Patient characteristics and inequalities in doctors' diagnostic and management strategies relating to CHD: a video-simulation experiment
- PMID: 16002197
- DOI: 10.1016/j.socscimed.2005.05.028
Patient characteristics and inequalities in doctors' diagnostic and management strategies relating to CHD: a video-simulation experiment
Abstract
Numerous studies examine inequalities in health by gender, age, class and race, but few address the actions of primary care doctors. This factorial experiment examined how four patient characteristics impact on primary care doctors' decisions regarding coronary heart disease (CHD). Primary care doctors viewed a video-vignette of a scripted consultation where the patient presented with standardised symptoms of CHD. Videotapes were identical apart from varying patients' gender, age (55 versus 75), class and race, thereby removing any confounding factors from the social context of the consultation or other aspects of patients' symptomatology or behaviour. A probability sample of 256 primary care doctors in the UK and US viewed these video-vignettes in a randomised experimental design. Gender of patient significantly influenced doctors' diagnostic and management activities. However, there was no influence of social class or race, and no evidence of ageism in doctors' behaviour. Women were asked fewer questions, received fewer examinations and had fewer diagnostic tests ordered for CHD. 'Gendered ageism' was suggested, since midlife women were asked fewest questions and prescribed least medication appropriate for CHD. Primary care doctors' behaviour differed significantly by patients' gender, suggesting doctors' actions may contribute to gender inequalities in health.
Similar articles
-
Influence of patient characteristics on doctors' questioning and lifestyle advice for coronary heart disease: a UK/US video experiment.Br J Gen Pract. 2004 Sep;54(506):673-8. Br J Gen Pract. 2004. PMID: 15353053 Free PMC article. Clinical Trial.
-
Country differences in the diagnosis and management of coronary heart disease - a comparison between the US, the UK and Germany.BMC Health Serv Res. 2008 Sep 29;8:198. doi: 10.1186/1472-6963-8-198. BMC Health Serv Res. 2008. PMID: 18823556 Free PMC article.
-
Women and men with coronary heart disease in three countries: are they treated differently?Womens Health Issues. 2008 May-Jun;18(3):191-8. doi: 10.1016/j.whi.2008.01.003. Womens Health Issues. 2008. PMID: 18457754 Free PMC article.
-
New medicines in primary care: a review of influences on general practitioner prescribing.J Clin Pharm Ther. 2008 Feb;33(1):1-10. doi: 10.1111/j.1365-2710.2008.00875.x. J Clin Pharm Ther. 2008. PMID: 18211610 Review.
-
Factors impacting on doctors' management of acute low back pain: a systematic review.Eur J Pain. 2009 Oct;13(9):908-14. doi: 10.1016/j.ejpain.2008.11.013. Epub 2008 Dec 24. Eur J Pain. 2009. PMID: 19110456 Review.
Cited by 36 articles
-
Influence of psychiatric or social backgrounds on clinical decision making: a randomized, controlled multi-centre study.BMC Med Educ. 2019 Dec 12;19(1):461. doi: 10.1186/s12909-019-1897-z. BMC Med Educ. 2019. PMID: 31830962 Free PMC article. Clinical Trial.
-
Do poor patients suffer from inaccurate diagnoses more than well-to-do patients? A randomized control trial.BMC Med Educ. 2019 Oct 22;19(1):386. doi: 10.1186/s12909-019-1805-6. BMC Med Educ. 2019. PMID: 31640683 Free PMC article. Clinical Trial.
-
Does gender matter? An analysis of men's and women's accounts of responding to symptoms of lung cancer.Soc Sci Med. 2017 Oct;191:134-142. doi: 10.1016/j.socscimed.2017.09.015. Epub 2017 Sep 8. Soc Sci Med. 2017. PMID: 28917622 Free PMC article.
-
Implicit bias in healthcare professionals: a systematic review.BMC Med Ethics. 2017 Mar 1;18(1):19. doi: 10.1186/s12910-017-0179-8. BMC Med Ethics. 2017. PMID: 28249596 Free PMC article. Review.
-
Patient satisfaction with doctor-patient interaction and its association with modifiable cardiovascular risk factors among moderately-high risk patients in primary healthcare.PeerJ. 2017 Feb 21;5:e2983. doi: 10.7717/peerj.2983. eCollection 2017. PeerJ. 2017. PMID: 28243527 Free PMC article.
Publication types
MeSH terms
Grant support
LinkOut - more resources
-
Full Text Sources
-
Other Literature Sources
-
Medical
