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Female doctors are more likely to be called directly in patient portal messages

Female physicians are more likely to be addressed by their first name in electronic medical record (EMR) patient portal messages, researchers found.

In the adjusted analysis, female physicians were more than twice as likely as male physicians to use their first names in messages from patients (OR 2.15, 95% CI 1.68-2.74 , P JAMA Network Open report in research letter.

Yang and co-authors found that physicians and primary care physicians with DO degrees were also more likely to use their names in patient information, but less than female physicians.

“Whether resolved informally by other medical professionals or patients, the removal of titles (without using one’s appropriate title) may negatively affect physicians and show a lack of respect, and may lead to less physical form, they wrote.

UCSF’s Lekshmi Santhosh and Leah Witt, compared with their male colleagues, found that physicians spent more time on EMR after hours, Take longer notes and receive more patient information each month.

Santhosh and Witt write, “The cumulative experience of female physicians with this microaggression and unfair workload Described as ‘a thousand cuts’, a key factor in burnout. “

They wrote: “With the increase in thousands of layoffs,” they wrote, “with the experience of bias at work, the EHR workload (which is variable) and often uncompensated), disproportionate family and childcare responsibilities, and conflict that often deprives women of their personal and professional responsibilities. Doctors all come from the medical workforce, right? Is it any wonder that the Great Resignation movement has had the greatest impact on women in medicine? “

In their study, Yang and colleagues reviewed the period from October 1, 2018 to October 1, 2018 to September 30, 2021. Using natural language processing algorithms Messages were evaluated to identify salutations used by patients and to classify them according to form. They defined formal greetings as “Dr (or physician) Last Name” or “Dr (or Doctor) First Last Name”.

Ultimately, they identified 90,830 messages from 34,829 patients. Of these, 29,498 messages (32.5%) from 14,958 patients included the doctor’s name in the greeting or closing line.

They found that physicians with DO degrees were also nearly twice as likely to be addressed by their first name in patient information (OR 1.86, 95% CI 1.20-2.88, P=0.006), primary care physicians were approximately 50% more likely to treat in this way (OR 1.48, 1.16-1.89, P=0.002 ).

Yang and colleagues also found that female patients were approximately 40% less likely to address their doctor by their first name (OR 0.57, 95% CI 0.50-0.65, P

A limitation of one study was that the researchers could not control whether physicians preferred informal addresses and potential cultural, racial, or ethnic nuances. In addition, relying on natural language processing may not correctly identify all greetings, and the results may not be generalizable beyond a health system.

However, they have to It concluded that efforts to improve any negative effects “should focus on a supportive culture,” with a particular focus on addressing unconscious bias. They wrote that this included “formal guidelines, practice changes, direct patient education, and exploration of Further research in other areas of unconscious bias”.

Jennifer Henderson joined MedPage Today as a business and investigative writer in January 2021. She has covered healthcare in New York City industry, life sciences and legal practice etc.


This study was funded by the Mayo Clinic Small Grants Program.

Editor Witt reported receiving personal fees from the Curbsiders Internal Medicine Podcast and a grant from the Health Resources and Services Administration in addition to the submitted work.



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