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Do gender and race affect decisions about pain management?
C S Weisse1, P C Sorum, K N Sanders
1Department of Psychology, Union College, Schenectady, NY 12308, USA. weissec@union.ede
Journal of General Internal Medicine
|April 25, 2001
Summary
Physician gender, not patient demographics, influenced pain management decisions. Male physicians prescribed more narcotics to white patients, while female physicians favored Black patients. Physician gender impacts pain treatment disparities.
Area of Science:
- Medical ethics
- Health disparities
- Pain management
Background:
- Patient gender and race are often cited as factors influencing medical treatment decisions.
- Previous research suggests potential biases in pain management based on patient demographics.
Purpose of the Study:
- To investigate whether patient gender and race impact physician decisions regarding pain management.
- To explore potential disparities in pain treatment based on patient and physician characteristics.
Main Methods:
- Experimental design utilizing medical vignettes to assess treatment decisions.
- 111 primary care physicians (61 male, 50 female) evaluated hypothetical patients with varying pain conditions (renal colic, back pain, sinusitis).
- Patient gender and race were systematically varied while symptom presentation and severity remained constant.
Main Results:
- No overall differences in treatment decisions or prescribed narcotic analgesic doses (hydrocodone) were found based on patient gender or race.
- Significant interactions emerged based on physician gender: male physicians prescribed higher hydrocodone doses to white patients with renal colic, while female physicians prescribed higher doses to Black patients.
- Similar patterns were observed for persistent kidney stone pain and persistent back pain, with physician gender mediating race- and gender-based prescribing differences.
Conclusions:
- Pain management decisions are influenced by physician gender, not solely by patient gender or race.
- Male and female physicians appear to respond differently to patient gender and/or racial cues, leading to observed disparities in pain treatment.
- These findings highlight the complex interplay of physician characteristics and patient demographics in pain management and underscore the need to address potential biases.