Impact of Physicians' Sex on Treatment Choices for Low Back Pain

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Little information is available regarding physicians' sex as a potential bias in making pain treatment decisions. This study investigated how sex of the medical care provider and patient characteristics influence choices that are made in the treatment of low back pain.


Data of 186 charts of patients with low back pain (46% males) who were seen by trained residents were analyzed in this retrospective observational study. The primary outcome was the first treatment choice that was made, which was categorized in three groups: pharmacological therapy; invasive procedures; or other options at the time of first consultation. Chi-square statistics and multinominal logistic regression analysis were used to examine associations between physicians' and/or patients' sex and treatment choices.


Physicians' sex was found to be a significant predictor of the first decision that was made in the treatment of low back pain. Female physicians tended to prescribe more pharmacological agents as their first treatment choice. No significant sex differences were found for invasive therapies or other treatment options as a first choice. These findings were found to be independent from previous received pain therapies before consultation by the specialized pain clinician. Further, patients' sex did not influence decisions on pain management nor did gender concordance or discordance in the patient–physician relationship.


Physicians' sex had a significant impact on pain management decisions in patients with low back pain. Female physicians prescribed more pharmacological agents as their first choice compared to male physicians.

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