EFFECT OF PHYSICIAN GENDER ON THE PRESCRIPTION OF ESTROGEN REPLACEMENT THERAPY

OBJECTIVE: To determine if women cared for by female physicians are mo re Likely to receive postmenopausal estrogen replacement therapy than women cared for by male physicians. DESIGN: Case-control study with fo llow-up telephone survey. SETTING: An outpatient practice at an urban teaching hospital in Boston, Massachusetts. PARTICIPANTS: Subjects wer e women begun on estrogen replacement therapy during an Is-month perio d; controls were matched on age and month of visit. Seventy-one cases (mean age 60 years, 41% nonwhite) and 142 controls (mean age 60 years, 48% nonwhite) were identified. Fifty-two (82%) of 64 eligible case pa tients and 89 (80%) of 111 eligible control patients completed a follo w-up telephone interview assessing their preferences for female physic ians and interest in estrogen replacement therapy. MAIN RESULTS: After adjusting for potential confounders using conditional logistic regres sion, patients with female physicians were more likely to begin estrog en replacement therapy than those seen by male physicians (odds ratio [OR] 5.4; 95% confidence interval [CI] 1.8, 15.3). Case patients selec ted their primary care physician more often than control patients and were more interested in estrogen replacement therapy. After adjusting for potential confounders including patients' preferences to select th eir physician and their interest in estrogen replacement therapy, pati ents with female physicians were still more likely to begin estrogen r eplacement therapy than those seen by male physicians (OR 11.4, 95% CI 1.1, 113.6). CONCLUSIONS: We conclude that female patients are more l ikely to be prescribed estrogen replacement therapy if they are cared for by female physicians rather than male physicians even after accoun ting for patient preferences. Further research is required to determin e whether these differences reflect differences in physicians' knowled ge or attitudes regarding estrogen replacement therapy or reflect gend er differences in how physicians discuss estrogen replacement therapy with their patients.