Factors Related to Differential Treatment and Practice Limitations Amongst Urologists: A Report of American Urological Association 2021 Census Data

Objective: To assess rates of urologist-reported differential treatment in practice and practice limitations based on characteristics of urologists. identity. Materials and Methods: The 2021 AUA Census samples were linked with the United States (US) practicing urologist population file and assigned proper sample weighting to adjust for non-response bias. Responses to 2 questions of the Census related to (1) (negative) differential treatment experienced in practice and (2) limitations in patients/diagnoses seen in practice due to different aspects of respondent…s identity were evaluated. Responses were stratified based on self-reported gender (female vs male) and race (White vs non-White); results were compared using a chi-squared test. Results: A total of 1742 urologists, representing 13,790 practicing US urologists through post-stratified weighting, responded to the Census. Overall, amongst those who answered the relevant questions, 16.3% reported having experienced differential treatment in practice due to their identity and 6.1% reported being limited in patients/diagnoses seen in practice due to their identity. Women were more likely than men to have experienced differential treatment (75.0% vs.ß10.2%, P.ß<.ß.001) and to be limited in patients/diagnoses seen in practice (27.0% vs.ß3.7%, P.ß<.ß.001). Similarly, non-White respondents were more likely than White urologists to both have experienced differential treatment (30.4% vs.ß14.1%, P.ß<.ß.001) and to be limited in patients/diagnoses seen in practice (12.8% vs.ß5.0%, P.ß<.ß.001). Conclusion: Female and non-White urologists are more likely to experience differential treatment in their practice and limitations in the scope of their practice. Further studies are needed to characterize these experiences and explore the etiologies of these differences.