How COVID-19 shifted ophthalmologist-patient communication

(Image Credit: AdobeStock/Jacob Lund)

Jasmine S. Brown and colleagues found that there are gender differences in ophthalmologist communication patterns, and the COVID-19 pandemic impacted these differences. Female physicians sent longer response communications to patients and more responses per patient compared with male physicians.¹

Brown, first author of the report, is affiliated with the Perelman School of Medicine at the University of Pennsylvania, and the Scheie Eye Institute, University of Pennsylvania, both in Philadelphia.

Effective patient-centered communication^2,3 is critical for ophthalmic patients because it can convey the importance of the treatment plan and enhance adherence.^4,5 Gender differences in communication have increasing relevance in ophthalmology given the rising representation of women within the specialty over the past 50 years (from 4% in 1969 to 27% in 2019), according⁶ to the authors, who published their results in the American Journal of Ophthalmology.

In their retrospective cohort study, the researchers studied gender differences in virtual ophthalmologist communication patterns before and after the COVID-19 pandemic to determine response time and response length among ophthalmologists and to establish if factors related to COVID-19 impacted these ophthalmologists’ communication patterns.

The researchers collected messages sent by ophthalmic patients at Penn Medicine over a 5-year period. The researchers evaluated the differences in the number of physician messages sent for a given patient and the median response length and response time to patient inquiries and messages based on year and physician gender.

Results of message analysis

“Female ophthalmologists sent longer response messages to their patients (median [25^th, 75^th percentiles] response length for women vs. men; 672 [492-965] characters vs. 637 [460, 918] characters; P < 0.0001) and a higher number of response messages per patient compared to their male counterparts (mean [SD] for women vs. men; 5.5 [2.9] vs. 3.0 [1.5]; P = 0.04),” Brown and colleagues reported.

Regarding the peri- and post-COVID-19 periods, the result showed a greater gender difference, in that the male ophthalmologists sent a higher percentage of same-day responses from 2017 to 2020 (P < 0.0001), while the female ophthalmologists sent a higher percentage of same-day responses from 2021 to 2022 (P < 0.0001). The largest gender difference in same-day responses was seen in 2020 (34% for men vs. 30% for women; (P < 0.0001).

In commenting on their findings, the authors said, “Overall, this study suggested that female ophthalmologists had more patient-physician dialogue on an online healthcare portal by sending longer messages to their patients and sending more messages per patient. These communication trends suggest that female ophthalmologists may have utilized a more patient-centered, interactive communication pattern, which may contribute to improved health outcomes. In 2020, male ophthalmologists sent more same-day responses compared to female ophthalmologists, the largest gender difference in same-day responses across the study period. This highlights potential gender disparities within ophthalmology that was amplified during the COVID-19 pandemic. Our study illustrates the importance of gender diversity within ophthalmology. With the anticipated use of artificial intelligence-based telehealth communications, it is vital that the algorithms are based on a diverse physician population to prevent the loss of nuanced gender-influenced communication patterns present among ophthalmologists and other physicians.”

They advised that future studies may help determine the potential association between these communication patterns, eye health outcomes, and physician burnout.

References

1. Brown JS, Mumford S, Alexis DA, Ross AG, Higginbotham EJ. Gender differences in patient-physician communication in ophthalmic practice, pre- and post-Covid 19. Am J Ophthalmol.2025;S0002-9394(25)00133-3. doi: 10.1016/j.ajo.2025.03.020

2. Stewart MA. Effective physician-patient communication and health outcomes: A review. CMAJ. 1995;152:1423–1433. http://www.cmaj.ca/cgi/content/abstract/152/9/1423.

3. Milkman KL, Akinola M, Chugh D. Temporal distance and discrimination: An audit study in academia. Psychol Sci. 2012;23:710–717. https://www.jstor.org/stable/23262484. 10.1177/0956797611434539.

4. Moore SG, Richter G, Modjtahedi BS. Factors affecting glaucoma medication adherence and interventions to improve adherence: A narrative review. Ophthalmol Ther. 2023;12:2863–2880. https://link.springer.com/article/10.1007/s40123-023-00797-8. 10.1007/s40123-023-00797-8.

5. Morse AR. Improving medication adherence to reduce vision loss in patients with glaucoma: Low hanging fruit? Ophthalmology.;122:1280–1282. https://www.clinicalkey.es/playcontent/1-s2.0-S0161642015003978. 10.1016/j.ophtha.2015.04.019.

6. Gill HK, Niederer RL, Shriver EM, et al. An eye on gender equality: A review of the evolving role and representation of women in ophthalmology. Am J Ophthalmol. 2022;236:232–240. https://dx.doi.org/10.1016/j.ajo.2021.07.006. 10.1016/j.ajo.2021.07.006.