Does your gender influence your clinical decision-making?

By Naveed Saleh, MD, MS, for MDLinx
Published April 9, 2019

Key Takeaways

Have you ever wondered whether male or female physicians take different approaches to patient care? Well, this certainly seems to be the case. Female physicians tend to take a more robust approach when deducing patient care, according to a recent study published in Gynecologic Oncology Reports.

“Significant differences were identified in the way male and female doctors acquired information en route to a decision,” wrote the authors, led by Raphael Gotlieb, Division of Experimental Surgery, Faculty of Medicine, McGill University, Montreal, Canada. “The results show the influence of gender on the amount of time it takes them to make a clinical decision, the amount of information they interact with, their decision strategy, and the importance they attribute to the cost of the medical procedure in the non-crisis situation.”

Study participants included 84 gynecologic oncologists, fellows, and residents (42 male doctors [18 staff, 24 residents] and 42 female doctors [19 staff, 23 residents]; average age: 37 years) from Canada.

The team evaluated clinical decision-making skills using a new online decision-matrix software that was developed to provide insight into the process of decision-making in medical situations. The software adhered to a decision matrix including evidence-based criteria, alternatives, and implications.

Specific scenarios tested included crisis and non-crisis cases for endometrial cancer surgery.

Male doctors in the study spent less time making decisions than female doctors (8.35 vs. 11.03 minutes, respectively; P < 0.006).

The researchers found that more information was accessed and reviewed in the non-crisis scenario by both male and female physicians. However, female physicians accessed a significantly higher percentage of information bins (46%) vs their male colleagues (28%; P < 0.03) in the crisis and non-crisis scenarios.

In addition, more female physicians used the alternative-based information acquisition process in the non-crisis scenario (36%) vs male physicians (10%; P=0.01). Similar results were observed in the crisis scenario (33% of female vs 21% of male doctors; P=0.36).

Female physicians were less cost conscious with respect to medical procedures when determining a final decision in the non-crisis scenario. But no difference in cost consciousness was observed between genders in the crisis situation.

Furthermore, no difference was seen between genders with respect to the final decision in the non-crisis scenario. However, female and male physicians chose different procedures in the crisis scenario (P=0.07). Most female doctors (> 50%) chose alternative procedure C (clipping) compared with male doctors (< 25%), who tended to opt for alternative procedure E (convert to an open procedure).

Findings on decision-making uncovered in the current study are similar to results from online consumer shopping studies, wherein women have been observed to comprehensively acquire more information and take more time to shop. Men, on the other hand, took less time searching while shopping online and used shortcuts to limit their search. In other words, men, on average, don’t consider all available information to the extent that women do.

On a related note, other researchers have shown that female physicians spend more time with their patients. In other studies, a link between gender and clinical outcomes has been demonstrated.

Limitations of the current study included drawing on a sample of only Canadian physicians and a clinical case reflecting the practice of gynecology, which could limit the applicability of these findings to other fields. Moreover, the current study was not designed to compare the impact of gender differences on the quality of medical decision-making.

“Further understanding of these differences might allow to refine medical education and residency training, as part of our continuous efforts to improve clinical care,” concluded the authors.

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