[Gnumed-devel] Gender as "required"

[James Busser]

was: modification request: display of DOB and Gender


I would like to present an argument for why gender, although it  
should be available and usually completed in the "Register new  
patient" widget", should not be "required" i.e. that it be permitted  
to be null.

I cannot imagine the front line staff asking a patient "what is your  
sex"? I would bet money that if it does not happen to be contained on  
a patient's ID presented to the front desk, the front desk staff  
simply judge it from the name and/or phenotype of the person, and  
assign a value on that basis.

Therefore, when entered, there may be no actual *authenticity* to the  
entry.

When a front desk staff would not be sure the gender of a patient,  
they are presently forced to ask the patient -- which, in crowded  
reception areas, or even privately, could be embarrassing to one or  
the other -- or to put in a guess.

When trying to obtain information from my patient from another  
agency, I have been asked the patient's name, and date of birth,  
health number or agency number, and sometimes address or phone  
information, but never their sex/gender.

Gender in the backend does not really protect against duplicate  
patient creation, because I cannot imagine you would truly have two  
patients with the same name and date of birth who would be  
legitimately differentiated by actually being of 2 different sex/ 
genders.

So the main purpose that gender would seem to serve is to assist what  
clinical decision support systems (reproductive health screening,  
cancer screening etc) that may be able to be interfaced to GNUmed  
later and, to a lesser extent, statistics.

If we made it gender not required, it can still be left, through  
social control practices, for the front desk staff to be directed to  
enter it routinely (as they do the other information like address and  
phone numbers) *except* they would omit it when they may truly be  
unsure. This would assist those instances I myself experience when  
referred a new patient with partial information --- typically with a  
foreign name, whose gender cannot be surmised --- who otherwise  
cannot be entered into the system, and cannot be scheduled, on  
account of a piece of information that the desk staff are missing.

The absence of a value for gender would be signaled easily enough by  
the absence of the automatic title/salutation (Mr/Ms) and, as well,  
if the below display suggestion is implemented that combines the  
display of DOB with Gender and Age, the null gender could be denoted  
with "?"

On 22-Jan-08, at 8:50 PM, James Busser wrote:

> This would permit us to combine the newly reclaimed 70 pixels of  
> width with the "Age" space, to provide a combination of Age +  
> Gender + DOB, pushing Caveat slightly to the right if needed, to  
> yield:
>
>         YYYY-MM-DD Gender YYageMMage
>         e.g. 1958-05-14 M 59y8m
> I would abbreviate Gender in this display to the first character  
> (in many cases, regardless of language, this will be M or F, or  
> rarely T).