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Patient choice of provider type in the emergency department: perceptions and factors relating to accommodation of requests for care providers
  1. Aasim I Padela1,
  2. Sandra M Schneider2,
  3. Hua He3,
  4. Zarina Ali4,
  5. Thomas M Richardson2
  1. 1Department of Emergency Medicine, University of Michigan, Ann Arbor, Michigan, USA
  2. 2Department of Emergency Medicine, University of Rochester Medical Center, Rochester, New York, USA
  3. 3Department of Biostatistics, University of Rochester Medical Center, Rochester, New York, USA
  4. 4Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
  1. Correspondence to Aasim I Padela, Robert Wood Johnson Foundation Clinical Scholars Program, 6312 Med Sci Bldg I, 1150 W. Medical Center Drive, Ann Arbor, MI 48109-5604, USA; aasim{at}


Background Patient satisfaction is related to the perception of care. Some patients prefer, and are more satisfied with, providers of the same gender, race or religious faith. This study examined emergency medical provider attitudes towards, as well as patient and provider characteristics that are associated with, accommodating such requests.

Methods A survey administered to a convenience sample of participants at the 2007 American College of Emergency Physicians Scientific Assembly. The nine-question survey ascertained Likert-type responses to the likelihood of accommodating patient requests for specific provider types. Statistical analyses used Wilcoxon rank-sum, Wilcoxon signed-rank and Cochran's Q tests.

Results The 176 respondents were predominately white (83%) and male (74%), with a mean age of 42 y. Nearly a third of providers felt that patients perceive better care from providers of shared demographics with racial matching perceived as more important than gender or religion (p=0.02). Female providers supported patient requests for same gender providers more so than males (p<0.01). Provider race, practice location, type and duration did not significantly affect the level of accommodation. When requesting like providers, female patients had higher accommodation scores than male patients (p<0.001), non-whites than whites (p<0.05), with Muslim patients (male or female) most likely to be accommodated (p<0.01).

Conclusion Accommodating patient requests for providers of specific demographics within the emergency department may be related to provider characteristics. When patients ask for same gender providers, female providers are more likely to accommodate such a request than male providers. Female, non-white and Muslim patients may be more likely to have their requests honoured for matched providers.

  • Patient choice
  • cultural accommodation
  • healthcare disparities
  • gender concordance
  • patient satisfaction
  • clinical assessment
  • competence
  • ethics
  • environmental medicine
  • other
  • management
  • emergency department management
  • quality assurance

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  • Funding Department of Emergency Medicine, University of Rochester Medical Center.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the University of Rochester Research Subjects Review Board.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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