Women MDs Spend More Time With Patients: Does It Matter?

Shelly M. Reese

Disclosures

June 23, 2011

In This Article

Don't Generalize About Abilities

Whatever the reason, it would be misguided to draw sweeping generalizations about the relative abilities of physicians based on their genders. There's no indication that a physician's gender or the amount of time spent with a patient affects outcomes. Perhaps women are socialized to be more natural communicators, but men and women are equally capable of learning communication skills, notes Kim Templeton, MD, an orthopedic surgeon who often conducts patient-physician communication seminars for the American Academy of Orthopedic Surgeons. What's more, she emphasizes, all physicians -- regardless of gender -- can and should work to improve their patient communication skills.

"More time with the patient doesn't necessarily translate to better outcomes. It's not quantity, it's quality of time with a healthcare provider that matters," she says. Dr. Templeton notes that in surveys the most satisfied patients tend to think their doctors spent more time with them than they actually did.

That's an important distinction. While some have speculated that the growing number of female physicians will lead to a "feminization" of healthcare, it's a stretch to project that office visits will grow longer as a result, particularly given the current emphasis on making healthcare more efficient.

"Physicians may want to spend more time with patients, but unless we change the healthcare financing paradigm, that may not be possible," Dr. Templeton notes, "So it comes back to teaching people to communicate."

Practice Climate Makes an Impact

Sanford J. "Sandy" Brown, MD, Family Medicine, Fort Bragg, California, feels that practice climate -- not gender -- is the key factor in how much time a doctor spends with the patient.

"I think it has a lot more to do with the climate of your practice than with your sex," says Brown. "If you're an employed physician, there are often expectations of how many patients you need to see. You may have a quota, and you may be forced to see 4-6 people per hour. When you're seeing that many people, you have to maintain the schedule or you'll run pretty late."

By contrast, says Brown, if you're in an independent practice, you don't have a quota to meet. "If you're working for yourself, you have much more control over how much time you'll spend with patients."

Although spending more time with patients won't make one a better doctor, Brown says, it may influence patients' perceptions of their doctor. "Patients tend to rate their doctors based on how much time they spend and whether the doctor answered their questions. Based on that, patients may feel that a doctor who spends more time is a better doctor."

All in a Day's Work

Theresa Rohr-Kirchgraber, MD, Associate Professor of Clinical Pediatrics and Medicine at Indiana University School of Medicine, describes a recent day seeing patients at an Indianapolis clinic with a male medical student.

"He read me his report and told me a patient was doing well in school," recalls Dr. Rohr-Kirchgraber. "But when I'd ask the patient, 'So what does that mean? How many As? How many Bs?' It turned out there were a couple of Ds and an F. That led me to ask a lot more questions." Questions about academic performance uncovered that the young man had difficulty sleeping and was cutting class because he'd been deeply depressed.

The medical student reported that another patient said she wasn't sexually active, Dr. Rohr-Kirchgraber recalls. "So I asked her, 'When was the last time you had sex?' She said, 'Two days ago, but we broke up.'"

The pattern of conversations was repeated time and again. At the end of the day the medical student noted, "I can't believe you were able to get so much out of these kids."

Dr. Rohr-Kirchgraber's response: "You have to be willing to take the time and ask more questions."

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