Do women and men receive different care for sore throats?

Several studies have shown differences in the rates at which women and men receive treatment for several common medical problems, especially heart disease. The reason for these differences and the extent to which men and women receive different treatments for other problems is unclear. The purpose of the current study was to determine whether there are differences in the rates men and women receive antibiotic therapy for pharyngitis (sore throat), whether these differences are related to differences in disease severity or comorbidity across the sexes, and whether these differences could be due to prejudice against women by male clinicians. This was a retrospective analysis of data at two university student health services in Pennsylvania and Nebraska. Male clinicians did not prescribe antibiotics at significantly different rates for male and female patients, but female clinicians prescribed antibiotics more frequently for their male patients.The original data collection was supported in part by a grant from the National Library of Medicine, LM-04321.Presented in part at the Annual Meeting of the Society for Medical Decision Making, Portland, Oregon, October, 1992, and at the Third Primary Care Research Conference, Atlanta, Georgia, 1993.We thank Jane Kreisberg and Linda Rizjis for coordination of the collection of the original data, Linda Gray for help with data entry, and Cheryl Kull and Mary Martino for secretarial support. We are grateful to all the physicians who participated in the original study.     

What Changes in Therapy? Who Changes?

SUMMARY

A central component of therapeutic change involves facilitating the capacity to move and be moved by the other. Another way of saying this might be that change entails experiencing a greater freedom of relational movement. The question of who and what actually changes in the process of therapy is the focus of the three vignettes that follow. They highlight, among other things, the recognition and acknowledgment of mutuality as an essential force within the relational matrix and the ever-changing landscape that this creates. Each of these examples of a change process bears, as well, a particular stamp of its own, and thus speaks to the unique personality of every therapeutic dyad.     

Suicidology: A Look Backward and Ahead

Using the metaphor of “a long run’ to describe our progress in suicidology, the author looks back to discuss important concepts that have become well established, such as clues to suicide, ambivalence, crisis services, suicide consultations, and psychological autopsies. An example is the psychological autopsy of Marilyn Monroe. Follow-up studies of crisis center clients have indicated that chronically suicidal clients are at the greatest risk of suicide. Recommendations for the long-term treatment of such patients are provided. Research on youth suicide is reported. Finally, the author looks ahead toward new developments in training and treatment.