Choosing a Specialist: An Explanatory Study of Factors Influencing Patients in Choosing a Urologist

Abstract

<b><i>Objectives:</i></b> While research on doctor-patient interaction has often focused on the decision-making abilities of physicians, it rarely centers around the question of how patients choose their respective practitioners. Research on fundamental decision processes is of high importance and understanding the factors that influence people’s choices in real-life decision-making would potentially provide patients, and physicians alike, with the means to provide better resources to achieve greater satisfaction from visits to a medical practitioner. <b><i>Methods:</i></b> At our tertiary referral center, patients were given the opportunity to voluntarily participate in our survey. We collected questionnaires from 1,002 patients during their visit from November 2018 to February 2020. Statistical analysis was performed using SPSS V26.0 software (SPSS Statistics, Version 26.0.; IBM, Armonk, NY, USA). Results are reported as percentages for categorial variables. <b><i>Results:</i></b> Our patient cohort consisted of a higher percentage of men than of women (82 vs. 18%) with significantly more men having a university-based education (44 vs. 31%; <i>p</i> = 0.001). Women were more likely to have statutory health insurance than men (85 vs. 74%; <i>p</i> = 0.013). Men significantly preferred to be treated by a doctor of the same sex (24 vs. 8%; <i>p</i> < 0.001), which significantly increased with age. Overall, more women than men trusted a referral by their primary care physician (75 vs. 66%, <i>p</i> = 0.017), while preference of a higher academic degree in the attending urologist was significantly correlated with the patients’ education. <b><i>Conclusions:</i></b> Information on a specialist, such as professional qualifications and academic accomplishments, is easily accessible to patients with or without access to the Internet. However, recommendations and referrals, in addition to consistent care by the same treating physician, seem to be of high importance to all patients, regardless of gender or age.

What Factors Determine the Patients’ Choice in Finding Their Office Urologist?

“…According to data from a tertiary hospital in Germany, the personal recommendation by a physician or a relative friend is of high significance, too. 16 In the same study, the age group 20–40 is more enthusiastic about searching for a urologist using the Internet. 16 On the other hand, a significant proportion of patients search the internet regarding their medical condition before presenting to the clinic.…”

“… 16 In the same study, the age group 20–40 is more enthusiastic about searching for a urologist using the Internet. 16 On the other hand, a significant proportion of patients search the internet regarding their medical condition before presenting to the clinic. 13 …”

“…Someone could claim that this agrees with Berger et al, who mentioned the hospital’s reputation as a vital factor and Tamalunas et al, who described the importance of professional skills and academic criteria. 13 , 16 Board certifications and academic degrees provide acceptable rational proof of an efficient and well-trained urologist. On the other hand, younger individuals believe that the more important of an experienced urologist is a detailed examination and think that the patient should be the urologist’s priority.…”

Gender Bias in Urology: How Do Patients Really Choose Their Urologist?

“…Although research has begun to increasingly focus on patient satisfaction, there is only limited knowledge on how patients choose their urologist and for gender preference. 4,5,[9][10][11][12] Recently, we could show that patients chose their urologist based on fairly rational grounds, focusing on certain core variables, such as professional skill and academic criteria of the urologist, or being attended by the same urologist at every visit, or by personal referral. 5 These findings were later corroborated with the European Association of Urology Section of Outpatient and Office Urology (ESUO) questionnaire by Zachariou, et al 4 Those studies included board certification as surrogate for professional skill, and academic degree as visible external factor for professional accomplishment.…”

“…Although research has begun to increasingly focus on patient satisfaction, there is only limited knowledge on how patients choose their urologist and on the impact of gender. 4,5,[9][10][11][12] Patients in the German healthcare system provide an ideal study cohort, as Germany has one of the most restrictionfree and consumer-oriented healthcare systems. Compared to other healthcare systems, in which insurance networks may greatly influence patients' choice of a urologist according to a particular healthcare plan or healthcare provider, as is often the case in the US, the German healthcare system allows patients to seek nearly any type of care they wish, and whenever they want it.…”