38: Patient preference responses to encounters with FPMRS surgeons

Abstract

Understanding patient preferences about provider characteristics is an under-explored area in Female Pelvic Medicine and Reconstructive Surgery (FPMRS). The objective of this study was to describe FPMRS patient preferences for care, including provider gender, age, experience, as well as presence of medical trainees. This was a multicenter, cross-sectional survey-based study. Patient preferences were assessed with a voluntary, self-administered, anonymous questionnaire prior to their first FPMRS patient consult. Patients expressed preferences on a five-point Likert scale addressing provider gender, age, experience, and presence of medical trainees. Descriptive statistics were used to summarize patient characteristics and provider preferences. Associations of patient age, race, and education with FPMRS care preferences were evaluated with chi-square or Fisher’s exact tests, as appropriate. A total of 615 women participated from 8 sites including all geographic regions across the US. 70.8% were white with a mean age of 58.5 ± 14.2 years (Table 1). Urinary incontinence was the most commonly reported primary symptom (45.9%), followed by pelvic organ prolapse (28.9%) although most patients (50.4%) presented with more than one symptom. 51.4% saw a female provider at their initial visit. Patients were more likely to see a provider 45-60 years old (42.8%) with more than 15 years of experience (60.9%) (Table 2). Important characteristics considered by patients choosing a provider include: female provider (73.3%), 5-15 years of experience (54%), and provider age 45-60 years old (37.7%). Sixty-five percent of patients preferred a female provider and 10% preferred a male provider. 16% of patients preferred a provider less than 45 years old, 36% preferred a provider 45-60 years old, and 11% preferred a provider greater than 60 years old. Most patients preferred a provider with 5-15 or more than 15 years of experience (49% and 46%, respectively). Eleven percent preferred the presence of trainees while 24% preferred their absence (Figure 1). The majority of patients were scheduled with their FPMRS provider based on physician referral (61.9%) or first available appointment (17.7%). Qualitative descriptions of patient preferences revealed considerations of bedside manner, experience and the feeling of being comfortable with a female provider. There was no association between patient age, race, or education level and their preference for provider gender (p=NS). Patients tended to choose providers within their own age group (p=0.02). Although most patients had no preference for the presence of trainees, as education level increased, more patients preferred the absence of trainees (p=0.01). Patient preferences regarding FPMRS providers included female gender, provider age 45-60 years old with greater than 5 years of experience. Further investigation is needed to identify qualitative components associated with these preferences.View Large Image Figure ViewerDownload Hi-res image Download (PPT)