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The influence of patient and doctor gender on diagnosing coronary heart disease

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Adams, Ann, Buckingham, C.D., Lindenmeyer, Antje, McKinlay, John B., Link, Carol, Marceau, Lisa and Arber, Sara. (2008) The influence of patient and doctor gender on diagnosing coronary heart disease. Sociology of Health & Illness, Vol.30 (No.1). pp. 1-18. ISSN 0141-9889

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Official URL: http://dx.doi.org/10.1111/j.1467-9566.2007.01025.x

Abstract

Using novel methods, this paper explores sources of uncertainty and gender bias in primary care doctors’ diagnostic decision making about coronary heart disease (CHD). Claims about gendered consultation styles and quality of care are re-examined, along with the adequacy of CHD models for women. Randomly selected doctors in the UK and the US (n=112, 56 per country, stratified by gender) were shown standardised videotaped vignettes of actors portraying patients with CHD. ‘Patients’ age, gender, ethnicity and social class were varied systematically. During interviews, doctors gave free-recall accounts of their decision making, which were analysed to determine patient and doctor gender effects. We found differences in male and female doctors’ responses to different types of patient information. Female doctors recall more patient cues overall, particularly about history presentation, and particularly amongst women. Male doctors appear less affected by patient gender but both male and especially female doctors take more account of male patients’ age and consider more age-related disease possibilities for men than women. Findings highlight the need for better integration of knowledge about female presentations within accepted CHD risk models, and do not support the contention that women receive better quality care from female doctors.

Item Type:	Journal Article
Subjects:	R Medicine > RC Internal medicine
Divisions:	Faculty of Medicine > Warwick Medical School > Education Development and Research Faculty of Medicine > Warwick Medical School > Mental Health and Wellbeing Faculty of Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Sex discrimination in medicine, Coronary heart disease -- Diagnosis
Journal or Publication Title:	Sociology of Health & Illness
Publisher:	Blackwell
ISSN:	0141-9889
Date:	January 2008
Volume:	Vol.30
Number:	No.1
Page Range:	pp. 1-18
Identification Number:	10.1111/j.1467-9566.2007.01025.x
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Restricted or Subscription Access
Description:	Version accepted by publisher (post-print, after peer review, before copy-editing).
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URI:	http://wrap.warwick.ac.uk/id/eprint/178