Essec Business School

Governments worldwide are increasingly incorporating policies that create or enhance consumer choice in the health care market. One such policy is the freedom to choose one’s general practitioner (GP). In a recent study, Karine Lamiraud, Professor of Economics and chaired professor of the ESSEC Innovation & Health Chair, investigated the extent to which patients in France prefer consulting a GP with the same gender. She finds that patients are significantly more likely to choose a gender-concordant GP - and outlines potential implications of this when it comes to healthcare access. 

Why is GP choice so important?

The determinants of GP choice are a key topic in health economics. One strand of the literature has examined patient preferences regarding physician gender when selecting a GP. However, despite growing interest in this issue, the empirical evidence on gender concordance in GP choice remains relatively limited (Kerssens et al., 1997; Godager, 2012; Cabral and Dillender, 2024; Walker et al., 2024; Pruckner et al., 2025).  Surveys on patients’ choice of GP highlighted that respondents found it easier to talk to a gender-concordant GP, and felt more at ease during intimate physical examinations with them (Kerssens et al., 1997). Elsewhere, women reported that gender-concordant GPs “would be more likely to treat them with respect, understand their concerns, believe them, provide needed testing and treatments, make them feel comfortable, and ask appropriate questions instead of making assumptions” (Cabral and Dillender, 2024). These findings highlight the key role of gender concordance when selecting a GP. This topic is of major importance because patients who cannot consult a GP of their preferred gender are more likely to forgo consultation, increasing their risk of medical issues down the line if they don’t receive care in due time.

How can we better understand patients’ healthcare choices?

The study by Professor Lamiraud and her colleagues used health insurance claims data for a representative sample of 83,123 enrollees covered by MGEN, a nonprofit health care insurer that processes National Health Insurance claims for professionals in the education, culture, research, and sports sectors throughout France. This allowed the researchers to study GP choice and its implications in a real-world context, rather than via self-reported survey data. Although the GP workforce in France has become increasingly feminized—with women accounting for 47.6% of GPs in 2019[1]—the proportion of female GPs varied substantially across departments, ranging from 33% to 57% at the time of the study.

The results show that, after controlling for the density of male and female GPs and all other factors:

• Female patients were significantly more likely than their male counterparts to choose a female GP. The probability of consulting a female GP was, on average, 7.5 percentage points higher for female patients than for male patients.
• The research team also found that older patients were significantly less likely to consult a female GP than a male GP.
• Patients coming from higher socioeconomic categories were significantly more likely to consult a female GP than those with a lower socioeconomic level.
• Furthermore, people living in rural areas were significantly less likely to consult a female GP.
• There is also some evidence that those with chronic conditions were significantly less likely to consult a female GP.

Taken together, this shows that the availability of a GP of the same gender can impact patients’ medical choices. With patients able to choose their physician in countries like France, governments should be aware of how medical staffing can impact population health in unintended ways.

What do these results tell us about medical deserts?

This study estimated, for the first time, the impact of patient gender-concordant GP preferences on policies aimed at addressing doctor shortages in the so-called “medical deserts” or underserved areas—i.e., geographic areas where healthcare needs are partially or fully unmet due to insufficient medical supply. These policies typically seek to increase medical density by inserting additional GPs. Although these policies are a key feature of public health in many low-, middle-, and high-income countries (Dolea et al., 2009; Swami and Scott, 2021), they do not consider GP availability in terms of gender. Government authorities focus on how they can attract GPs to areas, without considering the preferences of the local population.  The results show that introducing male  GPs into areas with low female  GP densities has a smaller impact than introducing female GPs into these areas, and vice versa.

How can we reduce geographical and gender inequities in access to medical care?

• Current policies could be made more effective by considering the gender of the GPs assigned to underserved areas.This could be achieved by introducing incentives for GPs to locate or relocate to underserved areas that differ by gender.
• Medical schools or certifying bodies could also tackle this issue by implementing training programs designed to reduce gender bias in medical care.
• Another solution would be to educate patients to accept consultations with non–gender-concordant GPs.

Countries all over the world are facing the challenge of medical deserts and how best to serve their rural populations. In this study, Dr. Lamiraud and her colleagues use the example of France to find that one underexplored challenge is that of gender concordance between the patient and their chosen GP, and identifies this as a major factor influencing patient care.

References

Cabral, M., Dillender, M. (2024). Gender Differences in Medical Evaluations: Evidence from Randomly Assigned Doctors. American Economic Review, 114 (2), 462–99.

Dolea, C., Stormont, L., and McManus, J. (2009). Increasing access to health workers in remote and rural areas through improved retention. Geneva: World Health Organization.

Godager, G. (2012). Birds of a feather flock together: A study of doctor–patient matching. Journal of Health Economics, 31(1), 296–305.

Kerssens, J. J., Bensing, J. M., and Andela, M. G. (1997). Patient preference for genders of health professionals. Social Science & Medicine, 44(10), 1531–1540.

Lamiraud K,  Le Guern M, Rockinger M, Sevilla-Dedieu C (2026). Preference for gender concordant GP and medical deserts. Review of Economics of the Household.https://doi.org/10.1007/s11150-026-09852-2

Pruckner, G.J, Stiftinger, F., Zocher, K. (2025). When women take over: Physician gender and health care provision. Journal of Health Economics, 102, 103 000.

Swami, M. and Scott, A. (2021). Impact of rural workforce incentives on access to gp services in underserved areas: Evidence from a natural experiment. Social Science & Medicine, 281, 114045.

Walker, B., Wisniewski, J., Tinkler, S., Torres, J., Sharma, R. (2024). Identity and access: Gender-based preferences and physician availability in primary care. Journal of Economic Behavior and Organization, 224, 1022–1036.

Footnote

[1] Recent statistics suggest that the share of female GP has increased to 52,4% in 2025 (DREES, 2025). However, geographic disparities persist.