Gender Differences in Colonoscopy: Implications for Clinical Practice and Female Gastroenterologists.

Area of Science:

• Gastroenterology
• Medical Practice Management
• Health Economics

Background:

• Colonoscopy can be technically challenging in female patients, who may prefer female endoscopists.
• A disparity exists in the number of female versus male endoscopists.
• These factors may lead to gender-based differences in colonoscopy practices.

Purpose of the Study:

• To investigate gender differences in colonoscopy procedure duration.
• To analyze the proportion of female patients seen by female versus male endoscopists.
• To explore the potential revenue implications of these gender differences in screening colonoscopy.

Main Methods:

• Analysis of procedure time and gender demographics in 16,573 screening colonoscopies.
• Inclusion of data from 27 male and 7 female endoscopists over a three-year period.
• Modeling of revenue impacts based on procedure duration, patient gender proportion, and adenoma detection rates.

Main Results:

• Screening colonoscopies were 8.8% longer for female patients across all endoscopists (p < 0.001).
• Female endoscopists performed 71.2% female exams, compared to 50.8% for male endoscopists (p < 0.001).
• Lower adenoma detection rates (ADR) in females reduced polypectomy frequency and reimbursement; an estimated 9.6% revenue loss per session for female gastroenterologists was observed.

Conclusions:

• Longer colonoscopy duration in females and a higher proportion of female patients seen by female endoscopists contribute to practice differences.
• Lower adenoma detection rates in female patients impact reimbursement.
• These gender-related disparities may play a role in the gender pay gap within gastroenterology.