HEALTH SERVICES RESEARCH

Does physician bias affect the quality of care they deliver? Evidence in the care of sexually transmitted infections

A Khan¹, D Plummer², R Hussain³ and V Minichiello³

¹ Social Research Centre, University of Queensland, Qld 4072, Australia
² School of Education, University of the West Indies, Port of Spain, Trinidad
³ School of Health, University of New England, NSW 2351, Australia

Correspondence to:
Dr A Khan, Social Research Centre, The University of Queensland, St Lucia, Qld 4072, Australia; a.khan2{at}uq.edu.au

Background: Primary care providers are well placed to control the spread of sexually transmitted infections (STI); however, care is likely to be influenced by their attitudes and beliefs. The present study investigates the relationship between general practitioner’s (GP) self-reported level of comfort in dealing with patients with STI and the care they deliver.

Methods: A postal survey was conducted using a stratified random sample of 15% of GPs practising in New South Wales, Australia, to assess practitioners’ management of STI. A total of 409 GPs participated in the study yielding a response rate of 45.4%.

Results: Although over two-thirds (69–72%) of GPs were comfortable in managing STI in heterosexual or young patients, fewer than half (40–46%) felt comfortable caring for patients who were sex workers, indigenous, people who inject drugs, gay or lesbian. Practitioners who were comfortable were more likely to offer sexual risk assessment, safe-sex counselling, and were less likely to report limited ability to influence patients’ risk behaviours. Practitioner discomfort was positively associated with reporting constraints in sexual history-taking and the need for training in sexual health.

Conclusions: Practitioners’ care and support for patients with STI are influenced by their inexperience, lack of skills and/or attitudes. The reasons for GP discomfort in managing STI patients need further exploration as does its impact on patient care.

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This article has been cited by other articles:

• Zablotska, I B, Imrie, J, Bourne, C, Grulich, A E, Frankland, A, Prestage, G (2008). Improvements in sexual health testing among gay men in Sydney, Australia, 2003-2007. Int J STD AIDS 19: 758-760 [Abstract] [Full Text]  
• Khan, A., Plummer, D., Hussain, R., Minichiello, V. (2008). Preventing sexually transmissible infections in Australian general practice. Int J STD AIDS 19: 459-463 [Abstract] [Full Text]