The following is a summary of “Women physicians receive lower Press Ganey patient satisfaction scores in a multicenter study of outpatient gynecology care,” published in the SEPTEMBER 2023 issue of Obstetrics and Gynecology by Rogo-Gupta, et al.

Recent data indicated that patient satisfaction surveys may be inherently biased, impacting female physicians disproportionately. For a study, researchers sought to understand the connection between physician gender and patient satisfaction, specifically in outpatient gynecologic care across multiple healthcare facilities.

The study was conducted across multiple institutions and employed population-based survey analysis using Press Ganey patient satisfaction survey data. The surveys were conducted from January 2020 to April 2022 and encompassed outpatient gynecology visits at five distinct community-based and academic medical institutions. The primary endpoint under examination was the likelihood of patients recommending their physician. Each survey response was individually analyzed. Demographic information, including self-reported age, gender, and race and ethnicity (categorized as White, Asian, or Underrepresented in Medicine, which combines Black, Hispanic or LatinX, American Indian or Alaskan Native, and Hawaiian or Pacific Islander), was collected through these surveys. Survey responses were subjected to generalized estimating equation models, with results organized according to the physician. Statistical analyses included the computation of odds ratios, 95% CIs, and P-values, with statistical significance established at P<.05. SAS, version 9.4 (SAS Institute Inc., Cary, NC), was utilized for data analysis.

The study compiled data from 15,184 surveys representing 130 physicians. Most physicians (73%) were female, and most identified as White (75%). The patient demographics exhibited a similar trend, with 69% identifying as White (n=10,495 [69%]). Around 57% of visits were race-concordant, indicating that both patient and physician reported the same race. Analyses of survey scores revealed that female physicians were less likely to receive topbox scores (74% vs. 77%). After adjusting for various factors, including patient age and physician race, the analysis found that female physicians had 19% lower odds of obtaining topbox scores (95% CI, 0.69–0.95). Notably, patient age showed a robust association with scores, with older patients (aged 63 and above) displaying over three times the odds of providing topbox scores (odds ratio, 3.10; 95% CI, 2.12–4.52) compared to their younger counterparts. The patient and physician’s race and ethnicity also displayed substantial effects on the odds of receiving topbox recommendation scores. Both Asian physicians and patients exhibited lower odds of obtaining topbox recommendation scores compared to White physicians and patients (odds ratio: 0.89 [95% CI, 0.81–0.98] and 0.62 [95% CI, 0.48–0.79], respectively). Conversely, Underrepresented Medicine physicians and patients displayed significantly increased odds of receiving topbox recommendation scores (odds ratio: 1.27 [95% CI, 1.21–1.33] and 1.03 [95% CI, 1.01–1.06], respectively). No significant correlation was observed between the physician age quartile and the odds of topbox recommendation scores.

The findings from the extensive survey study, spanning multiple healthcare institutions and employing Press Ganey patient satisfaction surveys, demonstrated that female gynecologists had an 18% lower likelihood of receiving top patient satisfaction scores than their male counterparts. Given the current application of these surveys to evaluate patient-centered care, it was imperative to address and mitigate the apparent biases influencing the outcomes.

Source: ajog.org/article/S0002-9378(23)00415-5/fulltext