Stratification in professional careers arises in part from interpersonal dynamics in client-expert dyads. To reduce perceived uncertainty in judgments of the quality of experts, clients may rely on ascriptive characteristics of experts and on pairwise, relational factors to assess the advice they receive. Two such characteristics, expert gender and client-expert gender concordance, may lead to differences in clients’ trust in expert advice. To explore these issues, we investigate the incidence of patient-initiated second opinions (SOs) in medicine. In an examination of millions of medical claims in Massachusetts, we find that male patients are much more likely than female patients to obtain an SO if the first specialist they consult is female. Moreover, when the first specialist a patient consults is gender non-concordant and the patient seeks an SO, male patients are substantially more likely to switch to a same-gender specialist in the SO visit. Because patients who lack confidence in the advice of the first-seen specialist infrequently return to this specialist for medical services, female specialists generate lower billings. Analyses of medical spending in follow-up visits suggest that gendered patterns in questioning the advice of medical experts have the potential to contribute substantially to the gender pay gap in medicine.

职业生涯中的分层部分源于客户-专家二人组的人际动态。为了减少对专家质量判断的感知不确定性，客户可能会依赖专家的归属特征和成对的相关因素来评估他们收到的建议。两个这样的特征，专家性别和客户-专家性别一致性，可能会导致客户对专家建议的信任程度不同。为了探讨这些问题，我们调查了医学中患者发起的第二意见 (SO) 的发生率。在对马萨诸塞州数百万医疗索赔的检查中，我们发现如果男性患者咨询的第一位专家是女性，那么男性患者比女性患者更有可能获得 SO。而且，当患者咨询的第一个专家性别不一致并且患者寻求 SO 时，男性患者在 SO 就诊中更有可能转为同性别专家。由于对首次就诊专家的建议缺乏信心的患者很少返回该专家处接受医疗服务，因此女性专家产生的费用较低。对随访中医疗支出的分析表明，质疑医学专家建议的性别模式有可能对医学领域的性别薪酬差距产生重大影响。女性专家的收入较低。对随访中医疗支出的分析表明，质疑医学专家建议的性别模式有可能对医学领域的性别薪酬差距产生重大影响。女性专家的收入较低。对随访中医疗支出的分析表明，质疑医学专家建议的性别模式有可能对医学领域的性别薪酬差距产生重大影响。