Preferred Physicians Research Articles

P07.18 Ease and comfort of a novel herswabtmvaginal self-sampling device for the detection of sexually transmitted infections

Introduction Eve Medical Inc. (Toronto, Canada) has developed a novel HerSwab TM device for self-collection of vaginal samples for STI screening. The objective of this study was to survey opinions on ease and comfort from women using the HerSwab TM . Methods A total of 189 women with infection prevalence of 10.6% for C. trachomatis and 2.6% for N. gonorrhoeae by Aptima Combo 2 assay testing signed consent for a physician-collected sample with a vaginal swab and a self-obtained vaginal sample using the HerSwab TM device. The order of collection was randomised. A research coordinator demonstrated steps for proper self-sampling following instructions in the HerSwab TM package. Following self-collection, each participant completed a 5-point Likert Scale questionnaire indicating ease (5 steps) and comfort (3 steps) of self-collection. Additional questions included: whether the instructions were easy to follow; whether there was anything that participants would change about the device; whether participants preferred physician or self-collection and why; and whether participants would consider self-sampling at home. Results The majority of women experienced high levels of ease and comfort. Instructions were easy to follow for 97.1% (169/175); 80.9% (140/173) preferred self-collection over physician-collection; and 79.7% (137/172) would consider self-collection at home. Reasons for preferring self-collection included convenience, privacy, confidentiality, an opportunity for self-education of own body, greater access for people with disabilities, comfort, and a reduction of physical and psychological stress. Suggestions to improve ease and comfort included making the brush bristles softer and including arrows on the handle of the device to better indicate the direction of turning. Conclusion Vaginal self-sampling with the HerSwab TM device demonstrated high levels of ease and comfort. The majority of women found the instructions easy to follow, preferred self-sampling over physician sampling and would consider self-collection at home. Organisers of STI screening programs should benefit from this personal feedback on vaginal self-collection. Disclosure of interest statement Dr. Chernesky has received research funding from Eve Medical Inc.

'Talk to me': a mixed methods study on preferred physician behaviours during end-of-life communication from the patient perspective.

BackgroundDespite the recognized importance of end‐of‐life (EOL) communication between patients and physicians, the extent and quality of such communication is lacking.ObjectiveWe sought to understand patient perspectives on physician behaviours during EOL communication.DesignIn this mixed methods study, we conducted quantitative and qualitative strands and then merged data sets during a mixed methods analysis phase. In the quantitative strand, we used the quality of communication tool (QOC) to measure physician behaviours that predict global rating of satisfaction in EOL communication skills, while in the qualitative strand we conducted semi‐structured interviews. During the mixed methods analysis, we compared and contrasted qualitative and quantitative data.Setting and ParticipantsSeriously ill inpatients at three tertiary care hospitals in Canada.ResultsWe found convergence between qualitative and quantitative strands: patients desire candid information from their physician and a sense of familiarity. The quantitative results (n = 132) suggest a paucity of certain EOL communication behaviours in this seriously ill population with a limited prognosis. The qualitative findings (n = 16) suggest that at times, physicians did not engage in EOL communication despite patient readiness, while sometimes this may represent an appropriate deferral after assessment of a patient's lack of readiness.ConclusionsAvoidance of certain EOL topics may not always be a failure if it is a result of an assessment of lack of patient readiness. This has implications for future tool development: a measure could be built in to assess whether physician behaviours align with patient readiness.

Knowledge of advance directive and perceptions of end-of-life care in Chinese-American elders: The role of acculturation.

This study aimed to describe knowledge of an advance directive (AD) and preferences regarding end-of-life (EoL) care communication, decision making, and designation of surrogates in Chinese-American elders and to examine the role of acculturation variables in AD awareness. Survey data were collected through face-to-face interviews on a sample of 385 Chinese-American elders aged 55 or above living in the Phoenix metropolitan area. The choice of language (Mandarin, Cantonese, or English) and place of interview (senior apartments, Chinese senior centers, or homes) was at the respondent's preference. Hierarchical logistic regression analysis was employed to examine the influence of acculturation variables on AD awareness. Some 21% of participants had heard about ADs, and only 10% had completed one. Elders with higher acculturation levels (OR = 1.04, p < 0.10) and those residing more than 20 years in the United States (OR = 6.87, p < 0.01) were more likely to be aware of ADs after controlling for the effects of demographics, health, and experiences of EoL care. The majority preferred physicians to initiate AD discussions (84.9%) and identified burdens on families as the most important factor in making EoL decisions (89.3%). About 55.1 % considered daughters as the preferred healthcare surrogate. Acculturation levels influence awareness of an AD, and family values are crucial in EoL care decision making. Cultural factors should be considered in designing and delivering appropriate programs to promote knowledge of EoL care among Chinese-American elders and their families.

Dynamic appointment scheduling with patient preferences and choices

Purpose – The purpose of this paper is to maximize the expected revenue of the outpatient department considering patient preferences and choices. Design/methodology/approach – Patient preference refers to the preferred physician and time slot that patients hold before asking for appointments. Patient choice is the appointment decision the patient made after receiving a set of options from the scheduler. The relationship between patient choices and preferences is explored. A dynamic programming (DP) model is formulated to optimize appointment scheduling with patient preferences and choices. The DP model is transformed to an equivalent linear programming (LP) model. A decomposition method is proposed to eliminate the number of variables. A column generation algorithm is used to resolve computation problem of the resulting LP model. Findings – Numerical studies show the benefit of multiple options provided, and that the proposed algorithm is efficient and accurate. The effects of the booking horizon and arrival rates are studies. A policy about how to make use of the information of patient preferences is compared to other naive polices. Experiments show that more revenue can be expected if patient preferences and choices are considered. Originality/value – This paper proposes a framework for appointment scheduling problem in outpatient departments. It is concluded that more revenue can be achieved if more choices are provided for patients to choose from and patient preferences are considered. Additionally, an appointment decision can be made timely after receiving patient preference information. Therefore, the proposed model and policies are convenient tools applicable to an outpatient department.

Factors That Affect Consultation and Screening for Fecal Incontinence

Fecal incontinence (FI) affects 15% of people age 70 years and older, but only 10% to 30% discuss FI with their physicians. We aimed to identify barriers that prevent people from consulting with their physicians, and that prevent physicians from screening for FI. We performed structured interviews of 124 individuals with FI (mean age, 56 y; 87.9% women) recruited from 6 medical offices at the University of North Carolina Hospitals from June 2012 through March 2013. The subjects completed the Fecal Incontinence Severity Index and the Fecal Incontinence Quality of Life Scale questionnaires. Interview questions aimed to determine which patients had consulted physicians for FI. Eleven of the 56 physicians with patients included in the study responded to the survey. Eighty-eight of the 124 participants consulted with their physicians about FI (consulters). These individuals had a higher incidence of depression than the 36 subjects who did not consult with their physicians about FI (nonconsulters; P = .04), but similar Fecal Incontinence Severity Index scores. A smaller proportion of nonconsulters were aware of available treatments than consulters (P < .01). Fifty-six percent of nonconsulters said their FI was not serious enough to consult a physician. There was no difference between consulters and nonconsulters in embarrassment in talking about FI. Among consulters, 88% initiated the conversation about FI with their physician. Seven of the 11 responding physicians screened for FI, but only screened high-risk patients. The 4 physicians who did not screen for FI were unaware of its prevalence, viewed FI as a low priority, or stated that patients were responsible for reporting their own symptoms. Based on surveys of physicians and patients, many patients have insufficient knowledge about the availability and effectiveness of treatments for FI. Some people with FI do not discuss it with their physician because their symptoms are mild, and most prefer physicians to ask them directly about FI. Educating patients and physicians about the prevalence of FI and management strategies may improve consultation rates.

Dress and deportment of medical residents: formal or informal?

Health care workers, including physicians, have adopted more casual dress. The appearance of a physician may influence patients' opinion of physician knowledge, competence and trustworthiness. We hypothesized that medical inpatients and outpatients would rate these attributes higher in residents who dressed and acted in a more formal manner. Prospective cohort included both inpatients and outpatients. One hundred thirty three patients, aged 62.3 ± 16 years, 49% of whom were female, were surveyed. One of two male resident physicians approached each patient, ostensibly to obtain consent to a brief mini-mental status examination. The physician was dressed, and acted, either "formally" (F) or "informally" (I). Patients then completed a six item questionnaire, using a 5 point Likert scale, to assess their confidence in the resident. Total scores could be 6 to 30. Total scores were compared using one-way ANOVA. Patients' perceptions were high for both F and I: 25.5 ± 3.1 vs. 24.1 ± 3.0, respectively (p=0.013). This difference was driven by the "lab coat" question: patients generally preferred physicians to wear a lab coat (3.9 ± 1.0 vs. 2.8 ± 1.3, p < 0.0001). Responses to four of the other five questions were numerically, but not statistically, higher in F. There was no difference in preference between the two residents: 24.6 ± 2.8 vs. 24.9 ± 3.5, p=0.56. More formal dress and demeanor by residents leads to a modest, but significant, increase in patient perception of the resident's value. Wearing a white lab coat, in particular, has a positive effect.

Impressões de pacientes, médicos e estudantes de Medicina quanto a aparência dos médicos

ObjectiveTo investigate the impressions made by different styles of dress and appearance adopted by physicians on patients, medical students and other physicians in Brazil. MethodsTwo hundred fifty nine patients, 119 students, and 99 physicians answered questions related to a panel of male and female physicians’ pictures covering the following styles: white clothing; white coat; formal, informal, and casual garments; and surgical scrubs. They also reported their level of discomfort with a list of 20 items for professional appearance of both genders. ResultsMost of the answers of the volunteers involved using white clothes or white coat, and in many situations the percentages of preference referred for these styles were close. Physicians and students preferred physicians wearing surgical scrubs for emergency visits, and doctors with informal style for discussing psychological problems with male professionals. Patients most often chose white clothing in response to questions. Regarding male professionals, all three groups reported high degree of discomfort for the use of shorts and bermuda shorts, multiple rings, facial piercing, sandals, extravagant hair color, long hair, and earrings. For females, high levels of discomfort were reported to shorts, blouses exposing the belly, facial piercing, multiple rings, extravagant hair color, and heavy makeup. ConclusionBrazilian patients, physicians, and medical students form a better initial impression of physicians using clothing traditionally associated with the profession and exhibiting more conventional appearance. The use of entirely white garments appears to be a satisfactory option in this country.

Why do some patients prefer to leave decisions up to the doctor: lack of self-efficacy or a matter of trust?

Decision-making preferences among cancer survivors during their follow-up care remains understudied and limited research examines factors that underlie these preferences. The purpose of this study was to assess cancer patients' decision-making preferences during follow-up care, the role of trust and self-efficacy, and the effect of preferences on health outcomes. Six hundred twenty-three bladder, leukemia, and colorectal cancer survivors were recruited to the Assessment of Patient Experiences of Cancer Care study between April 2003 and November 2004. Respondents were asked about their follow-up care experiences, including decision-making preferences, trust in physicians, self-efficacy, health-related quality of life (HRQOL), and health appraisal. Unadjusted mean scores of trust and self-efficacy measures by decision preference group were examined. Multinomial logistic and linear regressions were conducted to examine predictors of decision-making preferences and the impact of decision-making preferences on HRQOL and health appraisal. While the majority of patients preferred shared decision-making (61.0%), 16.1% preferred to control their decisions and 22.1% preferred physician control over decisions. Compared to the other groups, patients preferring physician control had greater trust in their physician (p < 0.001), similar self-efficacy for engaging in the decision-making process, and lower self-efficacy for taking responsibility over decisions (p < 0.001). There were no notable differences between decision-making groups on outcome measures. Patients who prefer physicians to control decisions are as confident about participating in the decision-making process and experience similar health outcomes as those preferring greater decisional control. Physicians need to tailor their communication behavior to encourage participation and trust among all patients. Findings from this study provide unique insights into the decision-making preferences of cancer patients during receipt of follow-up care, which remains an understudied phase of cancer care delivery. Results underscore the need for approaches to decision-making and patient engagement to become more nuanced and to encourage patients to participate in decision-making in ways they are most comfortable. Furthermore, physicians and health care professionals should foster environments that promote trust and clear communication regardless of patient decision-making styles.

Human Papillomavirus Self-Sampling in Cameroon

The study aimed to assess acceptability and preference for self-collected human papillomavirus tests (self-HPV) compared with traditional physician-sampled Pap tests (physician sampling) in a low-resource country. Women were recruited through a cervical cancer screening campaign conducted in Cameroon. Written and oral instructions were given to carry out an unsupervised self-HPV, followed by a physician-collected cervical sample for HPV testing and cytology. Subsequently the women were asked to answer a questionnaire. A total of 243 women were prospectively enrolled in this study. Median age of participants was 39 years (range = 25-65 years). Acceptability score was higher for self-HPV (p < .001) compared with physician sampling. Preference was lower for self-HPV than physician sampling (29% vs 62%; p < .001). Most participants thought that physician sampling was more reliable than self-HPV (59% vs 1%; p < .001). Women who preferred physician sampling were significantly more likely to have low knowledge about cervical cancer and a low educational level. Although most of the women were more comfortable and less embarrassed with the self-HPV, they did not trust the method and did prefer physician sampling. The study underlines the need not only to educate women about HPV, cervical cancer, and its prevention but also to reassure them about the accuracy of self-HPV.

A Study Regarding Spanish-Speaking Parents’ Preference of Physician Attire in the Pediatric Emergency Room

A study to determine Spanish-speaking parents' acceptance of the physician's attire in the pediatric emergency department. The attire of the physicians does not matter for the parents. The sample size was 450. An anonymous patient survey with no identifiers was used. The sample questionnaire was enclosed, and the parents were asked to answer the questionnaire. The results were interesting; patients preferred physicians who wear hospital scrubs (410/450 or 91%) and short hair (430/450 = 96%). They preferred physicians wearing sneakers (430/450 = 96%) compared with dress shoes, and male physicians with moustaches/beards and wearing glasses (450/450 = 100%). Parents did not like women physicians wearing makeup and high heels. Parents prefer physicians wearing hospital scrubs and sneakers and having short hair. This could indicate that parents do not prefer formal attire in the pediatric emergency room (ER). Also, a gender difference was noticed. Parents do not prefer women physicians with high heels and make up. But, they tolerate male physicians with moustaches/beards. This could be related to the fact that most of the parent questionnaires were answered by Spanish women. Results are interesting and useful in addressing the question of physicians' attire in the pediatric ER in the context of a predominantly Spanish speaking population.

Presence of chaperones during pelvic examinations in southeast Nigeria: Women′s opinions, attitude, and preferences

To assess the opinions, attitude, and preferences of Nigerian women to the presence of chaperones during pelvic examinations. A cross-sectional survey of first time gynecology clinic attendees on their opinions, attitudes, and preferences with respect to the presence of chaperones during their pelvic examinations. The interview was conducted with the aid of semi-structured, researcher-administered questionnaires. One hundred and nineteen (51.7%) of the respondents preferred female physicians for pelvic examination, 23 (10%) preferred male physicians and 88 (38.3%) had no gender preference. When the examining physician is a male, 124 (53.9%) respondents would like to have chaperones during pelvic examinations while 106 (46.1%) would not. Eighty-three percent of respondents preferred nurse chaperones. Age, level of education, and parity did not have any significant relationship with the attitude of the respondents toward the presence of chaperones ( P = 0.503, 0.525, and 0.605 respectively). We conclude that most southeastern Nigerian women would prefer their pelvic examinations to be done by a female physician or to be attended by a nurse chaperone if the examining physician is a male. We recommend a routine offer of chaperones during such examinations while respecting the patients' right to refuse the offer.

Recognising the importance of ‘family time-out’ in consultations: an exploratory qualitative study

ObjectivesPatients are often accompanied by family or companions during consultations, but little is known about how this might influence the process. We explored how the presence of a companion in...

Perceptions of patients, physicians, and medical students on physicians’ appearance*

ObjectiveTo investigate the impressions made by different styles of dress and appearance adopted by physicians on patients, medical students, and other physicians in Brazil. MethodsTwo hundred fifty nine patients, 119 students, and 99 physicians answered questions related to a panel of male and female physicians’ pictures covering the following styles: white clothing; white coat; formal coat; formal, informal, and casual garments; and surgical scrubs. They also reported their level of discomfort with a list of 20 items for professional appearance of both genders. ResultsMost of the answers of the volunteers involved using white clothes or white coat, and in many situations the percentages of preference referred for these styles were close. Physicians and students preferred physicians wearing surgical scrubs for emergency visits, and doctors with informal style for discussing psychological problems with male professionals. Patients most often chose white clothing in response to questions. Regarding male professionals, all three groups reported a high degree of discomfort for the use of shorts and bermuda shorts, multiple rings, facial piercings, sandals, extravagant hair color, long hair, and earrings. For females, high levels of discomfort were reported for shorts, blouses exposing the belly, facial piercings, multiple rings, extravagant hair color, and heavy makeup. ConclusionBrazilian patients, physicians, and medical students form a better initial impression of physicians using clothing traditionally associated with the profession and exhibiting a more conventional appearance. The use of entirely white garments appears to be a satisfactory option in this country.

Muslim Women's Physician Preference: Beyond Obstetrics and Gynecology

When Emirati (Muslim) women (n = 218) were asked about their preferred physician (in terms of gender, religion, and nationality) for three personal clinical scenarios, a female was almost exclusively preferred for the gynecological (96.8%) and “stomach” (94.5%) scenarios, while ±46% of the women also preferred a female physician for the facial allergy scenario. Only 17% considered physician gender important for the prepubertal child scenario. Just over half of the women preferred a Muslim physician for personal examinations (vs. 37.6% for the child). Being less educated and having a lower literacy level were significant predictors of preferred physician religion for some personal scenarios, whereas a higher education level was a significant predictor for physician gender not mattering for the facial allergy scenario. Muslim women's preference for same gender physicians, and to a lesser extent religion, has implications for health care services beyond obstetrics and gynecology.

Physicians' nonverbal behaviors: Oncology patients perspective.

6158 Background: Studies have shown an association between physician nonverbal behaviors and patient satisfaction. The purpose of this study is to determine the nonverbal behaviors of physicians preferred by cancer patients. Methods: A survey questionnaire was given to patients who were receiving chemotherapy at the Mayo clinic out patient chemotherapy unit. Questions included patient demographics and patients' preference on the nonverbal behaviors. The responses were rated into three groups (agree, don't mind, disagree). Results: A total of 253 patients were surveyed. The mean age of these patients were 68 (23-87) years. One hundred and forty eight (58%) patients were females. Majority of the patients had solid cancers 201 (79%). When patients were asked if they preferred the physician standing during the medical interview, 41 (16%) agreed and 34 (13%) disagreed while the majority178 (71%) did not mind. Similarly when asked about the preference of their doctors sitting on a chair, 85 (34%) patients agreed with physician sitting on a chair while 13 (5%) patients disagreed. When asked about the propriety of patting the shoulder when patients appeared emotional, 56% found it acceptable. Similarly holding the patient's hand was favored by 45 (22%). When patients were asked about the preference of physician sitting on the bed 179 (77%) of the patients did not mind, 51 (20%) of the patients disagreed while 23 (9%) patients agreed. When patients were asked how often they had a physician sitting on their bed without asking them, 23 (9%) patients reported either some times or frequently. When asked about which position makes the patients most comfortable 23 (9%) patients reported sitting on the bed, 55 (22%) patients preferred standing while majority of the patients 175 (69%) reported sitting on a chair. Conclusions: Patients from our study preferred physicians adopt a seated posture during the medical interview. When patients were feeling emotional, they preferred patting on the shoulder to holding hands. It is crucial to respect personal space and preferable to avoid sitting on the bed. No significant financial relationships to disclose.

Non-Attendees' Attitudes to the Design of a Cardiac Rehabilitation Programme Focused on Information of Risk Factors and Professional Involvement

Enhancing the accuracy of the content of cardiac rehabilitation programmes (CRPs) and providing the mediators preferred by patients can increase attendance rates in line with secondary prevention goals. The aim of this study was therefore to explore non-attendees' attitudes to the design of a CRP focused on information of risk factors and professional involvement. Consecutive patients with coronary heart disease (n=100) who declined to participate in a CRP answered a questionnaire focusing on patients' attitudes to risk factors and cardiac rehabilitation. Non-attendees considered that information of hypertension and information of sedentary lifestyle constituted the most important content of a CRP. Physicians, nurses and social workers were considered the most suitable professional categories. Females preferred nurses when discussing smoking issues while males preferred physicians. More males compared to females preferred occupational therapists for dealing with stress, physicians for depression and social workers for social isolation. Non-attendees' attitudes are similar to those of attendees and quite traditional in that they favour physician or nurse-led activities. There is a difference in attitude between male and female.

Patient (pt) evaluation of the Oncology Pt Emergency Network (OPEN): Implications for oncology practices

6545 Background: Pt emergency preparedness is important in disasters (Katrina, Los Angeles fires 2007). MOASC developed a preparedness program OPEN (www.open-central.com; Proc ASCO 2007 abstract 17003, 2006 abstract 6142). This study determined pt satisfaction with OPEN. Methods: Pts were given wallet cards with emergency information (diagnosis, stage, treatment, doses), and a copy of their EMR history. Pts completed a survey and a semistructured interview to validate results. Results: Of 190 consecutive pts, 28% were male, 86% had cancer. Pts uniformly ranked importance of this program high (1.22/ scale of 1 best-3 worst). Pts felt they were able to keep their medical records up to date, and by themselves (1.22–1.33/3), and said all pts should participate (1.20/3). Although designed for disasters, pts also wanted OPEN records for reviewing themselves (94%), taking to other doctors (97%), using at emergency rooms (99%), and when traveling (99%). 96% wanted paper copies, significantly more than e-mail (48%, p < 0.001), or fax (18%, p < 0.001). 63% wanted records available on the doctor website for remote access by the pt or other physicians, still less than by paper (p < 0.001). 21% also wanted it on a portable drive, but only 14% wanted it on a national password protected website (less than doctor website p < 0.0001). EMR usage by physician was ranked high (1.51/5). Pts preferred physicians to use EMR to monitor compliance of care with national guidelines (1.56/5). Pts did not want to pay extra for EMR services (2.40/3). Pts more commonly wanted copies of their medical records kept by a son or daughter (55%) compared to other family (2%-12%) or friend (2%, p<0.0001). 90% said they would recommend OPEN to family members. Interviews documented increased trust in the physician for participating in OPEN. Conclusions: OPEN, the first tested patient emergency preparedness program, is highly rated by pts and can be used for free by all oncologists. Pts desire physicians to use EMR and monitor guideline compliance. Many pts want electronic access to medical records through the physician's office, but do not desire national database storage of their records. OPEN enhances the physician-pt relationship and is highly recommended. Supported by grants from ASCO and Astra-Zeneca. Author Disclosure Employment or Leadership Consultant or Advisory Role Stock Ownership Honoraria Research Expert Testimony Other Remuneration Medical Oncology Association of Southern California

Patients′ attitude towards medical students rotating in the dermatology clinic

Objective:To study the attitudes of the patients towards medical students rotating in the dermatology clinic in the King Fahad Hospital of the University (KFHU).Materials and Methods:One hundred and two adult outpatients attending the KFHU in Alkhobar, Saudi Arabia during the period March to June 2004 completed a questionnaire to evaluate their receptiveness towards medical students attending with the dermatologist.Results:Almost 57% preferred physician and medical student participation in their care and 46% welcomed their presence during physical examination. The majority of patients (64.8%) felt comfortable disclosing personal information to the medical student and (68.7%) enjoyed the interaction with the medical students. Patients (63.7%) agreed that the students understood their healthcare needs.Conclusion:The majority of the patients in this study enjoyed their interactions with the students and felt comfortable disclosing information. Some patients want to spend time alone with the physician so permission for medical student participation should be requested.

Population preferences and choice of primary care models: A discrete choice experiment in Sweden

Objective To examine which attributes are important when individuals choose between primary care models. In particular, we studied whether individuals that were given a choice preferred individual family physicians (GP) or a primary care team consisting of physicians and nurses (PCT). Method A questionnaire survey, designed as a discrete choice experiment, was sent to 1600 individuals in Sweden. In the questionnaire, different primary care models were constructed on the basis of five attributes: GP versus primary care team, waiting time for non-emergency visits, user charges, ability to choose provider, and degree of influence over the care received. Individual preferences and willingness to pay for attributes were regressed against such characteristics as age, gender, education, and health status (as measured by EQ-5D). Results The response rate was 58%. Waiting time, user charges, ability to choose provider, and degree of influence over the care received were each statistically significant discriminants ( p < 0.001). Willingness to pay per visit was 224 SEK for great compared to limited degree of influence over the care received, 164 SEK for ability to choose a provider and 111 SEK for each 1 day reduction in waiting time for non-emergency visits. Subgroup analysis showed that older individuals and individuals in poor health preferred the option to register with a GP whereas working individuals and individuals living at a greater distance from a hospital preferred the option to register with a primary care team.

Biosketch of Ernst Ludwig Wynder

Arab American women have preferred women physicians of their own culture in the past. The primary aim of this study is to determine the current influence of religion/culture among MENA women and their preferences for physicians of same sex, culture, and religion on the avoidance and uncomfortableness of routine and women's health exams.A cross sectional community survey including religiosity and the importance of physician matched sex, culture, and religion was completed. Outcome measures were avoidance of a routine physical exam, or a women's health exam because of religious/cultural issues; and the uncomfortableness of the women's health exam. Linear regression modeling was used to evaluate the association between outcomes and potential predictors, with significance assessed using a bootstrap method.The responses of 97 MENA women 30–65 years old showed that MENA women agreed that they would avoid routine health exams because of religious/cultural issues if their physician was of the same religion or culture as they were (p < 0.001, p < 0.05, respectively) or they had less education (p < 0.05). MENA women also avoided women's health exams due to religious/cultural issues if her physician was of the same religion as she (p < 0.01).MENA women 30–65 years old may no longer be bound to a female physician of their same religion/culture for their health exams.This work was supported by NIH through the Michigan Institute for Clinical and Health Research UL1TR002240 and The University of Michigan Rogel Cancer Center P30CA046592-29-S4 grants.