Disciplined doctors: Does the sex of a doctor matter? A cross-sectional study examining the association between a doctor's sex and receiving sanctions against their medical registration

Unwin, Emily; Woolf, Katherine; Wadlow, Clare; Dacre, Jane

doi:10.1136/bmjopen-2014-005405

Cited by 26 publications

(47 citation statements)

References 16 publications

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“…On the other hand, US PHPs (11), which report data mainly coming from doctors in mandatory treatment because of SUDs, show a significantly different distribution (less than 20% of sick doctors were women and their evolution and prognosis was better than men’s) (28). Similarly, in our study, women were more likely to be self-referred to the program, while men were more frequently involved in compulsory treatment actions in line with previous studies (21, 29). …”

Section: Discussionsupporting

confidence: 92%

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Gender Differences in Demographic and Clinical Features of Physicians Admitted to a Program for Medical Professionals with Mental Disorders

et al. 2016

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ObjectiveTo examine the demographic and clinical differences between men and women admitted to a Physicians’ Health Programme (PHP).MethodRetrospective chart review of 778 medical records of physicians admitted to the Barcelona PHP from February 1, 1998 until December 31, 2015.ResultsWomen admitted to the Barcelona PHP were younger than men, were more likely to be self-referred and to be admitted for a non-addictive mental disorder. Prevalence of unipolar affective disorders (60.1 vs. 37.6%), adjustment disorders (62.4 vs. 37.6%), and obsessive–compulsive disorder (61.1 vs. 38.9%) was significantly higher among women, whereas prevalence of alcohol use disorders was lower (32.7 vs. 67.3%). Nevertheless, both groups were similar with regard to medical specialty, working status, length of their first treatment episode, and presence of hospitalization during that episode. After multivariate analysis, age, type of referral, and main diagnosis (addictive disorders vs. other mental disorders) discriminated the differences between groups.ConclusionWomen physicians seem to be more prone to voluntarily ask for help from PHPs and are more likely to suffer from mood and anxiety disorders compared to men. However, mental disorders’ severity may be similar in both groups. More studies are needed to clarify the gender factors related to this behavior.

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Section: Discussionsupporting

confidence: 92%

“…A recent study conducted in the UK showed that female doctors have reduced odds of receiving sanctions on their medical registration when compared with their male colleagues (21). …”

Section: Introductionmentioning

confidence: 99%

Gender Differences in Demographic and Clinical Features of Physicians Admitted to a Program for Medical Professionals with Mental Disorders

et al. 2016

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“…Previous research has shown that male doctors receive more sanctions after controlling for time since primary medical qualification, non-domestic primary medical qualification, and specialty. 3 However, in the current study there was no evidence to suggest a sex difference in warning/sanction rates among this highly selected group of GPs who completed a test of competence as part of an investigation. This suggests that the final decision on warnings or sanctions showed no sex bias beyond the differences in test performance.…”

Section: Strengths and Limitationscontrasting

confidence: 76%

“…1,2 Male doctors are nearly three times more likely to be sanctioned than female doctors. 3 The reasons underlying this difference are not clear.…”

Section: Introductionmentioning

confidence: 99%

Sex differences in fitness to practise test scores: a cohort study of GPs

et al. 2019

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BackgroundTests of competence are written and clinical assessments taken by doctors under investigation by the General Medical Council (GMC) who have significant performance concerns. Male doctors on average perform more poorly in clinical assessments than female doctors, and are more likely to be sanctioned. It is unclear why.AimTo examine sex differences in the tests of competence assessment scores of GPs under investigation by the GMC, compared with GPs not under investigation, and whether scores mediate any relationship between sex and sanction likelihood.Design and settingRetrospective cohort study of GPs’ administrative tests of competence data.MethodAnalysis of variance was undertaken to compare written and clinical tests of competence performance by sex and GP group (under investigation versus volunteers). Path analysis was conducted to explore the relationship between sex, written and clinical tests of competence performance, and investigation outcome.ResultsOn the written test, female GPs under investigation outperformed male GPs under investigation (Cohen’s d = 0.28, P = 0.01); there was no sex difference in the volunteer group (Cohen’s d = 0.02, P = 0.93). On the clinical assessment, female GPs outperformed male GPs in both groups (Cohen’s d = 0.61, P<0.0001). A higher clinical score predicted remaining on the UK medical register without a warning or sanction, with no independent effect of sex controlling for assessment performance.ConclusionFemale GPs outperform male GPs on clinical assessments, even among GPs with generally very poor performance. Male GPs under investigation may have particularly poor knowledge. Further research is required to understand potential sex differences in doctors who take tests of competence and how these impact on sex differences in investigation outcomes.

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“…In our review, there was a substantial over-representation of men in the number of doctors found guilty of medical misconduct. This finding is supported throughout the literature 1 3 4 6 8 30. Reviews undertaken by Clay and Konatser31 and Kohatsu et al 32 suggest that men are considerably over-represented in this population within the USA, with 90% and 91% of the misconduct cases perpetrated by men respectively.…”

Section: Discussionmentioning

confidence: 68%

A focused mapping review and synthesis of a priori risk factors associated with medical misconduct

et al. 2019

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BackgroundMedical misconduct is an international problem. It is judged according to whether a doctor has endangered the health of the public. Little is known about the risk factors associated with medical misconduct. To inform patient safety, we undertook a focused mapping review and synthesis (FMRS) of tribunal reports retrieved from the Medical Practitioners Tribunal Service (MPTS).MethodsA four-phase FMRS was undertaken: (1) identification and retrieval of 1-year tribunal transcripts from the MPTS (focus), (2) analysis of transcripts to identify patterns mapped to ‘a priori’ risk factors (mapping), (3) peer review of the data (calibration) and (4) creation of a risk profile (synthesis).ResultsOut of the 351 investigative tribunals, 249 (70.94%) resulted in a guilty verdict. 82.73% of all guilty verdicts led to the removal of the doctor from practice. Through the identification of four a priori risk factors, we developed a model of risk associated with medical misconduct: (1) being male, (2) primary medical qualification (PMQ) outside of the UK, (3) working within general practice and surgical specialties, and (4) having passed PMQ more than 20 years ago. Notable ‘unconfirmed’ factors, such as locum work, PMQ achieved outside of the European Union, increasing age and lack of clinical guidance are also relevant to what is deemed professional behaviour and what is not.ConclusionsThe findings can inform debates about patient safety and lay the groundwork for further research into medical misconduct. Prospective studies should focus on confirming the contributory factors and relationship between these four a priori risk factors for medical misconduct: being male, PMQ outside of the UK, increasing age and working in general practice or surgical settings.

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Disciplined doctors: Does the sex of a doctor matter? A cross-sectional study examining the association between a doctor's sex and receiving sanctions against their medical registration

Cited by 26 publications

References 16 publications

Gender Differences in Demographic and Clinical Features of Physicians Admitted to a Program for Medical Professionals with Mental Disorders

Gender Differences in Demographic and Clinical Features of Physicians Admitted to a Program for Medical Professionals with Mental Disorders

Sex differences in fitness to practise test scores: a cohort study of GPs

A focused mapping review and synthesis of a priori risk factors associated with medical misconduct

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