Work

The associations of consultant sex on herding‑like prescribing behaviour: evidence from a web-based experiment with female primary care physicians in England

Year: 2026

Type: article

Abstract: BACKGROUND: 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. METHODS: 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. RESULTS: (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. CONCLUSIONS: 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.

Source: BMC Medicine

DOI: 10.1186/s12916-026-04716-z

Authors: Sandro Tiziano Stoffel, Matthias Schwenkglenks, Berna Cennet Özdemir

Institutions: University of Basel, University College London, University of Bern, University Hospital of Bern

Language: English

Topic: Clinical Reasoning and Diagnostic Skills

Subfield: Family Practice

Field: Medicine

Domain: Health Sciences

SDGs: Good health and well-being, Gender equality

Open Access status: gold

Estimated APC paid: $4,190