The impact of physician-patient gender match on healthcare quality: An experiment in China

Despite growing evidence of gender disparities in healthcare utilization and health outcomes, there is a lack of understanding of what may drive such differences. We present novel evidence on the impact of physician-patient gender match on healthcare quality using the standardized patients (SPs) method in an experiment. The experiment collected 492 interactions between 18 standardized patients and 169 physicians in 63 community health centers in China's primary care setting, during August 17–28, 2017 and July 30–August 10, 2018. We find that, compared with female physicians treating female SPs, female physicians treating male SPs resulted in a 23.4 percentage-point increase in correct diagnosis and a 19.0 percentage-point increase in correct drug prescriptions. Despite these substantial gains in healthcare quality, there was no significant increase in medical costs or time investment. The gains in healthcare quality were partly attributed to better physician-patient communications, but not the presence of more clinical information. More importantly, female physicians treating male SPs prescribed more unnecessary tests but fewer unnecessary drugs to balance their time commitment and costs. The results suggest the potential role of cultural gender norms and physician defensive behavior when female physicians treat male SPs. Our findings imply that improving patient centeredness may lead to significant gains in the quality of healthcare with modest costs, while reducing gender differences in care quality.