Does Provider Gender Affect the Quality of Primary Care?

Women providers have a more patient-centered communication style than men, and some studies have found women primary care providers are more likely to meet quality performance measures.

To explore gender differences in the quality of primary care process and outcome measures.

Retrospective analysis of primary care performance data from 1 year (2018-2019).

A total of 586 primary care providers (311 women and 275 men) who cared for 241,428 primary care patients at 96 primary care clinics at 8 Veterans Affairs (VA) medical centers.

Our primary outcome was a composite quality measure that averaged all thirty-four primary care performance measures that assessed performance in cancer screening, diabetes care, cardiovascular care, tobacco counseling, risky alcohol screening, immunizations, HIV testing, opiate care, and continuity. Our secondary outcomes were performance on each of the 34 measures.

There was no difference in the average performance on our composite measure between men and women (75.8% vs. 76.6%, p = 0.17). Among the 34 primary care quality measures collected, there was no difference between male and female providers' performance. Using a more conservative cut-point, women were more likely to screen at-risk diabetic patients for hypoglycemia and document follow-up on risky alcohol behavior noted during patient check-in. These differences were clinically small and likely due to chance, given the multiple measures evaluated in this study.

We found little evidence of difference in the performance on primary care quality measures between male and female providers.