Gender bias may affect care of people with osteoarthritis, study finds

Mar 10, 2008

Unconscious prejudices among doctors may explain why women complaining of knee pain are less likely than men to be recommended for total knee replacement surgery, a study in today's issue of the Canadian Medical Association Journal suggests.

Toronto researchers used two standardized or "mystery" patients, one male and one female, both with moderate knee osteoarthritis reporting the same symptoms of knee pain. The patients received assessments from 67 physicians in Ontario. Physicians were twice as likely to recommend total knee replacement surgery (known as arthroplasty) to a male patient compared to a female patient. Overall, 67% of physicians recommended total knee arthroplasty to the male patient compared with 33% who recommended it to the female patient.

“Disparity in the use of medical or surgical interventions is an important health care issue, and this research suggests a gender bias in the treatment of patients who may need orthopedic surgery,” says lead author Dr. Cornelia Borkhoff, about the article based on her doctoral thesis while in the Clinical Epidemiology Program at the University of Toronto Faculty of Medicine’s Department of Health Policy Management and Evaluation.

This new study, the first ever demonstration of physician bias in an actual clinical setting (i.e., with patients during actual office visits with physicians in their offices) involved 38 family physicians and 29 orthopaedic surgeons because the researchers were interested in whether barriers for women exist between the family physician and the patient in obtaining a referral to an orthopaedic surgeon or between the surgeon and the patient in the decision to offer total knee replacement. A male patient was referred to an orthopaedic surgeon 35% more often than a female patient. The study also found that a man was nine times more likely than a woman to be recommended for a total knee replacement.

“Physicians may be at least partially responsible for the sex-based disparity in the rates of use of total joint arthroplasty,” says Dr. Borkhoff. “Physicians are susceptible to the same social stereotyping that affects all of our behavior. Decisions that stem from unconscious biases are not deliberate - physicians would be unaware of their unconscious biases affecting their decisions.”

“Acknowledging that a gender bias may affect physicians’ decision-making is the first step toward ensuring that women receive complete and equal access to care,” says the principal investigator of the study, Dr. James Wright, a Professor at the University of Toronto Faculty of Medicine’s Department of Health Policy Management and Evaluation and the Surgeon-in-Chief at The Hospital for Sick Children. “The next step is to develop creative interventions to address these disparities in health care.”

More than 90% of orthopedic surgeons recommended total knee replacement to the male patient, which also suggests that surgery is the right decision and represents the best care for patients with moderate knee osteoarthritis for whom medical therapy has failed.

“Our results support the need for clinician education programs to better inform physicians of the true risks of total joint arthroplasty, when and for whom to consider surgery, as well as, the potential benefits of early treatment,” says Dr. Borkhoff.

Source: University of Toronto

Explore further: Researcher develops, proves effectiveness of new drug for spinal muscular atrophy

add to favorites email to friend print save as pdf

Related Stories

Astronomers pinpoint 'Venus Zone' around stars

17 minutes ago

San Francisco State University astronomer Stephen Kane and a team of researchers presented today the definition of a "Venus Zone," the area around a star in which a planet is likely to exhibit the unlivable ...

History books becoming next fight in Texas schools

1 hour ago

The next ideological fight over new textbooks for Texas classrooms intensified Wednesday with critics lambasting history lessons that they say exaggerate the influence of Moses in American democracy and negatively portray ...

Amazon deforestation up 29 pc in 2013

1 hour ago

Deforestation in the Amazon rose 29 percent between August 2012 and July of last year to 5,891 square kilometers (2,275 square miles), Brazilian officials said Wednesday, posting an amended figure.

Recommended for you

A novel therapy for sepsis?

9 hours ago

A University of Tokyo research group has discovered that pentatraxin 3 (PTX3), a protein that helps the innate immune system target invaders such as bacteria and viruses, can reduce mortality of mice suffering ...

Cellular protein may be key to longevity

Sep 15, 2014

Researchers have found that levels of a regulatory protein called ATF4, and the corresponding levels of the molecules whose expression it controls, are elevated in the livers of mice exposed to multiple interventions ...

Gut bacteria tire out T cells

Sep 15, 2014

Leaky intestines may cripple bacteria-fighting immune cells in patients with a rare hereditary disease, according to a study by researchers in Lausanne, Switzerland. The study, published in The Journal of Experimental Me ...

User comments : 0