Dear Athena Garcia ,

Here is a few articles I found which you may use as a reference for you literature review

https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/1108557

https://link.springer.com/article/10.1007/s11606-008-0805-8

https://www.amjmed.com/article/S0002-9343(20)30098-X/fulltext

https://onlinelibrary.wiley.com/doi/abs/10.1111/1475-6773.12348

https://www.sciencedirect.com/science/article/abs/pii/S0363502315014951

https://pubmed.ncbi.nlm.nih.gov/30367329/

https://pubmed.ncbi.nlm.nih.gov/30239774/

Best regards.

Sincerely,

Naseem Wajdi

Hello Mr. Naseem Wajdi,

Thank you very much for your feedback and these related articles.

Appreciatively,

Athena Garcia

You need to look for information in journals related to primary care. Scientific articles do not consider this.

Mr. Wajdi's long list of sources looks very relevant. Many of those journals are read by the primary care audience.

Questions about outcomes compared to time costs are high priority in an age of medical cost-cutting, so you will find the topic covered in major scientific journals.

First visit primary care need to be a longer session compulsory if the patient already has blood and other relevant medical reports.

The follow up visits may not necessarily be longer one. Follow ups can also be online on a video conferences.

Research comparing women physicians to male physicians consistently finds that patient outcomes are, on average, better with women physicians. One difference between men and women physicians is that women spend more time with patients. There are also differences in content and style of communication, which require more time to execute.

Here is a recent review article on the field:

https://web-p-ebscohost-com.proxy.multcolib.org/ehost/pdfviewer/pdfviewer?vid=0&sid=200ab70e-e320-45b0-ad92-4a976b544f6a%40redis

Definitely especially in LMIC like mine, this has been observed severally.

Definetly. Because primary healthcare focus on screening ,identification of risk factors as welllas it focuses on prevention strategies. It improves ultimately the health outcomes .

There is evidence, cited above, that longer primary care visit times improve patient outcomes -- which is a long-term social and purpose-of-program benefit.

The obstacle to realizing these benefits is convincing managers that the short-term financial cost of more time per patient is worth it. Healthcare managers are incentivized to minimize cost, not maximize health.

I wish you luck.

Ms. Merilee Deborah Karr ,

Thank you for your input and feedback. I appreciate it. I have pulled up your reference but I do not have access to the Multnomah Library. Do you happen to have a DOI number or other reference I could pull up on my Univerity's Library.

Thank you!

Athena

Oh, I'm sorry. Here's a more useful link, free on the journal's website:

Article Are Women Really Better Physicians Than Men Are?

And there's a useful reference list:

References 1. Kim C, McEwen LN, Gerzoff RB, et al. Is physician gender associated

with the quality of diabetes care? Diabetes Care. 2005;28(7):1594-1598. 2. Berthold HK, Gouni-Berthold I, Bestehorn KP, Böhm M, Krone W. Phy- sician gender is associated with the quality of type 2 diabetes care. J Intern

Med. 2008;264(4):340-350. 3. Baumhäkel M, Müller U, Böhm M. Influence of gender of physicians and

patients on guideline-recommended treatment of chronic heart failure

in a cross-sectional study. Eur J Heart Fail. 2009;11(3):299-303. 4. Andersen MR, Urban N. Physician gender and screening: do patient

differences account for differences in mammography use? Women Health.

1997;26(1):29-39. 5. Frank E, Dresner Y, Shani M, Vinker S. The association between physicians’

and patients’preventive health practices. CMAJ. 2013;185(8):649-653. 6. Frank E, Harvey LK. Prevention advice rates of women and men physicians.

Arch Fam Med. 1996;5(4):215-219. 7. Franks P, Bertakis KD. Physician gender, patient gender, and primary

care. J Womens Health (Larchmt). 2003;12(1):73-80. 8. Franks P, Clancy CM. Physician gender bias in clinical decision making:

screening for cancer in primary care. Med Care. 1993;31(3):213-218. 9. Kruger J, Shaw L, Kahende J, Frank E. Health care providers’ advice to

quit smoking, National Health Interview Survey, 2000, 2005, and 2010.

Prev Chronic Dis. 2012;9:E130. 10. Lurie N, Slater J, McGovern P, Ekstrum J, Quam L, Margolis K. Preventive

care for women: does the sex of the physician matter? N Engl J Med.

1993;329(7):478-482. 11. Smith AW, Borowski LA, Liu B, et al. US primary care physicians’ diet-,

physical activity-, and weight-related care of adult patients. Am J Prev

Med. 2011;41(1):33-42. 12. Bertakis KD, Helms LJ, Callahan EJ, Azari R, Robbins JA. The influence

of gender on physician practice style. Med Care. 1995;33(4):407-416. 13. Krupat E, Rosenkranz SL, Yeager CM, Barnard K, Putnam SM, Inui TS. The practice orientations of physicians and patients: the effect of doctor- patient congruence on satisfaction. Patient Educ Couns. 2000;39(1):49-59.

14. Roter DL, Hall JA, Aoki Y. Physician gender effects in medical commu- nication: a meta-analytic review. JAMA. 2002;288(6):756-764.

15. Roter DL, Hall JA. Physician gender and patient-centered communication: a critical review of empirical research. Ann Rev Public Health. 2004; 25:497-519.

16. Jefferson L, Bloor K, Birks Y, Hewitt C, Bland M. Effect of physicians’ gender on communication and consultation length: a systematic review and meta-analysis. J Health Serv Res Policy. 2013;18(4):242-248.

17. Tsugawa Y, Jena AB, Figueroa JF, et al. Comparison of hospital mortality and readmission rates for Medicare patients treated by male vs female physicians. JAMA Int Med. 2017;177(2):206-213.

18. Dahrouge S, Seale E, Hogg W, et al. A comprehensive assessment of fam- ily physician gender and quality of care: a cross-sectional analysis in Ontario, Canada. Med Care. 2016;54(3):277-286.

19. Wallis CJD, Ravi B, Coburn N, et al. Comparison of postoperative out- comes among patients treated by male and female surgeons: a popula- tion based matched cohort study. BMJ. 2017;359:j4366.

20. Jerant A, Bertakis KD, Fenton JJ, Franks P. Gender of physician as the usual source of care and patient health care utilization and mortality. J Am Board Fam Med. 2013;26(2):138-148.

21. Ladouceur R. Fake medical news. Can Fam Physician. 2017;63(6):422.

Merilee Deborah Karr , excellent, thank you very much!

ResearchGate won't let me paste the free URL for the paper.

I'll try a different format.

C C N O N L I N E . o r g

and

CriticalCareNurse Vol 38, No. 3, JUNE 2018

There is more research of your original question about visit time and patient outcomes. This paper was just the first one I found in a quick search.

The conflict over visit time vs. patient outcome is very old, still ongoing, and fueled by the profit motive.

Women physicians are more likely to resist the profit motive, and spend more time with patients to achieve a better outcome. Both of my claims -- that women physicians spend more time, and achieve better outcomes -- are solidly evidence-based.

Carol Gilligan's research ("In a Different Voice"), explained why women differ from men so distinctly, in many fields. She found that the highest moral value for men and boys is to follow the rules, and for women and girls it is to strengthen connections.

The hierarchical, profit-driven culture of modern medicine is not a happy professional home for many women, and some men.

That worked, I found it.

Thank you again very much for your thoughtful and though-provoking responses.

not necessarily so...

Yes, there has been research demonstrating improved outcomes for both the patient and the clinician with longer appointment times. By broadening the clinician skill mix, primary care providers are able to offer longer appointments. Some of the challenges of this are discussed here https://bjgp.org/content/69/684/348

I also recall a paper (citation unknown!) that concluded that chronic pain sufferers had better outcomes from longer appointments than they did from medication. However, I may have misremembered this!

JAMA Health Forum – Health Policy, Health Care Reform, Health Affairs | JAMA Health Forum | JAMA Network

Association of Primary Care Visit Length With Potentially Inappropriate Prescribing

Hannah T. Neprash, PhD1; John F. Mulcahy, MSPH1; Dori A. Cross, PhD1; et alJoseph E. Gaugler, PhD1; Ezra Golberstein, PhD1; Ishani Ganguli, MD, MPH2,3

Author Affiliations Article Information

JAMA Health Forum. 2023;4(3):e230052. doi:10.1001/jamahealthforum.2023.0052

Antony Stones & Martijn Sijbom Thank you for your feedback.