Physician Gender Role in Treatment of Male and Female Patients in Cardiac Fellows’ Ambulatory Clinic

Abstract

AIM: The quality of care provided to ambulatory cardiac patients has been reported as being influenced by patient gender with women receiving less evidence-based treatments than men. In order to test whether the treating physician’s gender is in part responsible for this disparity, we compared compliance with performance measures for men and women patients treated by men and women physicians in our cardiology fellows’ ambulatory clinics. METHODS: All patients were enrolled into the American College of Cardiology (ACC) Practice Innovation And Clinical Excellence (PINNACLE®) registry. Data were collected between January 2009 and May 2012. The elements of care measured were 10 established ACC and American Heart Association (AHA) performance measures for coronary artery disease (CAD), congestive heart failure (CHF), and atrial fibrillation (Afib). Patients were evaluated for compliance with as many of the measures for which each was eligible. RESULTS: A total of 2001 patients with CAD (51%), CHF (19%) and non-valvular Afib (23.3%) were enrolled. The remaining 134 patients (6.7%) had hypertension only and were not included in the analysis. Mean age was 66.4 yrs. 51% of patients were female and 75% Caucasian. There were no statistically significant differences in treatment by patient gender, although when sub-stratified by physician gender, female patients treated by male physicians tended to be less likely to be on warfarin (p=0.07). In univariate analysis, female physicians were more likely than males to provide self-care education to CHF patients (p=0.017). In all other performance measures, there was no significant difference by physician gender on treatment of male and female patients CONCLUSION: Compliance with select performance measures was not influenced by the gender of the patient or the treating physician at our cardiology fellows’ ambulatory clinic.