A NATIONAL STUDY OF THE FACTORS INFLUENCING MEN AND WOMEN PHYSICIANS CHOICES OF PRIMARY-CARE SPECIALTIES

Background. Despite a recent increase in the percentage of graduating U.S. medical students planning to pursue generalist careers, interest in primary care among students is still far below what it was in the e arly 1980s and falls well short of the stated goal of the Association of American Medical Colleges that half of all graduates should choose generalist careers. Also during the past decade, the number of women s tudents and physicians has increased. Given the importance of concerns regarding the primary care work force, it is timely to examine the re lationship between gender and other factors that influence the decisio n to enter primary care. Method. Totals of 1,038 (65%) men and 558 (35 %) women primary care physicians selected from the 1983 and 1984 gradu ates of all allopathic U.S. medical schools were surveyed in early 199 3. Gender comparisons were made on the 19 variables that influenced th e physicians' decisions to enter primary care specialties and on the s ix factor scores derived from a factor analysis of these 19 variables. Also included in the gender comparisons were characteristics of pract ice, populations served, timing of making the decision to enter primar y care, and personal demographic information. Results. Men, more than women, were influenced to become primary care physicians by early role models. Women, more than men, were influenced by personal and family factors. Overall, medical school experience and personal values are tw o important factors that explained the largest variances of the 19 pre dictor variables influencing the physicians' choices of primary care d isciplines. There was no gender difference in place of origin, family income as a child, timing of the decision to become a primary care phy sician, or the amount of debt upon graduation. Conclusion. This nation wide study of primary care physicians indicates that men and women phy sicians differ in their perceptions of the relative importances of fac tors influencing the choice of a primary care specialty. Gender-specif ic factors should receive more attention in the development of success ful strategies to attract more medical students into primary care spec ialties.