Do female patients see their physicians differently? A population-based study evaluating perception of physician communication by patients with hidradenitis suppurativa

Hidradenitis suppurativa (HS) is a chronic, inflammatory skin condition that causes painful abscesses, nodules, fistulae, and fibrotic scars. Management of HS requires strong physician-patient communication; however, it is not known if male and female HS patients perceive physician communication differently. This study aimed to determine if patient-perceived quality of physician communication differs between male and female HS patients. This was a population-based, cross-sectional study using the Medical Expenditure Panel Survey from 2002 to 2015 and 2018. Linear univariate and multivariate regression analyses were used to compare male and female patients' perceptions regarding how well physicians (1) demonstrated respect (2) listened to patients, (3) explained information, and (4) spent sufficient time with patients. A total of 91,619 (weighted) HS patients aged 21-85 were included: 25,175 males (27.18%) and 66442 females (72.52%). On multivariate linear regression, compared to male patients, female patients perceived that clinicians were significantly worse at demonstrating respect (beta = -0.231, 95% confidence interval [CI] = -0.351 to -0.111, p = 0.003), listening (beta = -0.286, 95% CI = -0.391 to -0.181, p = 0.001), and explaining concepts (beta = -0.133, 95% CI = -0.267 to -0.000, p = 0.050). Findings were adjusted for age, race, ethnicity, income, insurance, education, and medical comorbidities. Female and male patients did not differ significantly in perceptions of time spent with clinicians (beta = -0.149, 95% CI = -0.362 to 0.064, p = 0.138). On subgroup analysis, both male and female patients perceived female physicians to better spend time with them compared male physicians (3.71 vs 3.32, p = 0.023). In conclusion, male patients with HS perceived better physician communication in regard to physician respect, listening, and explanations. Thoughtful physician communication is crucial in managing HS and may be especially important when treating female patients.