Abstract Objective This paper discusses the research focused on gender issues in healthcare communication. Methods The majority of papers discussed here are based on a research study in which 509 new ...adult patients were prospectively and randomly assigned to family practice or internal medicine clinics at a university medical center and followed for one year of care. Results There are significant differences in the practice style behaviors of female and male doctors. Female doctors provide more preventive services and psychosocial counseling; male doctors spend more time on technical practice behaviors, such as medical history taking and physical examination. The patients of female doctors are more satisfied, even after adjusting for patient characteristics and physician practice style. Female patients make more medical visits and have higher total annual medical charges; their visits include more preventive services, less physical examination, and fewer discussions about tobacco, alcohol and other substance abuse (controlling for health status and sociodemographic variables). The examination of gender concordant and discordant doctor–patient dyads provides a unique strategy for assessing the effect of gender on what takes place during the medical visit. Conclusion Doctor and patient gender can impact the physician–patient interaction and its outcomes. Practice implications The development of appropriate strategies for the implementation of knowledge about physician and patient gender differences will be crucial for the delivery of high quality gender-sensitive healthcare.
In 2022, Turkey encountered the formidable task of addressing an unprecedented loss of medical doctors and seeking remedies for potential issues within the healthcare system. This study set out to ...explore the inclination of 402 actively practicing Turkish doctors to depart from Turkey, assess the socio-demographic and socio-economic factors influencing this trend, and establish the hierarchy of raised concerns among doctors. Employing a cross-sectional and analytical approach, the study drew comparisons between doctors' demographic characteristics and the significance of their grievances, while also examining the correlation between the importance of complaints and the desire to remain in Turkey. The doctors' primary complaints encompassed financial challenges, instances of violence in the healthcare sector, and insufficient examination durations. The migration of doctors poses a substantial risk to healthcare accessibility, public health, and the sustainability of Turkey's healthcare delivery capacity. To mitigate this risk and curb doctor migration, corrective measures must be implemented to improve working conditions. Additionally, there is a need for further scientific research focusing on doctors' concerns, particularly in developing countries like Turkey, to expand the current body of literature on this subject.
A growing body of literature supports stigma and discrimination as fundamental causes of health disparities. Stigma and discrimination experienced by transgender people have been associated with ...increased risk for depression, suicide, and HIV. Transgender stigma and discrimination experienced in health care influence transgender people's health care access and utilization. Thus, understanding how stigma and discrimination manifest and function in health care encounters is critical to addressing health disparities for transgender people. A qualitative, grounded theory approach was taken to this study of stigma in health care interactions. Between January and July 2011, fifty-five transgender people and twelve medical providers participated in one-time in-depth interviews about stigma, discrimination, and health care interactions between providers and transgender patients. Due to the social and institutional stigma against transgender people, their care is excluded from medical training. Therefore, providers approach medical encounters with transgender patients with ambivalence and uncertainty. Transgender people anticipate that providers will not know how to meet their needs. This uncertainty and ambivalence in the medical encounter upsets the normal balance of power in provider–patient relationships. Interpersonal stigma functions to reinforce the power and authority of the medical provider during these interactions. Functional theories of stigma posit that we hold stigmatizing attitudes because they serve specific psychological functions. However, these theories ignore how hierarchies of power in social relationships serve to maintain and reinforce inequalities. The findings of this study suggest that interpersonal stigma also functions to reinforce medical power and authority in the face of provider uncertainty. Within functional theories of stigma, it is important to acknowledge the role of power and to understand how stigmatizing attitudes function to maintain systems of inequality that contribute to health disparities.
► Clinicians often respond to health care needs of transgender patients with uncertainty. ► Discomfort with uncertainty leads clinicians to reinforce medical authority with stigma. ► Functional theories of stigma should incorporate the role of power relations.
In the “internet plus” era, online healthcare platforms provide an effective way of easing the demand for hospitals, and their popularity among patients has been increasing sharply in recent years. ...Such platforms' effectiveness depends on whether there are adequate interactions between patients and doctors through multiple online consultations. Nonetheless, compared with face-to-face consultations, online patients' trust to the doctors and switching costs are often lower. Thus, many of them (in particular, those with chronic diseases) may terminate their cases after the very first consultation, jeopardizing the effectiveness of the online platforms. We adopt a trust development perspective to examine how doctors' online consultation behaviours can reduce patients' switching of doctors and how they enhance patient satisfaction, thereby offering insights to make such healthcare platforms more efficient and effective. By analyzing 77,248 patients' behaviours on an online healthcare platform covering the period 2014–2015, we find that the response time, the depth of interaction, and service content during the first consultation influence the patients' subsequent consultation behaviours significantly. Also, the effects of doctor response time, service content, and depth of interaction on patient satisfaction are different in different periods. Our findings offer managerial insights on managing patients' continuous consultation behaviours and enhancing their satisfaction by considering the time scope and service type. Also, they offer important insights into how online medical care can be delivered more effectively, so relieving the demand for traditional healthcare system capacity.
Malgré certains incidents de parcours, le doctorat fut l’expérience la plus marquante de ma vie intellectuelle. Un doctorat, c’est fait par du monde, mais ce projet exige une grande persévérance et ...de l’acharnement au travail. Surtout, condition première, il faut aimer lire, écrire et rechercher l’étincelle de la découverte. Ce livre a été écrit du point de vue des doctorants. Il couvre les différents aspects du doctorat, de l’inscription au programme à la soutenance de la thèse, en passant par la direction de thèse, la recension des écrits et l’écriture. L’ouvrage se veut concret et propose des solutions pour atténuer les problèmes qui se présentent à l’étudiant. Chaque doctorant a sa manière de réussir son doctorat. Toutefois, la passion d’apprendre transporte les personnes qui ont à cœur de mener à terme leur projet d’étude. Oui, le doctorat peut être une aventure passionnante !
To investigate the relationship between Body Mass Index (BMI) and adherence to recommended screening tests, addressing gaps in previous literature by utilizing a large cohort, while considering ...longitudinal changes in weight and the type of screening.
Data from Clalit Health Services in Israel were retrospectively analyzed, including participants aged 50 and above from 2002 to 2021. BMI measurements and various screening test records were examined. Generalized Estimating Equations were employed for analysis, adjusting for potential confounding variables, including age, gender, geographic location, and socioeconomic status.
The study included 634,879 participants with 4,630,030 BMI measurements and 56,453,659 test records. Participants were categorized into BMI cohorts at the time of the test, with overweight and obese individuals showing lower odds of undergoing intimate examination-based screening tests (mammography, PAPS, and skin examination), as opposed to higher odds of several non-intimate tests (e.g., diabetes and eye disorder screenings).
Our findings suggest that individuals with overweight and obesity are less likely to undergo screenings involving intimate physical examinations, potentially due to weight stigma and discomfort. This avoidance behavior may contribute to increased morbidity rates in these populations. Interventions addressing weight stigma, improving access to care, and enhancing patient engagement are warranted.
Highlights • Most patients wanted to be asked about religion/spirituality by their doctor. • A significant minority of patients did not desire or objected to doctor enquiry. • It is not clear how to ...identify which patients desire discussion of spirituality. • Patients and doctors do not always agree on what spiritual discussion entails.
In the nineteenth century, infants were commonly breast-fed; by the middle of the twentieth century, women typically bottle-fed their babies on the advice of their doctors.  In this book, Rima ...D. Apple discloses and analyzes the complex interactions of science, medicine, economics, and culture that underlie this dramatic shift in infant-care practices and women’s lives.     As infant feeding became the keystone of the emerging specialty of pediatrics in the twentieth century, the manufacture of infant food became a lucrative industry.  More and more mothers reported difficulty in nursing their babies.  While physicians were establishing themselves and the scientific experts and the infant-food industry was hawking the scientific bases of their products, women embraced “scientific motherhood,” believing that science could shape child care practices.  The commercialization and medicalization of infant care established an environment that made bottle feeding not only less feared by many mothers, but indeed “natural” and “necessary.”  Focusing on the history of infant feeding, this book clarifies the major elements involved in the complex and sometimes contradictory interaction between women and the medical profession, revealing much about the changing roles of mothers and physicians in American society. “The strength of Apple’s book is her ability to indicate how the mutual interests of mothers, doctors, and manufacturers led to the transformation of infant feeding. . . . Historians of science will be impressed with the way she probes the connections between the medical profession and the manufacturers and with her ability to demonstrate how medical theories were translated into medical practice.”—Janet Golden, Isis  
In all branches of medicine, effective communication between health care professionals and patients, families and carers is essential to ensure first-class treatment. Increasing public awareness of ...health issues and the ready availability of health information have lead the public to be more widely informed about common conditions and the treatments available. Patients therefore attend a medical consultation better informed so the need for improved communication skills is even greater. This book aims to demystify the ‘doctor-patient’ relationship in order that patients and potential patients can more easily understand the information which doctors are seeking to convey as well as gaining some insight into the difficulties of communication from a doctor’s perspective. Some conversations require specialised skills. Talking to people with difficult personalities and poor social skills can be challenging. Strong emotions of anger, frustration or distress need sensitive handling and particular age groups call on styles of address appropriate to their particular needs. Using the expertise of experienced doctors from many specialties this book covers not only the theory behind good communication skills but also gives a wealth of practical advice. The book covers ethical and legal issues, planning difficult conversations, the patient’s and doctor’s perspectives, issues surrounding special groups such as children and the elderly, and conversations with patients from different cultural backgrounds. Outlines of possible clinical cases posing specific problems are included with guidance on how to handle them.
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