Physician-patient gender and the recognition and treatment of depression in primary care

This study investigates the relationships among patient's gender, physician's gender, and physician's inquiries about depression symptoms and psychosocial stressors, treatment and subsequent medical record notation of depression in primary care. One hundred forty-six physicians at three sites were visited twice by a standardized patient (SP) who enacted either major depression with a psychosocial presentation or minor depression with a somatic presentation. Each of the two cases was portrayed by both male and female SPs who were assigned randomly to physicians. Results showed high rates of inquiry about depression symptoms and treatment, but rates varied considerably by presentation and across physician-patient gender combinations. Male physicians explored symptoms and discussed a diagnosis with female patients significantly more often than with male patients. Both male and female physicians recommended counseling more often for patients with the somatic presentation when they were female than when they were male. Record notations followed the same gender pattern.