Sex and gender influence medical decision making, yet little is known about how the sex of a consultant shapes the prescribing behaviour of female primary care physicians (PCPs). This study examined whether consultant sex affects female PCPs’ likelihood of following recommendations that conflict with clinical guidelines and explored the factors underlying trust in consultants. We conducted a web-based experimental study using case vignettes on sleeping medication and antibiotics. A total of 482 female PCPs in England were randomly assigned to conditions with no recommendation or with recommendations from male or female consultants. The outcomes included prescribing decisions, confidence, perceived difficulty, and effort. In the absence of recommendations, female PCPs rarely prescribe non-guideline medications, reflecting cautious baseline behaviour. Consultant recommendations increased prescribing across both vignettes, with higher rates in both consultant conditions than in the control condition (sleeping medication: 43.3% male vs. 33.6% female vs. 30.4% control, χ2(2, N = 482) = 6.61, p = 0.037; antibiotics: 14.9% male vs. 14.5% female vs. 5.3% control, χ2(2, N = 482) = 9.55, p = 0.008). Regression analyses confirmed that both male and female consultant recommendations significantly increased the odds of prescribing antibiotics compared with the control condition (male: OR = 3.33, 95% CI 1.43–7.76; female: OR = 3.29, 95% CI 1.39–7.79). Only the male consultant’s recommendation significantly increased the prescribing of sleeping medication (OR = 1.89, 95% CI 1.13–3.15), whereas the female consultant’s recommendation had no significant effect (OR = 1.22, 95% CI 0.71–2.10). However, direct comparisons between male and female consultants were not statistically significant. Across conditions, participants generally reported high confidence in their decisions and perceived low difficulty and effort. Consultant recommendations in the antibiotic vignette were associated with lower confidence and higher perceived difficulty and effort. Consultant recommendations, independent from consultant’s sex, increased the likelihood of non-guideline prescribing among female PCPs. The absence of statistically significant differences between male and female consultants suggests that the presence of a recommendation itself may be more influential than consultant sex. Strengthening physicians’ confidence and supporting guideline-based decision-making may help reduce susceptibility to social influence.
Stoffel et al. (Tue,) studied this question.