Reasons for encounter in primary care among French patients: Gender differences in presentation rates more pronounced among the patients of male practitioners.

backgroundEvidence has shown that the gender of general practitioners (GPs) and of patients plays a role in primary care, both in communication and practice style. However, less is known about how both genders interact in the reasons for encounter (RfEs). Studying RfEs by both patient and GP gender may help elucidate what symptoms or complaints lead women and men to consult a GP and specifically, if patients have preferences regarding the gender of their GP for specific problems. Given that men tend to consult less frequently and are often diagnosed at later stages of disease, it is essential to disentangle whether GP gender may act as a barrier for men in disclosing certain health concerns.

objectiveTo examine the influence of patients' and GPs' gender on the presentation of clinical RfEs.

methodsThis is an ancillary study from the French ECOGEN survey, an observational cross-sectional multicentre study conducted between November 2011 and April 2012. 54 GP interns working alongside 128 GP supervisors collected RfEs during consultations. Using mixed models, we first assessed the association between patient gender and each RfEs chapter (i.e., 13 dependent variables). We then stratified models according to GP gender. Finally, we compared the four GP-patient gender dyads (male GP-male patient, male GP-female patient, female GP-male patient, and female GP-female patient) in pairwise analyses.

resultsOverall, 20 613 patients were included, of whom 58% were women. Of the 128 participating GPs, 85 were men. Women had higher presentation rates across all chapters. The most common RfEs were those related to the respiratory system. Modest differences in presentation rates were observed between men and women when visiting a man GP, with men being less likely to present RfEs from the General and Unspecified, Digestive, Eyes, Ears, Neurological, and Respiratory chapters.

conclusionsOur study adds evidence on how gender plays a role in presenting health problems in primary care. Specifically, our findings suggest that men may be reluctant to present certain RfEs to men GPs. Acknowledging these gender effects in primary care may help strengthen the partnership between GPs and patients.