Background. Emphasis on ensuring women's access to preventive health s
ervices has increased over the past decade. Relatively little attentio
n has been paid to whether the sex of the physician affects the rates
of cancer screening among women. We examined differences between male
and female physicians in the frequency of screening mammograms and Pap
smears among women patients enrolled in a large Midwestern health pla
n. Methods. We identified claims for mammography and Pap tests submitt
ed by primary care physicians for 97,962 women, 18 to 75 years of age,
who were enrolled in the health plan in 1990. The sex of the physicia
n was manually coded, and the physician's age was obtained from the st
ate licensing board. After identifying a principal physician for each
woman, we calculated the frequency of mammography and Pap smears for e
ach physician, using the number of women in his or her practice during
1990 as the denominator. Using unconditional logistic regression, we
also calculated the odds ratio of having a Pap smear or mammogram for
women patients with female physicians as compared with those with male
physicians, controlling for the physician's and the patient's age. Re
sults. Crude rates for Pap smears and mammography were higher for the
patients of female than male physicians in most age groups of physicia
ns. The largest differences between female and male physicians were in
the rates of Pap smears among the youngest physicians. For the subgro
up of women enrolled in the health plan for a year who saw only one ph
ysician, after adjustment for the patient's age and the physician's ag
e and specialty, the odds ratio for having a Pap smear was 1.99 (95 pe
rcent confidence interval, 1.72 to 2.30) for the patients of female ph
ysicians as compared with those of male physicians. For women 40 years
old and older, the odds ratio for having a mammogram was 1.41 (95 per
cent confidence interval, 1.22 to 1.63). For both Pap smears and mammo
graphy, the differences between female and male physicians in screenin
g rates were much more pronounced in internal medicine and family prac
tice than in obstetrics and gynecology. Conclusions. Women are more li
kely to undergo screening with Pap smears and mammograms if they see f
emale rather than male physicians, particularly if the physician is an
internist or family practitioner.