The associations of consultant sex on herding‑like prescribing behaviour: evidence from a web-based experiment with female primary care physicians in England.

backgroundSex and gender influence medical decision making, yet little is known about how the sex of a consultant shapes the prescribing behaviour of female primary care physicians (PCPs). This study examined whether consultant sex affects female PCPs' likelihood of following recommendations that conflict with clinical guidelines and explored the factors underlying trust in consultants.

methodsWe conducted a web-based experimental study using case vignettes on sleeping medication and antibiotics. A total of 482 female PCPs in England were randomly assigned to conditions with no recommendation or with recommendations from male or female consultants. The outcomes included prescribing decisions, confidence, perceived difficulty, and effort.

resultsIn the absence of recommendations, female PCPs rarely prescribe non-guideline medications, reflecting cautious baseline behaviour. Consultant recommendations increased prescribing across both vignettes, with higher rates in both consultant conditions than in the control condition (sleeping medication: 43.3% male vs. 33.6% female vs. 30.4% control, χ

conclusionsConsultant recommendations, independent from consultant's sex, increased the likelihood of non-guideline prescribing among female PCPs. The absence of statistically significant differences between male and female consultants suggests that the presence of a recommendation itself may be more influential than consultant sex. Strengthening physicians' confidence and supporting guideline-based decision-making may help reduce susceptibility to social influence.