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- W1971842020 abstract "It is imperative that we further increase the number of female trainees in gastroenterology in order to allow women the opportunity to choose a gastroenterologist who optimizes their comfort level and patient satisfaction.The one-size-fits-all model of health care in which we have been operating has led to significant disparities in care between men and women for many conditions, such as cardiovascular disease, pain management, HIV care, and cancer screening. Yet, as it pertains to several aspects of their lives, such as education, career choices, marital decisions, family/children, and even choice of a health care provider, women have more options now than they did even 20 years ago. Currently, with more women practicing traditionally male-dominated medical specialties, these expanded options now exist in the primary-care as well as the subspecialty setting. Throughout the world, the number of female gastroenterologists is increasing. Consequently, patients may make different health care decisions. It is imperative that we further increase the number of female trainees in gastroenterology in order to allow women the opportunity to choose a gastroenterologist who optimizes their comfort level and patient satisfaction. In the article by Lee et al1Lee S.Y. Yu S.K. Kim J.H. et al.Link between preference for women colonoscopists and social status in Korean women.Gastrointest Endosc. 2008; 67: 273-277Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar in this issue of Gastrointestinal Endoscopy, the socioeconomic characteristics associated with the preference for a female colonoscopist were evaluated in Korean women.1Lee S.Y. Yu S.K. Kim J.H. et al.Link between preference for women colonoscopists and social status in Korean women.Gastrointest Endosc. 2008; 67: 273-277Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar The literature indicates that gender preferences are more often found in specialties that deal with more intimate and psychosocial health problems.2Kappahan C.J. Wilson K.M. Klein J.D. Adolescent girls' and boys' preference for provider gender and confidentiality by their health care.J Adolesc Health. 1999; 25: 131-142Abstract Full Text Full Text PDF PubMed Scopus (97) Google Scholar, 3Moettus A. Sklar D. Tandberg D. The effect of physician gender on women's perceived pain and embarrassment during pelvic examination.Am J Emerg Med. 1999; 17: 635-637Abstract Full Text PDF PubMed Scopus (29) Google Scholar In the current study,1Lee S.Y. Yu S.K. Kim J.H. et al.Link between preference for women colonoscopists and social status in Korean women.Gastrointest Endosc. 2008; 67: 273-277Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar 32.7% of women (16.2% female preference) had a gender preference for upper endoscopy. However, 45.5% of women reported a gender preference for colonoscopy (32.1% female preference). This is consistent with previously reported rates of 30% to 48% female preference for a colonoscopist.4Varadarajulu S. Petruff C. Ramsey W.H. Patient preference for gender of endoscopists.Gastrointest Endosc. 2002; 56: 170-173Abstract Full Text Full Text PDF PubMed Scopus (61) Google Scholar, 5Mences S. Inadomi J. Korsnes S. et al.Women patients' preference for women physicians is a barrier to colon cancer screening.Gastrointest Endosc. 2005; 62: 219-223Abstract Full Text Full Text PDF PubMed Scopus (103) Google Scholar, 6Farraye F.A. Wong M. Hurwitz S. et al.Barriers to endoscopic colorectal cancer screening: are women different from men?.Am J Gastroenterol. 2004; 99: 1-9Google Scholar Interestingly, women who were younger (average age 32 years), more educated, single, and employed tended to prefer a female colonoscopist.1Lee S.Y. Yu S.K. Kim J.H. et al.Link between preference for women colonoscopists and social status in Korean women.Gastrointest Endosc. 2008; 67: 273-277Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar The average age of women who preferred a male colonoscopist (13.4%) was 47 years. Furthermore, these women tended to be married, unemployed, and less educated than the women who preferred a female colonoscopist. In contrast, studies from the United States rarely report a preference for a male colonoscopist. This may reflect the generational and cultural differences that exist among women as they pertain to perceptions about male and female providers. While female gastroenterologists are becoming more prevalent in Korea and in many other parts of the world, older women may perceive men as having greater technical expertise as well as experience. However, in a British study by Shah and Ogden,7Shah R. Ogden J. ‘What's in a face?’ The role of doctor ethnicity, age, and gender in the formation of patients' judgements: an experimental study.Patient Educ Couns. 2006; 60: 136-141Abstract Full Text Full Text PDF PubMed Scopus (31) Google Scholar younger doctors and female doctors were judged, based on test subjects' study of a photograph, to have better personal and technical skills, better explanation skills, and to be more likely to explore emotional aspects of health.7Shah R. Ogden J. ‘What's in a face?’ The role of doctor ethnicity, age, and gender in the formation of patients' judgements: an experimental study.Patient Educ Couns. 2006; 60: 136-141Abstract Full Text Full Text PDF PubMed Scopus (31) Google Scholar In a study on patient preference for a healthcare professional, it was found that gender preferences in medicine are related to the ease with which patients are able to communicate with their doctor.8Kerssens J.J. Bensing J.M. Andela M.G. Patient preference for genders of health professionals.Soc Sci Med. 1997; 44: 1531-1540Crossref PubMed Scopus (152) Google Scholar Commonly, female health care providers are perceived to have better communication skills. However, within a range of health professions, only a minority of patients preferred a health care provider of a particular gender.8Kerssens J.J. Bensing J.M. Andela M.G. Patient preference for genders of health professionals.Soc Sci Med. 1997; 44: 1531-1540Crossref PubMed Scopus (152) Google Scholar Nonetheless, the differences in perception about health care providers' practices are impacted, to some extent, by past experiences, current needs, and very often, pure bias. Colorectal cancer (CRC) has the second highest cancer-related mortality rate in the United States.9National Cancer Institute. SEER Cancer Statistics Review 1997-2001. Available at http://seer.cancer.gov/. Accessed December 10, 2007.Google Scholar Endoscopic screening for CRC is effective because precancerous polyps can be removed during the procedure, thus preventing the development of colon cancer.10Winawer S.J. Zauber A.G. Diaz B. et al.The national polyp study: temporal sequence of evolving colorectal cancer form the normal colon Prevention of colorectal cancer by colonoscopic polypectomy.Gastrointest Endosc. 1993; 329: 1977-1981Google Scholar However, there are data to suggest that women are likely to delay or avoid undergoing screening colonoscopy until the gender preference is met.4Varadarajulu S. Petruff C. Ramsey W.H. Patient preference for gender of endoscopists.Gastrointest Endosc. 2002; 56: 170-173Abstract Full Text Full Text PDF PubMed Scopus (61) Google Scholar, 5Mences S. Inadomi J. Korsnes S. et al.Women patients' preference for women physicians is a barrier to colon cancer screening.Gastrointest Endosc. 2005; 62: 219-223Abstract Full Text Full Text PDF PubMed Scopus (103) Google Scholar, 6Farraye F.A. Wong M. Hurwitz S. et al.Barriers to endoscopic colorectal cancer screening: are women different from men?.Am J Gastroenterol. 2004; 99: 1-9Google Scholar, 11Menees S.B. Inadomi J.M. Korsnes S. et al.Women patients' preference for women physicians is a barrier to colon cancer screening.Gastrointest Endosc. 2005; 62: 219-223Abstract Full Text Full Text PDF PubMed Scopus (59) Google Scholar, 12Fidler H. Hartnett A. Cheng Man K. et al.Sex and familiarity of colonoscopist.Gastrointest Endosc. 2000; 32: 481-482Google Scholar, 13Varadarajulu S. Petruff C. Ramsey W.H. Patient preference for gender of endoscopists.Gastrointest Endosc. 2002; 56: 170-173Abstract Full Text Full Text PDF PubMed Google Scholar Yet, gender preferences are rarely seen in male patients. In fact, in a study investigating patient preference for a urologist, which included mostly men, no preference was found in the majority of patients.14Tempest H.V. Vowler S. Simpson A. Patient preference for gender of urologists.Int J Clin Pract. 2005; 59: 526-528Crossref PubMed Scopus (23) Google Scholar However, of the patients who did have a preference, women more often preferred the same gender. Gender preferences are most often associated with invasive examinations,8Kerssens J.J. Bensing J.M. Andela M.G. Patient preference for genders of health professionals.Soc Sci Med. 1997; 44: 1531-1540Crossref PubMed Scopus (152) Google Scholar as demonstrated in the study by Lee et al.1Lee S.Y. Yu S.K. Kim J.H. et al.Link between preference for women colonoscopists and social status in Korean women.Gastrointest Endosc. 2008; 67: 273-277Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar Menees et al11Menees S.B. Inadomi J.M. Korsnes S. et al.Women patients' preference for women physicians is a barrier to colon cancer screening.Gastrointest Endosc. 2005; 62: 219-223Abstract Full Text Full Text PDF PubMed Scopus (59) Google Scholar found that in women evaluated in a primary care setting, 43% preferred a female endoscopist. In this study and others, embarrassment was cited as the most common reason for the preference.11Menees S.B. Inadomi J.M. Korsnes S. et al.Women patients' preference for women physicians is a barrier to colon cancer screening.Gastrointest Endosc. 2005; 62: 219-223Abstract Full Text Full Text PDF PubMed Scopus (59) Google Scholar Dr Elta, in a previous editorial, offered modesty in women as a possible explanation for the difference between men and women with regard to gender preferences.15Elta G.H. Women are different from men.Gastrointest Endosc. 2002; 56: 308-309Abstract Full Text Full Text PDF PubMed Scopus (9) Google Scholar In many societies, women are nurtured from a very young age to exhibit modesty, particularly as it pertains to the breasts and pelvic organs. Thus, we should address in our conversations with patients, as well as in educational materials, issues on respect and preservation of dignity as they pertain to colonoscopy. Many of the previous studies have queried patients on gender preference for a colonoscopist in the primary care setting, in which many of the subjects are asymptomatic and colonoscopy may be less urgent. It is important to note that although the women in the study by Lee et al1Lee S.Y. Yu S.K. Kim J.H. et al.Link between preference for women colonoscopists and social status in Korean women.Gastrointest Endosc. 2008; 67: 273-277Abstract Full Text Full Text PDF PubMed Scopus (16) Google Scholar were recruited from a digestive disease center, presumptively for GI symptoms, a gender preference was also identified in young women. This study reflects the diversity of gender preference among Korean women based on age, education, employment, and marital status. Realizing that one size does not fit all, additional factors are likely to impact gender preference in Western cultures, and we must continue to study and address them accordingly. We know that, in order to improve compliance with screening colonoscopy, it is imperative that we further increase the number of female trainees in gastroenterology to allow women the opportunity to choose a gastroenterologist who optimizes their comfort level and patient satisfaction. As such, we have to continue the progress that the GI societies have made with regard to increasing the number of female gastroenterology trainees through mentorship, programming, and addressing work/family/life issues. Additionally, we must work to change perceptions that prohibit all patients from accessing the care that they need through patient education and physician training in gender-based medicine. Fortunately, women have greater options in the choice of a gastroenterologist. However, we should not allow perception or misperception to hinder our ability as gastroenterologists to provide CRC screening as well as diagnostic colonoscopy to all eligible women in a timely fashion. The author reports that there are no disclosures relevant to this publication." @default.
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- W1971842020 title "One size does not fit all" @default.
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