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Positive Patient-Provider Communication Elusive for Half of Women

Women were more likely than men to report poor patient-provider communication, adding to the barriers they face to healthcare access.

Sara Heath
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Published: 27 Feb 2023

Nearly half of young women have had a negative provider experience in the past two years, exposing serious lapses in patient-provider communication for this population, according to figures from the Kaiser Family Foundation.

Forty-six percent of the women ages 18 to 35 told the researchers they felt as though their providers were dismissive of their concerns, made assumptions about them, thought they were lying, blamed them for their health problems, or discriminated against them based on age, gender, race, sexual orientation, religion, or other personal characteristics.

Women’s healthcare, particularly healthcare for women of reproductive age, has been in the national spotlight since the Supreme Court overturned Roe v. Wade. This latest data adds to that conversation by illuminating the negative patient-provider relationships some young women report.

The number of young women reporting a poor provider interaction was similar across different demographics, with 45 percent of those in low-income households, 46 percent of those without insurance, and 45 percent of those with a disability or ongoing health condition saying they have experienced at least one of the above-mentioned negative interactions.

Things aren’t great for women who are moving out of reproductive age. Only a third of women ages 40 to 64 said their healthcare provider discussed what they can expect during menopause.

That figure rises to 42 percent when looking at women who have already gone through menopause and 39 percent when looking at those in the midst of menopause. However, only 19 percent of pre-menopausal women have discussed what they can expect with their providers.

Women under age 65 report poor provider interactions

The most common communication complaint from women ages 18 to 64 was that their clinicians were dismissive, with 29 percent saying so. One in five said their providers made assumptions about them, while 15 percent said their providers thought they were lying, and 13 percent said clinicians indicated blame for the patient’s medical problems.

There were some gender-based disparities, the researchers added. While 38 percent of women ages 18 to 64 said they experienced any kind of negative provider interaction, only 32 percent of men said the same. However, the most common types of negative interactions were the same across genders; men were also most likely to say their provider dismissed their concerns, just at a lower rate than their female peers.

Patient-provider communication falls flat

It’s not just respect in the exam room that’s missing. The researchers found that providers aren’t explaining medical concepts clearly for women. Around a fifth of women said patient-provider communication is substandard and that it’s hard to find a clinician who explains medical concepts in a way that they can understand.

That’s a big pitfall, considering the role patient health literacy and education play in patient activation and care management.

Meanwhile, patients said providers are neglecting conversations about the social determinants of health. More than half (58 percent) of women ages 18 to 64 said their providers are asking about their work, but only one in five are being asked about food security and access to transportation. Thirty percent said they have been asked about housing security.

The researchers did find that conversations about social determinants of health were more common among low-income women and women with Medicaid, two populations that may experience a higher SDOH burden. Even still, screening for and discussion of social determinants of health is critical for value-based and whole-person healthcare, the researchers indicated.

“Efforts to improve provider communication and interactions and address discrimination could improve women’s experiences with the health care system, alleviate some of the barriers many women still experience when they seek care, and reduce health disparities,” the researchers concluded.

These findings come as women of reproductive age face serious changes in reproductive healthcare policy and access. The Supreme Court’s overturning of Roe v. Wade has prompted changes in reproductive care access, leaving people of reproductive age with more limited options for getting birth control and other forms reproductive healthcare.

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