Identity and access: Gender-based preferences and physician availability in primary care

Abstract

Patient preferences for physicians may be influenced by shared characteristics such as gender. We analyzed experimental data from a survey of US adults in which respondents were asked to choose between physician profiles that on average varied only by gender. We find that female patients prefer female physicians to male physicians by 51.8 percentage points (95 % CI: 0.470 to 0.566, p < 0.01), and that result holds across Black, White, and Hispanic sub-groups. With no countervailing preference among male patients, this result holds in the overall sample at 26.8 percentage points (95 % CI: 0.228 to 0.307, p < 0.01). We also analyzed data from a simulated patient field experiment concerning access to primary care appointments and find that female physicians, on average, offer appointments 7.1 days later than male physicians (95 % CI: 5.1 to 9.1, p < 0.01), consistent with the finding that female physicians are preferred. Female physicians’ offices appear to favor female patients, offering appointments to them 2.6 days earlier compared to male patients (95 % CI: -5.3 to 0.195, p = 0.07). However, Hispanic female patients were offered 4.2-percentage-points fewer appointments compared to Hispanic males (95 % CI: -0.069 to -0.014, p < 0.01) by female physicians’ offices. Similarly, Black female patients were told that the physician is “not taking new patients” 3.5 percentage points more often (95 % CI: -0.004 to 0.073, p = 0.08) and were offered appointments that were 2.6 minutes shorter compared to Black males (95 % CI: -4.8 to -0.44, p = 0.02). Overall, our analysis suggests that female primary care physicians are in high demand relative to their supply, and that access to scarce female physicians is mediated by race and ethnicity.