Date of Award


Degree Name

Doctor of Philosophy




Heart disease is the number one killer among women in the United States. This dissertation examines how the knowledge base of rural physicians affects his/her approach to diagnosing female heart disease. It compares the knowledge base of doctors trained in osteopathic medicine with doctors trained in allopathic medicine to determine if knowledge base affects how women are diagnosed in comparison with men. Current data suggests that a male model of recognized heart symptoms is most often used to diagnose heart disease, that women and men experience different cardiac symptoms, and those physicians more often overlook and/or misdiagnose women presenting with heart disease. Because osteopathic medical education favors a holistic approach, it is hypothesized that osteopathic doctors would consider a broader range of complaints as having a cardiac component and that osteopathic physicians female physicians have historically taken a holistic approach, it is hypothesized that female physicians would diagnose heart disease in women patients at higher rates than male physicians. The study surveys 700 rural Michigan physicians, and uses a case history medical vignette to describe women's heart symptoms. Using cross tabulation and chi-square, statistically significant relationships were found between osteopathic and allopathic physicians, and between male and female physicians, for how physicians diagnose and treat female and male patients with heart symptoms. These findings have far-reaching policy implications for women's coronary heart disease outcomes.

Access Setting

Dissertation-Open Access