Prevalence and associations of gender concordance in general practice consultations: a cross-sectional analysis.

Abstract

Rationale, aims and objectives: Gender effects on physician-patient interactions are well-established and gender concordance of the physician-patient dyad influences consultation dynamics, person-centeredness and outcomes. We aimed to establish the prevalence and associations of gender-concordant and gender-discordant consultations of general practice (family medicine) trainees and to compare outcomes of gender-concordant and gender-discordant consultations.Method: A cross-sectional analysis from an ongoing cohort study. The outcome measure was whether a consultation included a gender concordant (female-female, male-male) or discordant (male-female, female-male) physician-patient dyad. Independent variables related to patient, physician (registrar), practice, consultation content and consultation outcome.Results: Five hundred and ninety-two general practice (GP) registrars (trainees) in 4 of Australia’s 17 regional training programs provided data on 56,234 individual consultations. Sixty-two point nine percent of consultations were gender-concordant (73.5% female-female, 26.5% male-male) and 37.1% were gender-discordant (47.0% male physician-female patient, 53% female physician-male patient). Associations of having a gender-concordant consultation were patient female gender and younger age (<55), the patient not being new to the registrar and the registrar being part-time, younger and having worked at the practice previously. Addressing a reproductive/contraceptive/ genital problem was associated with gender concordance. Gender-concordant consultations were ‘complex’: significantly longer than gender-discordant consultations, addressed a greater number of problems, resulted in more pathology ordered, more follow-up organised and more learning goals generated.Conclusions: Gender-concordant consultations may be more complex and gender-concordance is ‘sought’ by patients rather than being random. Thus, efforts could be made in general practice to provide access to both male and female GPs, especially for female patients or groups or patients with particular needs.