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Cited by 184Sex and Gender in HealthcarePatient-Provider Communication in HealthcareDiversity and Career in Medicine

Patient characteristics and inequalities in doctors’ diagnostic and management strategies relating to CHD: A video-simulation experiment

Arber, Sara, McKinlay, John, Adams, Ann, Marceau, Lisa, Link, Carol, O’Donnell, Amy·2006·Social Science & Medicine
DOI 10.1016/j.socscimed.2005.05.028
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Abstract

Numerous studies examine inequalities in health by gender, age, class and race, but few address the actions of primary care doctors. This factorial experiment examined how four patient characteristics impact on primary care doctors' decisions regarding coronary heart disease (CHD). Primary care doctors viewed a video-vignette of a scripted consultation where the patient presented with standardised symptoms of CHD. Videotapes were identical apart from varying patients' gender, age (55 versus 75), class and race, thereby removing any confounding factors from the social context of the consultation or other aspects of patients' symptomatology or behaviour. A probability sample of 256 primary care doctors in the UK and US viewed these video-vignettes in a randomised experimental design. Gender of patient significantly influenced doctors' diagnostic and management activities. However, there was no influence of social class or race, and no evidence of ageism in doctors' behaviour. Women were asked fewer questions, received fewer examinations and had fewer diagnostic tests ordered for CHD. 'Gendered ageism' was suggested, since midlife women were asked fewest questions and prescribed least medication appropriate for CHD. Primary care doctors' behaviour differed significantly by patients' gender, suggesting doctors' actions may contribute to gender inequalities in health.

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  • Arbera 2006 found midlife women were asked fewest questions.

    “Midlife women were asked fewest questions and prescribed least medication appropriate for CHD.”

    From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [32]

  • Arbera 2006 found midlife women were prescribed least medication appropriate for CHD.

    “Midlife women were asked fewest questions and prescribed least medication appropriate for CHD.”

    From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [32]

  • Arbera 2006 found the gender of the patient significantly influenced doctors' diagnostic and management activities.

    “The gender of the patient significantly influenced doctors’ diagnostic and management activities.”

    From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [32]

  • Many assumption studies attempted to make their vignettes as realistic as possible by having them validated by clinicians and by having participants view/read the vignettes as part of a normal day at work.

    “many of the assumption studies attempted to make their vignettes as realistic as possible by having them validated by clinicians [25–41] and also by having participants view/read the vignettes as part of a normal day at work [27–36, 39, 41].”

    From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [32]

  • Eight articles appeared to refer to the same data collected in a single cross-country comparison study, and a further two articles analysed the same data.

    “eight articles appeared to refer to the same data collected in a single cross-country comparison study [27–32, 34, 35] and a further two articles analysed the same data [45, 47].”

    From Implicit bias in healthcare professionals: a systematic review (2017) · cites this paper as [32]

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Authors
Arber, S., McKinlay, J., Adams, A., Marceau, L., Link, C., & O’Donnell, A.
Affiliations
  • University of Surrey (GB)
  • New England Research Institutes (US)
  • University of Warwick (GB)
Corresponding author
Arber, Sara
ORCID
Venue
Social Science & Medicine
Publisher
Elsevier BV
Published
2006-01
Volume
62
Issue
1
Pages
103-115
ISSN
0277-9536 (ISSN-L)
DOI
10.1016/j.socscimed.2005.05.028
OpenAlex
W2041598086
Cited by
184
References
1
Citations by year
2026: 3 · 2025: 6 · 2024: 10 · 2023: 6 · 2022: 10 · 2021: 7 · 2020: 10 · 2019: 13 · 2018: 8 · 2017: 5 · 2016: 12 · 2015: 6 · 2014: 6 · 2013: 9 · 2012: 9
FWCI
8.74
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Social Science & Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DigitalGeorgetown (Georgetown University Library) (submittedVersion)
Funders
National Institute on Aging (AG 16747, R01AG016747)
Topics
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Sex and Gender in Healthcare
  • Health Sciences › Health Professions › General Health Professions › Patient-Provider Communication in Healthcare
  • Social Sciences › Gender Studies › Diversity and Career in Medicine
Keywords
coronary artery disease, gender inequality in health, primary care physicians, diagnostic decision-making, clinical management, ageism, social class, race, middle-aged women, video vignettes, physician-patient interaction, sex differences in care
MeSH terms
Age Factors, Aged, Communication, Coronary Disease, Decision Making, Female, United Kingdom, Humans, Male, Middle Aged, Patient Education as Topic, Physician-Patient Relations, Practice Patterns, Physicians', Prejudice, Primary Health Care, Sex Factors, Social Class, United States, Video Recording

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