Women gynecologists receive lower press ganey patient satisfaction scores in a multi-center cross-sectional study

The objective of this study was to examine the relationship between physician gender and patient satisfaction of outpatient gynecology visits as measured by the Press Ganey patient satisfaction questionnaires in a nation-wide, multi-center cohort. Previous published findings from a single institution demonstrated women gynecologists are significantly less likely to receive top scores when compared to their men counterparts. The study was limited to a single institution with a predominately white and privately insured population and may not have been generalizable to institutions with different patient demographics. This cross-sectional study analyzed 15,184 Press Ganey patient satisfaction surveys of 130 gynecologists linked to outpatient gynecology visits at 5 institutions from 2013 to 2020 including self-reported demographics and satisfaction. The primary outcome variable was likelihood to recommend care provider (LTR). LTR is evaluated on a 1-5 scale where a score of 5, Very Good, is commonly compared to a score of 1–4, due to the skewed distribution of LTR scores (the Topbox approach). Comparison of Topbox LTR scores was made using chi-square tests, and modeling of scores using generalized estimating equations (GEE). The physician cohort was 72% women (n=10,861 surveys) and 28% men (n=4,287 surveys). Sixty-six percent of physicians were white, 16% Asian, and 18% were from race or ethnicities underrepresented in Medicine (URiM). In chi-square analyses, women physicians received an average Topbox score of 73.9% compared to 77.2% for men (p <0.0001). In the GEE model adjusting for race/ethnicity, patient and physician age, women gynecologists had significantly lower odds (17%) of receiving a top satisfaction score (OR 0.83; 95% CI 0.78-0.88; p <0.0001). Women gynecologists are 17% less likely to receive top patient satisfaction scores when compared to their male counterparts on the basis of gender alone in a multi-center study of outpatient gynecology care. As patient satisfaction assessments become increasingly incorporated into provider evaluation, incentives, and measures of care quality, we ought to critically examine how biases may impact the patient satisfaction assessment process to avoid undue negative impacts on women gynecologists.