Gender Concordance and Patient Outcomes in Indian Telemedicine: Retrospective Cross-Sectional Quantitative Study of 286,000 Consultations.

Background: Gender concordance (GC) between patients and physicians has been linked to trust and satisfaction in traditional health care. However, its role in telemedicine, especially in culturally complex settings like India, is underexplored. In India's culturally diverse and gender-sensitive context, understanding GC becomes particularly relevant for specialties such as gynecology, dermatology, psychiatry, and urology, where discussions often involve intimate or stigmatized concerns. Despite rapid telemedicine expansion, little empirical evidence exists on whether GC affects patient-reported outcomes in this context. Objective: This study examined whether GC significantly influences patient satisfaction and self-reported recovery in teleconsultations across India, with a focus on specialty-specific effects in culturally sensitive specialties. Methods: We conducted a retrospective cross-sectional analysis of 286,196 anonymized teleconsultation records from a national telemedicine platform (January 2023-December 2024) spanning across 20 medical specialties using binary logistic regression. Records missing gender or satisfaction data were excluded from the analysis; recovery analyses included only consultations with completed day-21 follow-up surveys (n=1170, 0.4%). Outcomes included patient satisfaction (ratings 4-5 on a five-point scale) and self-reported recovery at follow-up. Logistic regression models (Stata 17.0) tested associations between GC and outcomes, controlling for consultation time, duration, and physician experience. Subgroup analyses were conducted for the top 5 specialties. Each record included key data on consultation duration, timing, physician experience, specialty type, patient satisfaction rating, and self-reported recovery status. The study excluded the pediatrics specialty from the analysis to control for the parental bias. Results: Of the 286,196 consultations, 164,008 (60.4%) were gender-concordant. Overall, 261,213 of 286,196 (91.3%) patients reported good satisfaction. GC had a statistically significant negative association with patient satisfaction (odds ratio [OR] 0.87, 95% CI 0.85-0.90; P<.001). Across gender, the male doctor received higher satisfaction. In gynecology, female patient-female doctor pairs had significantly higher odds of reporting recovery (OR 4.53, 95% CI 0.8-25.3; P=.099). Overall, consultation timing (OR 0.99, 95% CI 0.998-0.999; P<.001) and patient satisfaction (OR 20.13, 95% CI 12.06-35.38; P<.001) were stronger predictors of self-reported recovery than GC. Conclusions: GC in telemedicine has a context-dependent impact. While it does not independently predict clinical recovery, it meaningfully shapes patient satisfaction. These findings highlight that gender sensitivity training and context-specific communication approaches may enhance telemedicine experiences in culturally sensitive domains. Integrating awareness of gender dynamics into telehealth design and policy could strengthen patient trust and engagement in virtual care. Future research should explore specialty-specific dynamics and improve follow-up response rates to better assess clinical outcomes.