There are land mines in physician-patient communications, too many to count.

The excerpt below is from a column by The New York Times writer of the column, Doctor and Patient, by Pauline W. Chen.

This is about new research that shows that the gender of the doctor land mine often is planted by patients—not the doctors.

A friend of mine, who once covered medicine himself, called me when he moved back to the area. He wanted my help in finding a doctor. He gave me his requirements about training, board certification and location but added that he wanted a woman doctor. “They listen better.”

I said that I thought he needed to pick the best doctor for himself, regardless of gender. That best doctor very well could be a woman. Maybe not.

No, he said stubbornly, he wanted a female.

By the time I went down his checklist, it was real work to find women doctors who matched up. One was not taking any new patients. Two were. I suggested that he visit both.

He went to a visit with the first one. He decided she’d be fine and called to tell me that.

“Well, that was easy,” I said. It seemed too easy as he has health problems which require careful management.

Three months later, he called back. “I was wrong. This is not right. We need to start over. I don’t care about gender. Let’s just find me the one I need.”

It’s important to look at trends in physician communications because, for one thing, they help medical educators see where they need to enhance training programs. These findings can help specialty societies beef up their offerings in continuing medical education.

What does this research mean to you, the patient?

The gender attitudes you, the patient, bring to the partnership matters. You may know these attitudes are there, as my friend did. He was biased in favor of a woman doctor.

You may not know that that you have attitudes about doctors and gender.

None of us can see inside our own subconscious minds. We don’t know what perceptions lurk there, as this column shows.

We do not know ourselves as patients as well as we may think. That is why being proactive in communications with all of your doctors is important. If you communicate the same way with doctors, male or female, you are doing you part to reduce the number of hidden land mines in that exam room.

I have had both male and female doctors. I did not, and do not, experience any differences in patient satisfaction.

The New York Times

…”Findings from other studies have also revealed that patients, regardless of gender, tend to be more assertive with women doctors, interrupting them and asking questions more frequently. While some experts have construed these interruptions as a sign of decreased respect, others contend that they in fact reflect a greater sense of comfort on the part of the patient. “Interruptions are not necessarily bad,” Dr. Hall observed. “They can be a sign of empowerment and of participation. Patients feel like they are really talking.” (Emphasis added)

…“You can’t necessarily say that women are better doctors,” said Dr. Klea D. Bertakis, lead author of that study and a professor of family and community medicine at the University of California, Davis. “It’s a matter of gender behaviors in the course of an encounter. Patients, as well as physicians, are bringing their specific backgrounds and experiences to that encounter; and we need to be aware of that.” (Emphasis added)

“Perhaps the most interesting finding in these studies of gender in the patient-doctor relationship involves male doctors who practice obstetrics and gynecology. While this group of male physicians has been shown to be significantly better than their female colleagues at showing empathy and talking to patients about their emotional concerns, many of their patients continue to have a strong preference for female doctors. (Ed. Note: This is about obstetrics and gynecology, a specialty in which it is especially likely women are more comfortable with women. It is not clear if this would hold true in other fields.)

“Patient-centered communication styles, it seems, may not be the only, nor even the most important, determinant of patient satisfaction.”

Source: New York Times, May 5, 2010