Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-28T19:36:34.522Z Has data issue: false hasContentIssue false
  • English
  • Français

Not Too Old, Not Too Young: Older Women’s Perceptions of Physicians

Published online by Cambridge University Press:  09 December 2015

Hazel MacRae
Hazel MacRae*
Affiliation:
Mount Saint Vincent University, Nova Scotia
*
†La correspondance et les demandes de tirés-à-part doivent être adressées à: / Correspondence and requests for offprints should be sent to: Hazel MacRae, Ph.D. Department of Sociology and Anthropology Mount Saint Vincent University 166 Bedford Highway Halifax, NS B3M 2J6 ([email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Older women interact with physicians more frequently than older men and younger persons, yet knowledge and understanding of their experiences with physicians is limited. The purpose of this study was to investigate older women’s perceptions of their interactions with physicians and to identify what older women want from physicians. Findings from in-depth interviews with 30 older women reveal the majority want to be actively involved in their own health care. In the patient–physician relationship, the women typically give priority to physicians’ personal attributes and behavior towards the patient. For many of the women, the age and gender of the physician also matter.

Résumé

Les femmes plus âgées interagissent avec les médecins plus souvent que les hommes âgés et les personnes plus jeunes; pourtant, la connaissance et la compréhension de leurs expériences avec les médecins sont limitées. Le but de cette étude était d'étudier les perceptions des femmes âgées de leurs interactions avec les médecins et d'identifier ce que les femmes veulent de leurs médecins. Les entrevues en profondeur avec 30 femmes âgées montrent que la majorité veulent être impliquée activement dans leurs propres soins de santé. Dans la relation patient-médecin, les femmes donnent généralement la priorité aux qualités personnelles de médecins et leur comportement à l'égard du patient. Pour de nombreuses femmes, l'âge et le sexe du médecin ont aussi leur importance.

Keywords

agingolder womenphysicianspatient-physician relationshiphealth caresymbolic interactionvieillissmentfemmes âgéesmédicinsrelation patient-médicinsoins de santéinteraction symbolique
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 34 , Issue 4 , December 2015 , pp. 545 - 560
Copyright
Copyright © Canadian Association on Gerontology 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adams, R., Price, K., Tucker, G., Nguyen, A.-M., & Wilson, D. (2012). The doctor and the patient—How is a clinical encounter perceived? Patient Education & Counseling, 86, 127–133. doi:10.1016/j.pec.2011.04.002Google Scholar
Adams, W., McIlvain, H., Lacy, N., Magsi, H., Crabtree, B., Yenny, S., et al. (2002). Primary care for elderly people: Why do doctors find it so hard? The Gerontologist, 42(6), 835–842.Google Scholar
Adelman, R. D., Greene, M. G., & Charon, R. (1991). Issues in the physician-elderly patient interaction. Ageing and Society, 11(2), 127–148.CrossRefGoogle Scholar
Adler, S., McGraw, S. A., & McKinlay, J. B. (1998). Patient assertiveness in ethnically diverse older women with breast cancer: Challenging stereotypes of the elderly. Journal of Aging Studies, 12, 331–350.Google Scholar
Alspach, J. G. (2012). Is there gender bias in critical care? Critical Care Nurse, 32(6), 8–13. doi: http://dx.doi.org/10.4037/ccn2012727 Google Scholar
Armstrong, P. (2006). Gender, health, and care. In Raphael, D., Bryant, T., & Rioux, M. (Eds)., Staying alive: Critical perspectives on health, illness, and health care (pp. 287–303). Toronto: Canadian Scholars’ Press.Google Scholar
Arora, N. K., & McHorney, C. A. (2000). Patient preferences for medical decision making: Who really wants to participate? Medical Care, 38(3), 335–341.CrossRefGoogle ScholarPubMed
Bastiaens, H., Van Royen, P., Pavlic, D. R., Raposo, V., & Baker, R. (2007). Older people’s preferences for involvement in their own care: A qualitative study in primary care in 11 European countries. Patient & and Counseling, 68, 33–42. doi:10.1016/jpec.2007.03.025.Google Scholar
Beisecker, A. E. (1996). Older person’s medical encounters and their outcomes. Research on Aging, 18, 9–31.Google Scholar
Bertakis, K. D., & Azari, R. (2012). Patient-centered care: The influence of patient and resident physician gender and gender concordance in primary care. Journal of Women’s Health, 21(3), 326–333. doi:10.1089/jwh.2011.2903.Google Scholar
Black, D. (2000). Editorial: Complaints, doctors, and older people. Age and Ageing, 29, 389–391.CrossRefGoogle ScholarPubMed
Blumer, H. (1969). Symbolic interactionism: Perspective and method. New Jersey: Prentice hall.Google Scholar
Burroughs, H., Lovell, K., Morley, M., Baldwin, R., Burns, A., & Chew-Graham, C. (2006). ‘Justifiable depression’: How primary care professionals and patients view late-life depression? A qualitative study. Family Practice, 23, 369–377. doi:10.1093/fampra/cmi115.Google Scholar
Bylund, C. L., & Makoul, G. (2002). Empathic communication and gender in the physician-patient encounter. Patient Education & Counseling, 48, 207–216.Google Scholar
Calasanti, T. M. (2008). Theorizing feminist gerontology, sexuality, and beyond: An intersectional approach. In Bengston, V., Gans, D., & Putney, A. (Eds.), Handbook of theories of aging (pp. 471–485). New York: Springer.Google Scholar
Calasanti, T. M., & Slevin, K. F. (2006). Age matters: Realigning feminist thinking. New York: Routledge.Google Scholar
Campbell, C., & McGauley, G. (2005). Doctor–patient relationships in chronic illness: Insights from forensic psychiatry. British Medical Journal, 330(7492), 667–670.Google Scholar
Cassell, E. J. (1986). The changing concept of the ideal physician. Daedalus, 115(2), 185–208.Google Scholar
Charmaz, K. (2006). Constructing grounded theory: A practical guide through qualitative analysis. Thousand Oaks, CA: Sage.Google Scholar
Cherubini, A., Corsonello, A., & Lattanzio, F. (2012). Underprescription of beneficial medicines in older people. Drugs Aging, 29(6), 463–475.Google Scholar
Coffey, A., & Atkinson, P. (1996). Making sense of qualitative data. Thousand Oaks, CA: Sage.Google Scholar
Cooper-Patrick, L., Gallo, J. J, Gonzales, J. J, Vu, H. T., Powe, N. R., Nelson, C., et al. (1999). Race, gender, and partnership in the patient-physician relationship. JAMA, 282(6), 583–589.Google Scholar
Currie, J. (2003). Manufacturing addiction: The overprescribing of benzodiazepines and sleeping pills to Women in Canada. Vancouver, BC: Centre of Excellence for Women’s Health.Google Scholar
Derose, K. P., Hays, R., McCaffrey, D. F., & Baker, D. W. (2001). Does physician gender affect satisfaction of men and women visiting the emergency department? Journal of General Internal Medicine, 16, 218–226.Google Scholar
Ditto, P. H., Moore, K. A., Hilton, J. L., & Kalish, J. R. (1995). Beliefs about physicians: Their role in health care utilization, satisfaction, and compliance. Basic and Applied Psychology, 17(1&2), 23–48.Google Scholar
Duberstein, P., Meldrum, S., Fiscella, K., Shields, C. G., & Epstein, R. M. (2007). Influences on patients’ ratings of physicians: Physicians demographics and personality. Patient Education & Counseling, 65(2), 270–274.Google Scholar
Edwards, C., Staniszweska, S., & Crichton, N. (2004). Investigation of the ways in which patients’ reports of their satisfaction with healthcare are constructed. Sociology of Health & Illness, 26(2), 159–183.CrossRefGoogle ScholarPubMed
Evans, K., & Robertson, S. R. (2009). “Dr. Right”: Elderly women in pursuit of negotiated health care and mutual decision making. The Qualitative Report, 14(3), 409–439. Retrieved from http://www.nova.edu/sss/QR/QR14-3/evans.pdf Google Scholar
Feldman, D. E., Huynh, T., Des Lauriers, J., Giannetti, N., Frenette, M., & Pilote, L. (2013). Gender and other disparities in referral to specialized heart failure clinics following emergency department visits. Journal of Women’s Health, 22(6), 526–531. doi: 10.1089/jwh.2012.4107Google Scholar
Fisher, S. (1986). In the patient’s best interest: Women and the politics of medical decisions. New Brunswick, NJ: Rutgers University Press.Google Scholar
Fisher, S., & Groce, S. B. (1985). Doctor-patient negotiation of cultural assumptions. Sociology of Health and Illness, 7(3), 342–373.Google Scholar
Freidson, E. (1989). Medical work in America. New Haven: Yale University Press.Google Scholar
Furnham, A., Petrides, K. V., & Temple, J. (2006). Patient preferences for medical doctors. British Journal of Health Psychology, 11, 439–449. doi:10.1348/135910705X67529.Google Scholar
Glaser, B. G., & Strauss, A. (1967). The discovery of grounder theory: Strategies for qualitative research. New York: Aldine De Gruyter.Google Scholar
Gochfeld, M. (2010). Sex-gender research sensitivity and healthcare disparities. Journal of Women’s Health, 19(2), 189–194. doi:10.1089/jkh.2009.1632.Google Scholar
Godfrey, J. R., & Felson, D. T. (2008). Toward optimal health: Managing arthritis in women. Journal of Women’s Health, 12, 729–734. doi:10.1089/jwh.2008.0879.Google Scholar
Greaves, L. (2009). Women, gender, and health research. In Armstrong, P., & Deadman, J. (Eds.), Women’s health: Intersections of policy, research, and practice (pp. 3–34). Toronto: Women’s Press.Google Scholar
Greene, M. G., & Adelman, R. D. (2003). Physician-older patient communication about cancer. Patient Education & Counseling, 50, 55–60. doi: 10.1016/S0738-3991(03)00081-8Google Scholar
Hamberg, K., Risberg, G., & Johansson, E. E. (2004). Male and female physicians show different patterns of gender bias: A paper-case study of management of irritable bowel disease. Scandinavian Journal of Public Health, 32, 144–152. doi: 10.1080/14034940310015401Google Scholar
Henderson, J. W. (1997). Issues in the medical treatment of elderly women. Journal of Women and Aging, 9, 107–115.CrossRefGoogle Scholar
Hewitt, J. P. (1991). Self and society: A symbolic interactionist social psychology. Boston: Allyn and Bacon.Google Scholar
Houle, C., Harwood, E., Watkins, M. A., & Baum, K. D. (2007). What women want from their physicians: A qualitative analysis. Journal of Women’s Health, 16, 543–550. doi: 19.1089/jwh.2006.MO79.Google Scholar
Koenig, H. G. (2007). Physician attitudes toward treatment of depression in older medical inpatients. Aging & Mental Health, 11(2), 197–204. doi: 10.1080/13607860600844457.CrossRefGoogle ScholarPubMed
Kuhlmann, E., & Babitsch, B. (2002). Bodies, health, gender- bridging feminist theories and women’s health. Women’s Studies International Forum, 25(4), 433–442.Google Scholar
Liang, W., Kasman, D., Wang, J. H., Yuan, E. H., & Mandelblatt, J. S. (2006). Communication between older women and physicians: Preliminary implications for satisfaction and intention to have mammography. Patient Education & Counseling, 64, 387–392. doi: 10.1016/j.pec.2006.04.004.Google Scholar
Lofland, J., & Lofland, L. H. (1995). Analyzing social settings: A guide to qualitative observation and analysis. Belmont, CA: Wadsworth.Google Scholar
Malat, J. (2001). Social distance and patients’ rating of healthcare providers. Journal of Health and Social Behavior, 42, 360–372.Google Scholar
Malat, J., & Hamilton, M. A. (2006). Preference for same-race health care providers and perceptions of interpersonal discrimination in health care. Journal of Health and Social Behavior, 47, 173–187.Google Scholar
Malatesta, V. J. (2007). Introduction: The need to address older women’s mental health issues. Journal of Women and Aging, 19, 1–12. doi:10.1300/JO7V19N01_01Google Scholar
Maly, R. C., Leake, B., & Sillman, R. (2004). Breast cancer treatment in older women: Impact of the patient-physician interaction. Journal of The American Geriatrics Society, 52, 1138–1145.Google Scholar
Marshall, C., & Rossman, G. H. (2011). Designing qualitative research. Thousand Oakes, CA: Sage.Google Scholar
Mast, M. S., Hall, J. A., & Roter, D. L. (2007). Disentangling physician sex and physician communication style: Their effects on patient satisfaction in a virtual medical visit. Patient Education & Counseling, 68, 16–22. doi:10.1016/j.pec.2007.03.020Google Scholar
Matusitz, J., & Spear, J. (2014). Effective doctor-patient communication: An updated examination. Social Work in Public Health, 29(3), 252–266. doi:10.1080/19371918.2013.776416Google Scholar
May, C., Rapley, T., Moreira, T., Finch, T., & Heaven, B. (2006). Technogovernance: Evidence, subjectivity, and the clinical encounter in primary care medicine. Social science & Medicine, 62, 1022–1030. doi: 10.1016/j.socscimed.2005.07.003Google Scholar
McCandless, N. J., & Conner, F. P. (1999). Older women and the health care system: A time for change. In Garner, D. (Ed.), Fundamentals of feminist gerontology (pp. 13–27). Binghamton: The Haworth Press.Google Scholar
McKinstry, B., & Ying Yang, S. (1994). Do patients care about the age of their general practitioner? A questionnaire survey in five practices. British Journal of General Practice, 44, 349–351.Google Scholar
Mead, G. H. (1934). Mind, self, and society. Chicago: University of Chicago Press.Google Scholar
Meisner, B. A. (2012). Physicians’ attitudes toward aging, the aged, and the provision of geriatric care: A systematic narrative review. Critical Public Health, 22(1), 61–72. doi:10.1080/09581596.2010.539592Google Scholar
Miles, S., & Leinster, S. J. (2010). Identifying professional characteristics of the ideal medical doctor: The laddering technique. Medical Teacher, 32, 136–140 doi: 10.3139070<215909031987Google Scholar
Nicolai, J., & Demmel, R. (2007). The impact of gender stereotypes of general practitioners’ communication skills: An experimental study using transcripts of physician-patient encounters. Patient Education & Counseling, 69, 200–205. doi:10.1016/j.pec.2007.08.013Google Scholar
Noori, K., & Weseley, A. J. (2011). Beyond credentials: The effect of physician sex and specialty on how physicians are perceived. Current Psychology, 30, 275–283. doi: 10.1007/s12144-011-9116-zGoogle Scholar
Nusbaum, M. R. H., Singh, A. R., & Pyles, A. A. (2004). Sexual healthcare needs of women aged 65 and older. Journal of The American Geriatrics Society, 52, 117–122.Google Scholar
Poot, A. J., den Elzen, W. P. J., Blom, J. W., & Gussekloo, J. (2014). Level of satisfaction of older persons with their general practitioner and practice: Role of complexity of health problems. PloS ONE, 9(4), 1–5. doi: 10.1371/journal.pone.0094326Google Scholar
Pritchard, K. I. (2007). Editorial: Have we been guilty of ageism in the primary treatment of breast cancer? British Journal of Cancer, 96, 1011–1012. doi: 10.1038/sj.bjc.6603697Google Scholar
Radecki, S. E., Kane, R. L., Soloman, D. H., Mendenhall, R. C., & Beck, J. C. (1988). Do physicians spend less time with older patients? Journal of The American Geriatrics Society, 36, 713–718. doi: 10.111/J.1532 – 5415.1988.tb07173.xGoogle Scholar
Rodwin, M.A. (1994). Patient accountability and quality of care: Lessons from medical consumerism and the patients’ rights. Women’s health and disability rights movements. American Journal of Law & Medicine, xx (142), 147–167.Google Scholar
Roter, D. L., & Hall, J. A. (2004). Physician gender and patient-centered communication: A critical review of empirical research. Annual Review of Public Health, 25, 497–519. doi: 10.1146/annurev.publhealth.25.101802.123134Google Scholar
Rubin, H. J., & Rubin, I. S. (1995). Qualitative interviewing: The art of hearing data. Thousand Oaks, CA: Sage.Google Scholar
Shah, R., & Ogden, J. (2006). ‘What’s in a face?’ the role of doctor ethnicity, age and gender in the formation of patients’ judgements: An experimental study. Patient Education & Counseling, 60, 136–141. doi: 10.1016/j.pec.2004.12.005.Google Scholar
Sidell, M. (1992). The relationship of elderly women to their doctors: In George, J., & Ebrahim, S. (Eds.), Health care for older women (pp. 179–196). Oxford: Oxford University Press.CrossRefGoogle Scholar
Silliman, R. A. (2009). When cancer in older adults is undermanaged: The breast cancer story. Journal of the American Geriatrics Society, 57, S259–S261. doi:10.1111/j.1532-5415.2009.02506.xGoogle Scholar
Street, R. L., Gordon, H., & Haidet, P. (2007). Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor? Social Science & Medicine, 65, 586–594. doi: 10.1016/j.socscimed.2007.03.036Google Scholar
Tannenbaum, C., & Mayo, N. (2003). Women’s health priorities and perceptions of care: A survey to identify opportunities for improving preventative health care delivery for older women. Age and Ageing, 32, 626–635.CrossRefGoogle Scholar
Tannenbaum, C., Nasmith, L., & Mayo, N. (2003). Understanding older women’s health care concerns: A qualitative study. Journal of Women & Aging, 15, 3–16.Google Scholar
Thomas, D. C., Johnston, B., Dunn, K., Sullivan, G. M., Brett, B., Matzko, M., et al. (2006). Continuing medical education, continuing professional development, and knowledge translation: Improving care of older patients by practicing physicians. Journal of The American Geriatrics Society, 54, 1610–1618.CrossRefGoogle ScholarPubMed
Todd, A. D. (1989). Intimate adversaries: Cultural conflict between doctors and women patients. Philadelphia: University of Pennsylvania Press.Google Scholar
Van den Hoonard, W. C. (1997). Working with sensitizing concepts: Analytical field research. Thousand Oaks, CA: Sage.Google Scholar
Van Til, L., MacQuarrie, C., & Herbert, R. (2003). Understanding the barriers to cervical cancer screening among older women. Qualitative Health Research, 13(8), 1116–1131. doi: 10.1177/1049732303255975Google Scholar
Waitzkin, H. (1991). The politics of medical encounters: How patients and doctors deal with social problems. New Haven: Yale University Press.Google Scholar
Weir, N. A., Kotecha, M., & Goel, K. L. (2007). Expanding choice options for older patients in relation to practice-based commissioning: A qualitative study of older patients in a small GP surgery. Quality in Primary Care, 15, 331–336.Google Scholar
Weitzman, P. F., Chang, G., & Reynoso, H. (2004). Middle-aged and older Latino American women in the patient-doctor interaction. Journal of Cross-Cultural Gerontology, 19, 221–239.Google Scholar
Weitzman, P. F., & Weitzman, E. A. (2003). Promoting communication with older adults: Protocols for resolving interpersonal conflicts and for enhancing interactions with doctors. Clinical Psychology Review, 23, 523–535.CrossRefGoogle ScholarPubMed
Willams, B., Coyle, J., & Healy, D. (1998). The meaning of patient satisfaction: An exploration of high reported levels. Social Science and Medicine, 47(9), 1351–1359.Google Scholar