Differences in Self-Reported Physical and Behavioral Health in Musculoskeletal Patients Based on Physician Gender

Background: Differences in patient-physician interactions based on physician gender have been demonstrated. However, the association between patients' self-perceived health and their decision to see a female versus male physician is still unclear.

Objective: To determine if self-reported physical or behavioral health is different in musculoskeletal patients who present to female vs male physicians. We hypothesized that patients who present to female physicians report worse physical and behavioral health.

Design: Cross-sectional study.

Setting: Tertiary academic medical center.

Patients: Consecutive 21 980 adult patients who presented to a musculoskeletal medicine specialist for initial evaluation of a musculoskeletal condition between April 1, 2016 and November 1, 2017.

Main outcome measures: Physical Function, Pain Interference, Anxiety, and Depression Computer Adaptive Test domains of the Patient-Reported Outcomes Measurement Information System (PROMIS). The primary study outcome was the mean difference (MD) in PROMIS scores by physician gender.

Results: Patients who presented to female physicians self-reported slightly worse health in all domains: Physical Function (female physicians 40.2, male physicians 42.4, MD -2.1; 95% confidence interval [CI] -2.5 to -1.8), Pain Interference (female physicians 61.6, male physicians 60.4, MD 1.3 [1.0-1.5]), Anxiety (female physicians 52.5, male physicians 51.4, MD 1.1 [0.8-1.5]), and Depression (female physicians 47.5, male physicians 46.2, MD 1.3 [0.9-1.6]) (all P < .001). Patients who presented to female physicians were also slightly younger (51.9 vs 52.4 years, P = .034) and more likely to be female (63% vs 56%, P < .001).

Conclusions: Patients who presented to female physicians self-reported slightly worse physical and behavioral health compared to those patients who presented to male physicians. Further investigation into this finding may provide insight into drivers of patients' preferences, which may enable physicians of both genders to optimize patient care.