The Role of Physician Gender in Variation in Breast Cancer Care.
Abstract
We have developed a unique experimental design, where clinical "patients" are developed for videotape and enacted by actors to simulate patient-physician encounter. Versions of each videotape are produced that maintain the same clinical information while varying those patient features as part of the experimental design. In each of two medical scenarios, we shall investigate five patient factors: age, race, socioeconomic status, comorbidity and mobility. The patients enacted on videotape are either 65 or 80 years of age, and either black or white. Socioeconomic status is either upper-level or lower-level, as expressed by a complex of characteristics, including dress, idioms of speech, and coverage by Medex versus Medicaid health insurance. Comorbidity is dichotomized as a patient free of chronic illness, or one with stable hypertension and diabetes on oral medication. Mobility is defined as either no disabling condition, or frailty as a woman with osteoarthritis of the knees requiring the use of a walker. Each of the 16 "characters" enacts two scenarios. In the first scenario, the patient presents with a question of a new breast mass, seeking diagnostic evaluation. In the second scenario, the patient presents with a confirmed .8 cm carcinoma by excisional biopsy and seeks recommendations for completion of diagnostic evaluation, primary and adjuvant therapies.
Document Details
- Document Type
- Technical Report
- Publication Date
- Oct 01, 1997
- Accession Number
- ADA344562
Entities
People
- Karen M. Freund
Organizations
- Boston Medical Center