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Gender Differences in Colonoscopy: Implications for Clinical Practice and Female Gastroenterologists

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An Editorial to this article was published on 10 June 2021

Abstract

Background and Aims

Performing colonoscopy can be technically challenging in female patients. Female patients may prefer having a female endoscopist. This preference, coupled with the fact that there are fewer female endoscopists, may result in gender differences in colonoscopy practice. We hypothesized that the duration of female colonoscopy is longer and that female endoscopists perform a higher proportion of female colonoscopy than male colleagues. We explored the potential revenue implications of gender differences in screening colonoscopy.

Methods

We analyzed procedure time and gender differences in 16,573 screening colonoscopies performed by 27 male and 7 female endoscopists over a three-year period in one large academic practice. We modeled the potential revenue impacts of differences in procedure duration, proportion of female colonoscopy and the frequency of detected adenomas.

Results

We found that screening colonoscopy takes 8.8% more time to complete in female patients compared to male patients for all endoscopists (p < 0.001), and that female endoscopists perform an average of 71.2% female exams compared to male endoscopists, who perform an average of 50.8% female exams (p < 0.001). Female patients had a lower detection adenoma rate (ADR), reducing the frequency of polypectomy and reimbursement in an RVU model. The observed gender differences could account for an estimated 9.6% revenue loss per 8-h session for a female gastroenterologist performing screening colonoscopy compared to a male counterpart.

Conclusion

Longer colonoscopy duration in females, increased proportion of female colonoscopies for female endoscopists and lower ADR in females may contribute to the gender gap in physician pay in gastroenterology.

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Funding

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Authors and Affiliations

  1. Division of Gastroenterology, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, USA

    Karin L. Andersson, Jasmine B. Ha, Diane R. Abraczinskas & James M. Richter

  2. Department of Medicine, Massachusetts General Hospital, Harvard Medical School, 55 Fruit Street, Boston, MA, USA

    Emily J. Campbell

Authors
  1. Karin L. Andersson
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  2. Jasmine B. Ha
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  3. Diane R. Abraczinskas
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  4. Emily J. Campbell
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  5. James M. Richter
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Contributions

All authors participated in the study planning, interpreting the data and drafting/editing the manuscript. Data analysis was performed by JH. All authors have reviewed the final draft submitted.

Corresponding author

Correspondence to Karin L. Andersson.

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An editorial commenting on this article is available at https://doi.org/10.1007/s10620-021-07083-2.

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Andersson, K.L., Ha, J.B., Abraczinskas, D.R. et al. Gender Differences in Colonoscopy: Implications for Clinical Practice and Female Gastroenterologists. Dig Dis Sci 67, 810–816 (2022). https://doi.org/10.1007/s10620-021-07079-y

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  • DOI: https://doi.org/10.1007/s10620-021-07079-y

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