Gender bias or patient preference for female practitioners in Obs/Gyn care.

We read the recent systematic review by Nguyen et al.1 published in your esteemed journal where they discussed the role of men in Obs/Gyn care. They argued that the decline of male doctors specialising in Obs/Gyn care is likely be due to gender bias and called for the attention of medical educators to create a genderinclusive working and training environment as a means of enhancing diversity in Obs/Gyn. It is not surprising that most of the studies that the authors included in their review indicated that women are more comfortable being seen and examined by women rather than men, be it specialists or medical students. Such a preference is manifested globally and not confined to a single ethnic or religious group as the authors found. Given the strong gender preference for women in Obs/Gyn settings, particularly when internal examinations are involved, I wonder if the call for medical educators to socially engineer to work against the wellmanifested women's preference is a healthy recommendation. I would like the authors to reconsider their recommendations in view of the modern evidencebased framework which value the patient's preference to be a key component in modern healthcare provision. Evidencebased medicine (EBM) is built upon three major pillars, namely best evidence, clinical expertise and patient's preference. Ever since David Sackett2 introduced the idea of EBM, the evidencebased community has been promoting the role of patient's preference in clinical practice. As articulated by Montori et al.,3 the patient preference includes patient perspectives, beliefs, expectations, goals for health and life and the processes that individuals use in considering the potential benefits, harms, costs and inconveniences of the management options.4 As such, in the context of Obs/Gyn care, we should consider gender preference for female doctors as a component that promotes better patient satisfaction and not as gender bias that somehow needs to be rectified.