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Ethnic and gender-based prejudice towards medical doctors? The relationship between physicians' ethnicity, gender, and ratings on a physician rating website
The Journal of Social Psychology
Abstract
We investigated manifestations of ethnic and gender-based prejudice in a rather understudied high-status environment, that is we studied biased ratings of physicians with a migration background and female physicians. In a preregistered, archival study, we analyzed ratings of more than 140,000 physicians on a German rating website for medical professionals. Results indicate that general practitioners (but not dentists or specialists) with non-German names are rated less favorably than general practitioners with German names. This effect did not vary across regional contexts with varying prosperity and diversity. Our analyses also revealed that female physicians are evaluated less positively than male physicians. Contrary to our assumptions, bias against female physicians was especially strong in medical sub-disciplines that are characterized by a high share of female physicians.
... Kauff et al. [2] investigated whether ethnic and gender bias could be found in the ratings of male and female physicians with a migration background. Their study suggests that general practitioners with non-German names were rated lower than general practitioners with German names. ...
... Their analyses also showed that female physicians were rated less positively. The question is whether these data biases have an effect on fine-tuned LLMs since these ethnic and gender biases have been demonstrated [2]. Therefore, we will investigate the effects of fine-tuning German or multilingual LLMs on the biased data in several downstream tasks . 1 In order to investigate the impact of gender-biased data on language models, we perform a number of fairness measurements on pre-trained and fine-tuned language models. ...
... This applies to the quantitative evaluations as well as to the texts [6]. For some of the PRWs, it has been shown that the data have a migration and gender bias with respect to practitioners, resulting in less favorable ratings for women and for practitioners with non-German names [2]. The question is whether these data biases affect fine-tuned large language models (LLMs), since these ethical and gender biases have been demonstrated. ...
... It has been established that patients perceive female providers more negatively than male providers (J. G. Chen et al., 2017;Kauff et al., 2021). Even though female providers display more affiliative and participatory communication behaviors (Cooper-Patrick et al., 1999;Hall et al., 1994), patients give more credit to male physicians compared to female physicians for being patient centered (Hall et al., 2014). ...
... These data also showed that female providers had lower ratings compared to male providers. Further, patients have been shown to rate providers of different ethnicities lower than those of their own ethnicity (Kauff et al., 2021). The data showed that White patients rated providers higher compared to non-White patients. ...
This research investigated the predictors of satisfaction for parents of pediatric patients after a clinical consultation. Specifically, we assessed whether perceptions of their provider's communication quality influenced the degree to which their (dis)satisfaction with consultation length associated with their provider rating and intent to recommend the provider's office. Using patient satisfaction survey data collected after initial clinical visits to a pediatric hospital (N = 12,004), we found that communication quality was a stronger predictor for those who were dissatisfied with their consultation length, whereas communication quality made a relatively smaller difference for those who were satisfied with their consultation length. Put another way, parents' dissatisfaction with their child's consultation length mattered little when they perceived their provider to be high in communication quality, but it reduced their ratings and intentions to recommend when they perceived their provider to be low in communication quality. These results suggest that providers' communication behaviors have the capacity to buffer patients' negative evaluations otherwise incurred from shorter than desired consultations.
... This leaves room for bias to be the difference maker in which of the three doctors is left with no patient. It has been shown that patients rate female doctors less favorably than male doctors (Wallace & Paul, 2016;Kauff et al., 2021). This means that an artificial intelligence system could be trusted more than female doctors but less than male doctors. ...
AI researchers and ethicists have long worried about the threat that automation poses to human dignity, autonomy, and to the sense of personal value that is tied to work. Typically, proposed solutions to this problem focus on ways in which we can reduce the number of job losses which result from automation, ways to retrain those that lose their jobs, or ways to mitigate the social consequences of those job losses. However, even in cases where workers keep their jobs, their agency within them might be severely downgraded. For instance, human employees might work alongside AI but not be allowed to make decisions or not be allowed to make decisions without consulting with or coming to agreement with the AI. This is a kind of epistemic harm (which could be an injustice if it is distributed on the basis of identity prejudice). It diminishes human agency (in constraining people's ability to act independently), and it fails to recognize the workers' epistemic agency as qualified experts. Workers, in this case, aren't given the trust they are entitled to. This means that issues of human dignity remain even in cases where everyone keeps their job. Further, job retention focused solutions, such as designing an algorithm to work alongside the human employee, may only enable these harms. Here, we propose an alternative design solution, adversarial collaboration, which addresses the traditional retention problem of automation, but also addresses the larger underlying problem of epistemic harms and the distribution of trust between AI and humans in the workplace.
... Explicit refusals of care, for instance, when a white patient expresses the desire of not to be treated by a black physician, is the most blatant example of explicit patient bias (Kimani et al., 2016;Rosoff, 2018). In an analysis of a German physician-rating website, Kauff et al. (2021) found that general practitioners with non-German names tended to be evaluated less favourably compared to German ones. ...
Increasing diversity in the healthcare workforce has brought to the foreground the importance of addressing phenomena of racism, discrimination, and bias against healthcare workers of diverse backgrounds. This paper aims to contribute to the growing literature on patient bias by exploring the experiences of migrant physicians practicing in Sweden using thematic content analysis of 17 semi-structured interviews and applying microaggressions theory. Four themes pertaining to different forms of patient bias experienced by the respondents emerged from the transcripts such as refusal of care, questioning language competence, questioning medical competence, and ethnic jokes/stereotypes. Four additional themes dealing with strategies implemented by the respondents to cope with patient bias were also identified, namely confrontation avoidance, collaboration with Swedish healthcare staff, self-disclosure, and active listening. The findings elucidate the need to encourage inclusion in the workplace by providing opportunities for continuous language training and collegial support.
... The crux with stereotypes is that even if we don't fully agree with them, we might nevertheless use them to assess others. Especially in situations where we have limited information, we need to act quickly, we are under a lot of stress, or we simply do not have the cognitive resources or motivation to engage more deeply, we fall back on socially shared stereotypes (e.g., Kauff et al., 2021). Whether the content of these stereotypes is completely outside the stereotype bearer's consciousness, as was assumed for many years, has recently become a subject of dispute again (see Infobox on Unconscious Bias). ...
The chapter titled "Causes and Consequences of Biases and (Gender-) Stereotypes" by Julian Anslinger examines the origins and effects of biases and stereotypes on decision-making and behavior. The author discusses the role of heuristics in the formation of biases and stereotypes. The chapter furthermore discusses the negative consequences of discrimination and the importance of understanding and combating biases and stereotypes in the pursuit of gender and social equality.
... Kauff et al. examined ratings of 140,000 physicians on a German website for health professionals and discovered that females and physicians with a migration background (identified by foreign names) were consistently rated lower than males. They suggest that although medicine is a prestigious profession, those within who are from low status groups (women and immigrants) may be easily targeted and perceived in a negative way (43). ...
Background
Patient bias and prejudice directed against physicians from diverse backgrounds is a frequent occurrence in healthcare. Female physicians have long experienced discrimination in the healthcare system based on their gender alone. The dynamic known as Patient Prejudice toward Providers (PPtP) is disproportionately affecting female physicians because it is frequently compounded by sexism.
Aim
The goal of this study was to explore the impact of PPtP on female resident and attending physicians.
Methods
Using transcribed one-on-one interviews from a larger study of PPtP affecting resident and attending physicians, ten interviews with female physicians (resident and attending) from diverse ethnic backgrounds and countries of training at a large academic medical center were analyzed. The authors independently reviewed the interviews using an iterative process within and across interviews to inductively identify repeating words, phrases, and concepts relevant to the study aim.
Results
Demographics of the ten participants included age (mean 34.6 years), ethnicity (6 Asian, 2 Hispanic, 2 African), and country of training (10% IMG vs. 90% US trained). Four of the interviewees were residents and six were attendings. Themes that emerged from the analysis included experiencing “A Gendered Continuum of Abuse,” “Establishing a Higher Standard of Competency,” “Overcoming the Stereotype of the White Male Physician,” “The Physicality of Self Identity,” and “The Need to be Protective of Minoritized Trainees.” All participants agreed that these perceptions created an adverse environment at the workplace and impacted on patient care.
Conclusions
Discrimination of physicians based on their gender or their race/ethnicity has been reported. This study highlights the compounded effects of patient prejudice on female minoritized physicians. Organizations and individuals should identify and implement strategies to address the impact of PPtP and sexism in order to create an environment where all women can thrive professionally.
Background
Doctor review websites have become increasingly popular as a source of information for patients looking to select a primary care provider. Zocdoc is one such platform that allows patients to not only rate and review their experiences with doctors but also directly schedule appointments. This study examines how several physician characteristics including gender, age, race, languages spoken in a physician’s office, education, and facial attractiveness impact the average numerical rating of primary care doctors on Zocdoc.
Objective
The aim of this study was to investigate the association between physician characteristics and patient satisfaction ratings on Zocdoc.
Methods
A data set of 1455 primary care doctor profiles across 30 cities was scraped from Zocdoc. The profiles contained information on the physician’s gender, education, and languages spoken in their office. Age, facial attractiveness, and race were imputed from profile pictures using commercial facial analysis software. Each doctor profile listed an average overall satisfaction rating, bedside manner rating, and wait time rating from verified patients. Descriptive statistics, the Wilcoxon rank sum test, and multivariate logistic regression were used to analyze the data.
Results
The average overall rating on Zocdoc was highly positive, with older age, lower facial attractiveness, foreign degrees, allopathic degrees, and speaking more languages negatively associated with the average rating. However, the effect sizes of these factors were relatively small. For example, graduates of Latin American medical schools had a mean overall rating of 4.63 compared to a 4.77 rating for US graduates (P<.001), a difference roughly equivalent to a 2.8% decrease in appointments. On multivariate analysis, being Asian and having a doctor of osteopathic medicine degree were positively associated with higher overall ratings, while attending a South Asian medical school and speaking more European and Middle Eastern languages in the office were negatively associated with higher overall ratings.
Conclusions
Overall, the findings suggest that age, facial attractiveness, education, and multilingualism do have some impact on web-based doctor reviews, but the numerical effect is small. Notably, bias may play out in many forms. For example, a physician's appearance or accent may impact a patient's trust, confidence, or satisfaction with their physician, which could in turn influence their take-up of preventative services and lead to either better or worse health outcomes. The study highlights the need for further research in how physician characteristics influence patient ratings of care.
Was genau ist eigentlich Künstliche Intelligenz? Was sind KI-Assistenzsysteme? Welche Vorteile und Gefahren bringen diese Technologien für Arbeitnehmende mit sich? Mit diesem Handbuch möchten wir Ihnen auf all diese Fragen verständliche Antworten geben und Ihnen einen leichten Einstieg in das Themengebiet Künstliche Intelligenz am Arbeitsplatz ermöglichen. Damit Sie jedoch nicht nur wissen, was KI ist, sondern KI am Arbeitsplatz erfolgreich mitgestalten können, finden Sie in diesem Handbuch darüber hinaus eine Vielzahl an Tipps, Methoden und Listen, die Sie bei der Gestaltung von KI-Assistenzsystemen am Arbeitsplatz unterstützen. Die Informationen, die Sie in diesem Buch finden, wurden in dem Projekt VEKIAA (Verantwortungsvolle Einbindung von KI-Assistenzsystemen am Arbeitsplatz) zusammengetragen, das in den Jahren 2020–2022 durch den Digitalisierungsfonds Arbeit 4.0 der Arbeiterkammer Wien gefördert wurde. Das VEKIAA-Projektteam, bestehend aus dem IFZ - Interdisziplinäres Forschungszentrum für Technik, Arbeit und Kultur sowie dem Forschungsunternehmen Pro2Future, verfolgte hierzu einen partizipativen Forschungsansatz für Technologieentwicklung. Mit diesem Ansatz wurden relevante Interessenvertretungen der Arbeitswelt aktiv in den Forschungsprozess miteingebunden, um sicherzustellen, dass die tatsächlichen Umstände rund um die Implementierung von KI-Assistenzsystemen an Arbeitsplätzen berücksichtigt werden und die abgeleiteten Methoden und Werkzeuge möglichst praxisnah und nützlich sind.
Background:
The h-index is a commonly used bibliometric in academic medicine which enumerates the number of publications (h) that have been cited h times. Recent investigations have suggested that gender-based differences in h-index may exist among academic physicians. We systematically reviewed studies of academic surgeons' h-index, hypothesizing that a significant difference would exist between the h-index of men and women at all academic ranks.
Methods:
Peer-reviewed journal articles authored by academic surgeons of any subspecialization in the United States between January 1, 2006, and November 20, 2017, were reviewed. We excluded studies of trainees or gender-based differences in funding without mention of h-index. Two reviewers assessed article quality using the Newcastle-Ottawa criteria. Pooled estimates of standard mean differences (SMD) in h-index between genders were calculated using random-effects meta-analyses. A subgroup analysis based on the academic rank was performed. Heterogeneity was assessed using the I2 statistic. Sensitivity analyses determined the effect of study on h-index. Meta-regression identified whether surgical specialty contributed to heterogeneity.
Results:
Twelve articles comparing h-index between genders were selected from 7950. Men possessed higher h-indices than women (SMD, 0.547; P < 0.001; I2 = 89.5%). Men exhibited higher h-indices at the assistant rank (SMD, 0.12; 95% confidence interval [CI], 0.01-0.24; P = 0.039) but not at the associate (SMD, 0.14; 95% CI, -0.06 to 0.33; P = 0.165) or full professor (SMD, 0.12; 95% CI, -0.08 to -0.31; P = 0.25) ranks.
Conclusions:
The h-index is higher for men than that for women in academic surgery overall but not at individual ranks. Further investigations are necessary to address limitations in h-index and to further characterize the relationship between h-index, gender, and promotion.
Secondary analyses of Revised NEO Personality Inventory data from 26 cultures (N = 23,031) suggest that gender differences are small relative to individual variation within genders; differences are replicated across cultures for both college-age and adult samples, and differences are broadly consistent with gender stereotypes: Women reported themselves to be higher in Neuroticism, Agreeableness, Warmth, and Openness to Feelings, whereas men were higher in Assertiveness and Openness to Ideas. Contrary to predictions from evolutionary theory, the magnitude of gender differences varied across cultures. Contrary to predictions from the social role model, gender differences were most pronounced in European and American cultures in which traditional sex roles are minimized. Possible explanations for this surprising finding are discussed, including the attribution of masculine and feminine behaviors to roles rather than traits in traditional cultures.
Big data presents unprecedented opportunities to understand human behavior on a large scale. It has been increasingly used in social and psychological research to reveal individual differences and group dynamics. There are a few theoretical and methodological challenges in big data research that require attention. In this paper, we highlight four issues, namely data-driven versus theory-driven approaches, measurement validity, multi-level longitudinal analysis, and data integration. They represent common problems that social scientists often face in using big data. We present examples of these problems and propose possible solutions.
The introduction to this special issue on psychological research involving big data summarizes the highlights of 10 articles that address a number of important and inspiring perspectives, issues, and applications. Four common themes that emerge in the articles with respect to psychological research conducted in the area of big data are mentioned, including: (a) The benefits of collaboration across disciplines, such as those in the social sciences, applied statistics, and computer science. Doing so assists in grounding big data research in sound theory and practice, as well as in affording effective data retrieval and analysis. (b) Availability of large data sets on Facebook, Twitter, and other social media sites that provide a psychological window into the attitudes and behaviors of a broad spectrum of the population. (c) Identifying, addressing, and being sensitive to ethical considerations when analyzing large data sets gained from public or private sources. (d) The unavoidable necessity of validating predictive models in big data by applying a model developed on 1 dataset to a separate set of data or hold-out sample. Translational abstracts that summarize the articles in very clear and understandable terms are included in Appendix A, and a glossary of terms relevant to big data research discussed in the articles is presented in Appendix B.
Physician rating websites have been gaining in importance in both practice and research. However, no evidence is available concerning patients' ratings of dentists on physician rating websites.
The aim of this study is to present a comprehensive analysis of the ratings of dentists on a German physician rating website over a 2-year period.
All dentist ratings on a German physician rating website (Jameda) from 2012 and 2013 were analyzed. The available dataset contained 76,456 ratings of 23,902 dentists from 72,758 patients. Additional information included the overall score and subscores for 5 mandatory questions, the medical specialty and gender of the dentists, and the age, gender, and health insurance status of the patients. Statistical analysis was conducted using the median test and the Kendall tau-b test.
During the study period, 44.57% (23,902/53,626) of all dentists in Germany were evaluated on the physician rating website, Jameda. The number of ratings rose from 28,843 in 2012 to 47,613 in 2013, representing an increase of 65.08%. In detail, 45.37% (10,845/23,902) of dentists were rated once, 43.41% (10,376/23,902) between 2 and 5 times, and 11.21% (2681/23,902) more than 6 times (mean 3.16, SD 5.57). Approximately 90% (21,324/23,902, 89.21%) of dentists received a very good or good overall rating, whereas only 3.02% (721/23,902) were rated with the lowest scores. Better ratings were given either by female or older patients, or by those covered by private health insurance. The best-rated specialty was pediatric dentistry; the lowest ratings were given to orthodontists. Finally, dentists were rated slightly lower in 2013 compared to 2012 (P=.01).
The rise in the number of ratings for dentists demonstrates the increasing popularity of physician rating websites and the need for information about health care providers. Future research should assess whether social media, especially Web-based ratings, are suitable in practice for patients and other stakeholders in health care (eg, insurance providers) to reflect the clinical quality of care.
Using a social identity theory approach, we theorized that recruiters might be particularly biased against skilled immigrant applicants. We refer to this phenomenon as a skill paradox, according to which immigrants are more likely to be targets of employment discrimination the more skilled they are. Furthermore, building on the common ingroup identity model, we proposed that this paradox can be resolved through human resource management (HRM) strategies that promote inclusive hiring practices (e.g., by emphasizing fit with a diverse clientele). The results from a laboratory experiment were consistent with our predictions: Local recruiters preferred skilled local applicants over skilled immigrant applicants, but only when these applicants were qualified for a specific job. This bias against qualified and skilled immigrant applicants was attenuated when fit with a diverse clientele was emphasized, but not when fit with a homogeneous clientele was emphasized or when the hiring strategy was not explained. We discuss the implications of our findings for research on employment discrimination against skilled immigrants, including the role of inclusiveness for reducing discriminatory biases.
In 2 meta-analyses, we examined the relationship between perceived discrimination and psychological well-being and tested a number of moderators of that relationship. In Meta-Analysis 1 (328 independent effect sizes, N = 144,246), we examined correlational data measuring both perceived discrimination and psychological well-being (e.g., self-esteem, depression, anxiety, psychological distress, life satisfaction). Using a random-effects model, the mean weighted effect size was significantly negative, indicating harm (r = -.23). Effect sizes were larger for disadvantaged groups (r = -.24) compared to advantaged groups (r = -.10), larger for children compared to adults, larger for perceptions of personal discrimination compared to group discrimination, and weaker for racism and sexism compared to other stigmas. The negative relationship was significant across different operationalizations of well-being but was somewhat weaker for positive outcomes (e.g., self-esteem, positive affect) than for negative outcomes (e.g., depression, anxiety, negative affect). Importantly, the effect size was significantly negative even in longitudinal studies that controlled for prior levels of well-being (r = -.15). In Meta-Analysis 2 (54 independent effect sizes, N = 2,640), we examined experimental data from studies manipulating perceptions of discrimination and measuring well-being. We found that the effect of discrimination on well-being was significantly negative for studies that manipulated general perceptions of discrimination (d = -.25), but effects did not differ from 0 when attributions to discrimination for a specific negative event were compared to personal attributions (d = .06). Overall, results support the idea that the pervasiveness of perceived discrimination is fundamental to its harmful effects on psychological well-being. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
Background
Physician rating websites (PRW) have been gaining in popularity among patients who are seeking a physician. However, little evidence is available on the number, distribution, or trend of evaluations on PRWs. Furthermore, there is no published evidence available that analyzes the characteristics of the patients who provide ratings on PRWs.
Objective
The objective of the study was to analyze all physician evaluations that were posted on the German PRW, jameda, in 2012.
Methods
Data from the German PRW, jameda, from 2012 were analyzed and contained 127,192 ratings of 53,585 physicians from 107,148 patients. Information included medical specialty and gender of the physician, age, gender, and health insurance status of the patient, as well as the results of the physician ratings. Statistical analysis was carried out using the median test and Kendall Tau-b test.
ResultsThirty-seven percent of all German physicians were rated on jameda in 2012. Nearly half of those physicians were rated once, and less than 2% were rated more than ten times (mean number of ratings 2.37, SD 3.17). About one third of all rated physicians were female. Rating patients were mostly female (60%), between 30-50 years (51%) and covered by Statutory Health Insurance (83%). A mean of 1.19 evaluations per patient could be calculated (SD 0.778). Most of the rated medical specialties were orthopedists, dermatologists, and gynecologists. Two thirds of all ratings could be assigned to the best category, “very good”. Female physicians had significantly better ratings than did their male colleagues (P
Surveys show that respondents from East Germany consistently show higher levels of ethnic prejudice than respondents from West Germany. Comparable differences can be found in statistics on crimes and violence against ethnic minority members. On the basis of three surveys (ALLBUS, 1996, N = 2893; Shell Youth Study (Deutsche Shell), 2000, N = 3560; and our own survey of school students, N = 769), the hypothesis that this difference can be largely explained by contrasting interethnic contact opportunities and experiences is tested and supported. Demographic data show that living in the Eastern or Western part of Germany offers differential opportunities for contact with foreigners. Structural equation analyses reveal that this difference, in turn, influences the number of foreigners in the neighborhood or classroom. As a consequence of these varying opportunities for contact, respondents report marked differences in more intimate and personal contact—such as having foreign friends or experiencing contact of personal importance. Foreign friends and importance of contact proved to be the relevant proximal contact variables that reduce ethnic prejudice. Beyond the German context, these results point to a more inclusive model of intergroup relations.
This study investigated whether sex discrimination existed in recruiters' evaluations of applicants in real employment interviews and, if so, whether other variables could explain it. The variables examined were the perceived similarity of the applicant to the recruiter, the interpersonal attraction felt by the recruiter toward the applicant, and the applicant's objectively measured and subjectively measured qualifications. Applicant sex did not directly or indirectly affect recruiters' evaluations of applicants in campus interviews, providing no evidence of sex discrimination. Instead, subjective qualifications had a significant effect on evaluations and also mediated the effects of perceived similarity, interpersonal attraction, and objective qualifications on evaluations. Recruiters saw stronger subjective qualifications in applicants with high scholastic performance whom they viewed as similar to themselves and whom they liked. Perceptions of these qualifications, in turn, were the primary determinant of evaluations. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Ethnic minority academicians face a number of challenges in the “ivory tower.” One set of challenges arises from the racial stereotypes that others hold, and the current research investigates the stereotypes held by students before they even meet such professors. After providing college preparatory students with a CV of a professor (differing in their race—White, Black, or Asian; their gender—male or female; and their academic discipline—Science or Humanities), students evaluated the professor on measures of competence, legitimacy, and interpersonal skills. We found that students evaluated Black professors to be significantly less competent and legitimate than their White and Asian counterparts. Both Black and Asian professors were judged to have significantly less interpersonal skills than White professors. No gender main effects emerged. Professors in science were judged to be more competent and legitimate than professors in humanities. Very few interactions surfaced. We discuss our results in terms of previous stereotype research and the implications our results have for further compounding the challenges that Black professors face in academia. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Background
Across countries and disciplines, studies show male researchers receive more research funding than their female peers. Because most studies have been observational, it is unclear whether imbalances stem from evaluations of female research investigators or of their proposed research. In 2014, the Canadian Institutes of Health Research created a natural experiment by dividing investigator-initiated funding applications into two new grant programmes: one with and one without an explicit review focus on the calibre of the principal investigator.
Methods
We analysed application success among 23 918 grant applications from 7093 principal investigators in all investigator-initiated Canadian Institutes of Health Research grant programmes between 2011 and 2016. We used generalised estimating equations to account for multiple applications by the same applicant and compared differences in application success between male and female principal investigators under different review criteria.
Findings
Overall application success across competitions was 15·8%. After adjusting for age and research domain, the predicted probability of success in traditional programmes was 0·9 percentage points lower for female applicants than male applicants (95% CI 2·0 lower–0·2 higher; odds ratio 0·934, 95% CI 0·854–1·022). In the new programme, in which review focused on the proposed science, the gap remained 0·9 percentage points (3·2 lower–1·4 higher; 0·998, 0·794–1·229). In the new programme with an explicit review focus on the calibre of the principal investigator, the gap was 4·0 percentage points (6·7 lower–1·3 lower; 0·705, 0·519–0·960).
Interpretation
Gender gaps in grant funding are attributable to less favourable assessments of women as principal investigators, not of the quality of their proposed research. We discuss reasons less favourable assessments might occur and strategies to foster fair and rigorous peer review.
Funding
None.
Glaubt man den einschlägigen Statistiken, schauen sich die weitaus meisten Patienten, die nach einem Arzt suchen, im Internet um. An Portalen, in denen Ärzte gelistet und auch bewertet werden, herrscht dort kein Mangel. Eher schon fehlt es an einer Antwort auf die Frage, was die dort verzeichneten Informationen tatsächlich wert sind.
Background:
Previous surveys have shown that patient satisfaction varies with the regional supply of physicians. Online ratings on physician-rating websites represent a relatively new instrument to display patient satisfaction results. The aim of this study was (1) to assess the current state of online ratings for two medical disciplines (dermatologists and ear, nose and throat (ENT) specialists), and (2) to analyze online derived patient satisfaction results according to the physician density in Germany.
Methods:
We collected online ratings for 420 dermatologists and 450 ear, nose, and throat (ENT) specialists on twelve German physician-rating websites. We analyzed the online ratings according to the physician density (low, medium, high physician density). For this purpose, we collected secondary data from both physician-rating websites and the regional associations of statutory health insurance physicians. Data analysis was performed using Median tests and Chi-square tests.
Results:
In total, 10,239 online ratings for dermatologists and 8,168 online ratings for ENT specialists were analyzed. Almost all dermatologists (99.3 %) and ENT specialists (98.9 %) were listed on one of the physician-rating websites. A total of 93.5 % of all listed dermatologists and 96.9 % of ENT-specialists were rated on at least one of the physician-rating websites. Significant differences were found in the distribution (i.e., percentage of listed or rated physicians) of the ratings according to the regional physician density on only one physician-rating website (p<0.001). Furthermore, online ratings were shown to be better in regions with a higher physician density on two physician-rating website. On jameda, for example, dermatologist ratings were better in regions with a higher physician density compared to regions with a lower number of physicians (average rating: 2.16 vs. 2.67; p<0.001).
Conclusions:
Online ratings of dermatologists and ENT specialists hardly differ in terms of regional physician density. Physician-rating websites thus do not appear to be appropriate to mirror differences in the health service delivery structure. Our findings thus do not confirm the results from previously published studies.
Background :
Prior research has shown a gender gap in the evaluations of emergency medicine (EM) residents' competency on the Accreditation Council for Graduate Medical Education (ACGME) milestones, yet the practical implications of this are not fully understood.
Objective :
To better understand the gender gap in evaluations, we examined qualitative differences in the feedback that male and female residents received from attending physicians.
Methods :
This study used a longitudinal qualitative content analysis of narrative comments by attending physicians during real-time direct observation milestone evaluations of residents. Comments were collected over 2 years from 1 ACGME-accredited EM training program.
Results :
In total, 1317 direct observation evaluations with comments from 67 faculty members were collected for 47 postgraduate year 3 EM residents. Analysis of the comments revealed that the ideal EM resident possesses many stereotypically masculine traits. Additionally, examination of a subset of the residents (those with 15 or more comments, n = 35) showed that when male residents struggled, they received consistent feedback from different attending physicians regarding aspects of their performance that needed work. In contrast, when female residents struggled, they received discordant feedback from different attending physicians, particularly regarding issues of autonomy and assertiveness.
Conclusions :
Our study revealed qualitative differences in the kind of feedback that male and female EM residents received from attending physicians. The findings suggest that attending physicians should endeavor to provide male and female residents with consistent feedback and guard against gender bias in their perceptions of residents' capabilities.
The behavior of women and men varies greatly depending on situations, cultures, and historical periods. This flexibility emerges as men and women tailor their division of labor to local ecological and socioeconomic demands. The resulting division is supported by childhood socialization practices that, in interaction with sex differences in child temperament, help boys and girls to develop psychologies suited to their likely adult activities. Although responsive to local conditions, the division of labor is constrained by women's childbearing and nursing of infants and men's size and strength. Because these biological characteristics influence the efficient performance of many activities in society, they underlie central tendencies in the division of labor as well as its variability across situations, cultures, and history. Gender roles-that is, shared beliefs about the traits of women and men-track the division of labor because people infer these traits from their observations of the sexes' behaviors. Social perceivers often essentialize these traits by regarding them as inherent in the biology or social experience of women and men. Gender role expectations, which tend to be consensual within cultures, influence behavior through proximal social psychological and biological processes, whereby (a) other people encourage gender-typical behavior and individuals conform to their own gender identities and (b) hormonal, reward, and cardiovascular mechanisms enable masculine and feminine behaviors.
In the Netherlands, support for ethnic discrimination, that is, support for a disadvantageous treatment of ethnic minorities in the housing and labour market, had decreased in the late 1970s and early 1980s, but has increased since the mid-1980s up to the early 1990s. In this article, we examine the effects of contextual characteristics (period and cohort characteristics) and individual characteristics on support for ethnic discrimination. Hypotheses, derived from Ethnic Conflict Theory, are tested by means of logistic regression analysis, using individual-level pooled data over the period 1979-1993 (N=20,156) as well as national-level time-series data, presumably indicative of period and cohort characteristics. Regarding period characteristics, the results show that support for ethnic discrimination is more widespread in times of high and increasing levels of ethnic immigration, as well as in times of growing unemployment. However, the level of unemployment as such has a negative effect on support for ethnic discrimination. Regarding cohort characteristics, the results show that the higher the level of ethnic immigration and unemployment during the formative years, the more widespread support for ethnic discrimination is. In addition, we found a positive effect of age. Regarding other individual characteristics, support for ethnic discrimination is particularly more widespread among less educated people.
It is a popular assumption that women and racial minorities who are numeric minorities in high-prestige work groups will advocate for a demographically similar other as a potential work group peer. However, these individuals may face special challenges in fulfilling this role. We discuss how three factors—the general social status associated with a specific demographic characteristic, the demographic composition of the work group, and the differential prestige accorded within organizations to work groups—interact to impact individuals' concerns about being considered valued members of work groups to which they belong (i.e., value threat). Based on an integration of sociological and psychological theories, we argue that value threat adversely affects individuals' propensity to support demographically similar others in selection and promotion processes. We identify three forms that value threat may take in situations involving such personnel decisions: collective threat, favoritism threat, and competitive threat, and we specify factors that may shape the intensity of each form.
Two processes of stereotyping, subtyping and subgrouping, are compared. Subtyping occurs when perceivers respond to members of a target group who disconfirm their stereotypes by seeing them as exceptions to the rule and placing them in a separate subcategory apart from members who confirm the stereotype. The more recently defined process of subgrouping refers to the perceiver's organization of information in terms of clusters of individuals based on their similarities and dif - ferences; subgroups can include confirmers and disconfirmers. We consider how subtypes and subgroups are defined, operationalized, and measured, their conse - quences for stereotype change, and the role of typicality. It is concluded that the clearest difference between subtyping and subgrouping is in terms of their conse - quences (subtyping leads to the preservation and subgrouping to differentiation of the stereotype). There are, however, some similarities between the processes, and at- tention is drawn to what future research is required, both to deepen our knowledge of each process and clarify their distinction.
There is a popular theory-based assumption that women, who are numerical minorities in high-prestige work groups, will advocate for other women as potential work group peers. However, these individuals may face special challenges in fulfilling this role. I examine how the prestige accorded to the work group and their numerical representation interact to impact women's concerns about being considered valued members of their groups and hence, their propensity to support other women in the selection process. I conducted three studies which showed that women will abdicate the opportunity to support highly or moderately qualified female candidates as potential work group peers. Furthermore, the concern that a highly qualified female candidate will be seen as more of a valued group member (competitive threat) and that a moderately qualified female candidate will adversely affect their value by reinforcing negative stereotypes about their demographic category (collective threat) partially mediated the relationship between numerical representation and work group prestige and women's preference for other women as work group peers.
A multidimensional approach to occupational gender type was explored. In Study 1, participants' spontaneous images of various jobs were elicited. The attributes generated were used to develop a job images questionnaire employed in Study 2 on which participants rated a random sample of 100 occupational titles. Occupational images were primarily structured on two orthogonal dimensions: prestige and gender type. The multidimensional approach to occupational gender-type was supported in that important gender-related occupational attributes (masculine personality trait requirements and analytical skills) did not load on the gender-type factor, but did load highly on the prestige factor. Thus, even though the prestige and gender-type factors were orthogonal, specific gender-related attributes were related to perceived occupational prestige.
Physician rating websites (PRWs) are gaining in popularity among patients seeking quality information about physicians. However, little knowledge is available about the quantity and type of information provided on the websites. Objective: To determine and structure the quantity and type of information about physicians in the outpatient sector provided on German-language physician rating websites.
In a first step, we identified PRWs through a systematic internet search using German keywords from a patient´s perspective in the two search engines Google and Yahoo. Afterwards, information about physicians available on the websites was collected and categorised according to Donabedian´s structure/process/outcome model. Furthermore, we investigated whether the information was related to the physician himself/ herself or to the practice as a whole.
In total, eight PRWs were detected. Our analysis turned up 139 different information items on eight websites; 67 are related to the structural quality, 4 to process quality, 5 to outcomes, and 63 to patient satisfaction/experience. In total, 37% of all items focus specifically on the physician and 63% on the physician's practice. In terms of the total amount of information provided on the PRWs, results range from 61 down to 13.5 items.
A broad range of information is available on German PRWs. While structural information can give a detailed overview of the financial, technical and human resources of a practice, other outcome measures have to be interpreted with caution. Specifically, patient satisfaction results are not risk-adjusted, and thus, are not appropriate to represent a provider's quality of care. Consequently, neither patients nor physicians should yet use the information provided to make their final decision for or against an individual physician.
Bias against foreign-born or -trained medical students and doctors is not well understood, despite its documented impact on recruitment, integration and retention. This research experimentally examines the interaction of location of medical education and nationality in evaluations of doctors' competence and trustworthiness.
A convenience sample of prospective patients evaluated fictitious candidates for a position as a doctor in community practice at a new local health clinic. All applicants were described as having the same personality profile, legal qualifications to practise, a multi-degree education and relevant work experience. The location of medical education (the candidate's home country or the UK) and national background (Australia or Pakistan) of the applicants were independently experimentally manipulated.
Consistent with previous research on skills discounting and bias, foreign-born candidates were evaluated less favourably than native-born candidates, despite their comparable education level, work experience and personality. However, overseas medical education obtained in the First World both boosted evaluations (of competence and trustworthiness) and attenuated bias based on nationality.
The present findings demonstrate the selective discounting of foreign-born doctors' credentials. The data show an interaction of location of medical education and birth nationality in bias against foreign doctors. On an applied level, the data document that the benefits of medical education obtained in the First World can extend beyond its direct outcomes (high-quality training and institutional recognition) to the indirect benefit of the attenuation of patient bias based on nationality.
To examine the association between physician race/ ethnicity, workplace discrimination, and physician job turnover.
Cross-sectional, national survey conducted in 2006-2007 of practicing physicians (n = 529) randomly identified via the American Medical Association Masterfile and the National Medical Association membership roster. We assessed the relationships between career racial/ethnic discrimination at work and several career-related dependent variables, including 2 measures of physician turnover, career satisfaction, and contemplation of career change. We used standard frequency analyses, odds ratios and chi2 statistics, and multivariate logistic regression modeling to evaluate these associations.
Physicians who self-identified as nonmajority were significantly more likely to have left at least 1 job because of workplace discrimination (black, 29%; Asian, 24%; other race, 21%; Hispanic/Latino, 20%; white, 9%). In multivariate models, having experienced racial/ethnic discrimination at work was associated with high job turnover (adjusted odds ratio, 2.7; 95% CI, 1.4-4.9). Among physicians who experienced workplace discrimination, only 45% of physicians were satisfied with their careers (vs 88% among those who had not experienced workplace discrimination, p value < .01), and 40% were contemplating a career change (vs 10% among those who had not experienced workplace discrimination, p value < .001).
Workplace discrimination is associated with physician job turnover, career dissatisfaction, and contemplation of career change. These findings underscore the importance of monitoring for workplace discrimination and responding when opportunities for intervention and retention still exist.
Ergebnisse einer Repräsentativ- und einer Betroffenenbefragung [Experiences of discrimination in Germany - A representative survey and a survey among targets
- S Beigang
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- M Otto
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Repräsentativ-und einer Betroffenenbefragung [Experiences of discrimination in Germany -A representative survey
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tionen/Expertisen/Expertise_Diskriminierungserfahrungen_in_Deutschland.pdf
Bund, Länder und Kreise
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Majorities of Americans see at least some discrimination against Black, Hispanic and Asian people in the U.S. Pew Research Center
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Zu welchem Arzt würden Sie gehen?
- T Fischer
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Arztberuf: Die Medizin ist weiblich [The medical profession is female
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A century after women gained the right to vote, majority of Americans see work to do on gender equality
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Stichprobenziehung für telefonische Zuwandererumfragen. Einsatzmöglichkeiten der Namensforschung (Onomastik) [Sampling for telephone-assisted surveys among migrants. Application of onomatology
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Berufsordnung der Landesärztekammer Brandenburg
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The consequences of authenticity: Quantifying racial signals and their effects on crowdfunding success
- L Rhue
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Reactions to vanguards: Advances in backlash theory
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Ausländeranteil in %
- Statistisches Bundesamt
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Migrationshintergrund [Migration background
- Statistisches Bundesamt
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Jeder zwölfte Arzt hat keinen deutschen Pass
- R Woratschka
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Experiences of discrimination in Germany - A representative survey and a survey among targets
- S Beigang
- K Fetz
- D Kalkum
- M Otto
Big data in social and psychological science: Theoretical and methodological issues
- L Qui
- S H M Chan
- D Chan