Gender of internal medicine resident impacts cancer preventive care for women

Abstract

Mammography and cervical screening are effective methods for early cancer detection in women. Recent reports showed that 69% of women ³45 years had a mammogram in the past 2 years and 16-55% of women had a Pap smear regularly. Internal medicine (IM) physicians are crucial players in women's health management and literature has identified that a physician’s gender impacts patient management in many areas of healthcare.
 We investigated mammogram and Pap smear recommendations by IM residents and examined differences in approaching women’s health issues between female and male residents. With IRB approval, one-hundred charts of new female patients were reviewed, which included female patients 45 years or older seen by IM residents for their first visit. All patients completed a questionnaire concerning previous medical conditions and care as part of clinic routine. Patient chart information, recommendations for mammogram and cervical cancer screening by the resident were recorded, along with the gender of the resident and supervising attending.
 The mean age of the patients was 61±9.3 years. Female residents were more likely to recommend a mammogram compared to male residents (36.7% and 16.4%, respectively). No significant differences in Pap smear recommendations were observed between female and male residents (9.3% and 10.1%, respectively). Attending physician’s gender did not influence screening recommendations.
 The recommendation rate for female patients to obtain important screening mammograms and Pap smears was low. These results are consistent with previous literature and indicate an urgent need for improved women’s health education in residency, with special attention to male residents.
 
 Keywords: Cancer prevention, Breast cancer, Cervical Cancer, Primary Care, Gender Disparity