High Prevalence of Gender Preferences for Endoscopists in an Inner City, Tertiary Care Population

Abstract

Patient preferences for the gender of endoscopists may play a more important role than previously expected. Prior studies focusing on Caucasian women of high socioeconomic status have shown a gender preference ranging from 43% to 48%. No study to date has evaluated the gender preferences of women from a diverse but predominantly low socioeconomic, non-Caucasian population. In addition, few studies have included men and none have demonstrated gender preferences among men. Our aim was to evaluate gender preferences for endoscopists in a diverse inner city, tertiary care setting. Methods: This was a prospective study in which a questionnaire was given to patients presenting for elective outpatient GI endoscopic procedures. Elements of the questionnaire included past medical history, social history, as well as preference for gender of the endoscopist. Patients who indicated a preference were asked specific reasons for their choice. Results: Three hundred and eight consecutive patients completed the survey. The patients responding were mainly women (59%) and African-American (57%) with a mean age of 54. Forty-two percent of women had a preference for the gender of their endoscopists vs 24 % of men (p < 0.01). Among women, there was no significant difference in gender preference between upper or lower GI procedures (47% and 39% respectively). Of patients who had preferences for the gender of their endoscopist, 92% of female patients and 67% of male patients had a preference for an endoscopist of the same gender. The primary reason given by these women was that a woman would be easier to talk to; whereas the men stated a man would less embarrass them. The primary reason given by the men with a preference for women was that a woman would be more gentle and easier to talk to. Patients with a history of low socioeconomic status (p < 0.05), emotional/physical abuse (p ≤ 0.01), and chronic pain (p ≤ 0.025) reported a higher rate of preference for gender of their endoscopists. Patients who reported abuse were more likely to be women (p < 0.025) and of lower socioeconomics (p < 0.01). There was no significant difference among other subgroups that were studied. Conclusion: Women of diversified background have comparable gender preferences to women of previous studies. We are the first to report that patients with a history of abuse, lower socioeconomics, and chronic pain are more likely to have a gender preference. We are also the first to report that up to a quarter of men have a preference for the gender of their endoscopist. Further focus on patient preferences may improve both the compliance of patients undergoing endoscopic procedures as well as patient care.