphine milligram equivalents (MMEs). Generalised estimating equation logistic and linear regression estimated the association of clinical competence, specialty, and country of origin with opioid prescribing and dose.Results7373 IMGs evaluated 65 012 patients for chronic pain; 15.2% received an opioid prescription. Increased clinical competence was associated with reduced opioid prescribing, but only among female physicians. For every 10% increase in the clinical competence score, the odds of prescribing an opioid decreased by 16% for female physicians (OR 0.84, 95% CI 0.75 to 0.94) but not male physicians (OR 0.99, 95% CI 0.92 to 1.07). Country of origin was associated with prescribed opioid dose; US and Canadian citizens prescribed higher doses (adjusted MME difference +3.56). Primary care physicians were more likely to prescribe opioids, but surgical and hospital-based specialists prescribed higher doses.ConclusionsClinical competence at entry into US graduate training, physician gender, specialty and country of origin play a role in opioid prescribing practices.

How full is the glass? A perspective on women in medical leadership in Canada

What do we really know about the representation of female physicians in medical leadership in Canada? Female representation on the current boards of the Canadian Medical Association and provincial/territorial medical associations is 23% and 40%, respectively. Identified barriers to female medical leadership include gendered organizational and workplace culture, gender bias, inflexible work practices, unequal childcare and domestic responsibilities, and biased performance assessment criteria and recruitment practices. Identified enablers include flexible tenure policies, systematic parental leave policies, greater inclusivity in the workplace, and formal mentorship structures. More has been written about the costs of leadership for female physicians rather than the benefits.