Abstract
The impact of physician sex on dimensions of medical care such as treatment prescriptions
and referrals has been underexplored, especially in a pain context. Also, few studies
have analyzed whether physician sex moderates the influence of patients' or clinical
situations' characteristics on pain management practices or its mediating processes.
Therefore, our goal was to explore whether physician sex moderates the effects of
patient (distressed) pain behaviors and diagnostic evidence of pathology (EP) on treatment
prescriptions and referrals for chronic low-back pain, and to explore the mediating
role of pain credibility judgments and psychological attributions on these effects.
A total of 310 general practitioners (GPs; 72.6% women) participated in a between-subjects
design, 2 (patient pain behaviors) × 2 (EP) × 2 (GP sex) × 2 (patient sex). GPs were
presented with vignettes depicting a fe(male) chronic low-back pain patient, with(out)
distress and with(out) EP (eg, herniated disc). GPs judged the patient's pain and
the probability of treatment prescriptions and referrals. Results showed that EP had
a larger effect on male than on female physicians' referrals to psychology/psychiatry.
Also, GP sex moderated the pain judgments that accounted for the effect of EP and
pain behaviors on prescriptions. These findings suggest framing medical decision-making
as a process influenced by gender assumptions.
Perspective
This paper shows that physician sex moderates the influence of clinical cues on pain
management practices and the mediating role of pain judgments on these effects. It
may potentially increase clinicians' awareness of the influence of gender assumptions
on pain management practices and contribute to the development of more gender-sensitive
services.
Key words
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Article info
Publication history
Published online: May 28, 2013
Accepted:
March 11,
2013
Received in revised form:
March 6,
2013
Received:
September 5,
2012
Footnotes
This research was funded by the main Portuguese Science Funding Agency–Fundação para a Ciência e Tecnologia (PTDC/PSI-PSO/099809/2008).
The authors have no conflicts of interest, financial or otherwise, related to this study.
Identification
Copyright
© 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.
