The Effect of Physicians' Social and Demographic Characteristics on Sexual Counseling

Abstract

Due to the increased prevalence of sexually transmitted diseases (STD) during the 1980s, there has been increased appreciation of the need to educate the public about STDs. One recommendation is to change physician behavior through education so that physicians' advice has a greater effect on their patients. This project, conducted at Georgetown University’s Department of Community and Family Medicine, investigated physician-patient counseling styles utilizing a Simulated Patient Evaluator (SPE) named Judy Green who visited physicians in the Washington Metropolitan area. The 961 physicians were randomly assigned to three intervention groups: group one was a control group; group two received educational materials; and group three received educational materials plus a 30 minute office visit with a trained simulated patient instructor. The results of this study do not indicate an overall significant difference in counseling provided by male and female physicians. The hypothesis that younger physicians are more comfortable discussing sexual practices and diseases than older physicians and are thus better able to sexually counsel Judy Green is somewhat supported. The hypothesis that gynecologists/obstetricians would most likely provide the most comprehensive interview advice in comparison to internists, general practitioners, and family practitioners is refuted by the trend observed in which ob/gyn scored the lowest on the summary scale, general/family practitioners scored the highest and internists fell in between. There was no overall support for the hypothesis that physicians in partnerships and group practices would have better counseling styles than physicians in solo practices. The fifth hypothesis that physicians of Group three would exhibit the greatest proficiency in conducting sexual interviews due to those physicians receiving the greatest amount of training for sexual counseling was not supported by the results of this study. The proposed hypothesis that physicians who received their medical education outside the U.S. provide less counseling advice than their American trained counterparts was supported by this study's findings. The results of this study support the hypothesis that physicians with accents would provide less safer sex counseling. From the research results, it is concluded that future CME programs should focus on improving sexual counseling for those physicians who have displayed the greatest lack of counseling skills: gynecologists, foreign medical graduates; and physicians with foreign accents.