Patients Use Different Words to Describe Satisfaction with Female versus Male Primary Care Physician Visits

Female physicians' reputations are more vulnerable, salaries are lower, and rates of burnout are higher compared with their male counterparts. Patient satisfaction metrics can affect reputation, reimbursement, incentives, and burnout. We hypothesized that patients may have gender-based expectations of primary care physicians (PCPs) that could differentially affect patient satisfaction for female PCPs. Because patient satisfaction surveys generate physician-specific data, we analyzed free-text patient satisfaction survey comments about outpatient visits with female and male PCPs.

We conducted a retrospective cross-sectional analysis of publicly available Consumer Assessment of Healthcare Providers and Systems (CAHPS) Clinician & Group survey responses from 2015 to 2019 attributed to 456 PCPs affiliated with one large healthcare system. Natural language processing identified frequencies of word use after stratification by "rate provider" scores and physician sex. We calculated overall and relative rates of word use between groups using Wald tests.

Free-text responses were contained in 112,076 surveys. The mean "rate provider" score was high (9.6/10) and did not differ by physician sex. Among the 92.8% highly rated visits, words used more often for female PCPs included time, caring, feel, concerns, and like and for male PCPs, the words included care, good, excellent, staff, and office.

When comparing high-rated PCP visits, patients used different words to describe satisfaction with their female versus male PCP visits, which may suggest that patients hold stereotyped gender expectations for PCPs. We propose that female PCP responses to stereotyped expectations-to achieve "top box" patient satisfaction scores, which affect compensation, reputation, and job satisfaction-may provide a perspective on sex-based differences in physician pay and burnout.