Another look at physicians' treatment of men and women with common complaints

A recent study of San Diego patients found that men received more extensive and appropriate diagnostic workups than women did for five common complaints (Armitage, K. J., Schneiderman, L. J., & Bass, R. A. Journal of the American Medical Association 1979, 241 2186–2187). This article is a broader analysis of medical care given to men and women for those complaints (fatigue, headache, vertigo/dizziness, chest pain, back pain), and it uses a national survey of ambulatory-care visits. We find that medical care is usually similar for men and women. When significant sex differences do appear, they often show that women receive more medical care during a visit. To some extent, differential care stems from different medical needs that men and women with a complaint have; when some medically relevant factors are controlled, half of the significant sex differences disappear. But half persist, and this suggests that psychosocial factors also underlie differential care for men and women. These may originate with patients (for example, their requests for particular services) or with physicians (for example stereotypes of men and women patients). In contrast to the San Diego study, the national data show that (1) women sometimes receive more diagnostic workups for the five complaints, and (2) when medical factors are controlled, sex differences in the extent and content of workups disappear. The only exception is that men with vertigo/dizziness receive more appropriate workups.