Patients' preferences in the provision of health care are an important consideration. Although several studies have investigated patients' preferences for male or female general practitioners, [1][2][3] few studies have considered preference for male or female surgeons, and preference of women for male or female breast surgeons has not been reported. Until recently the small numbers of female consultant surgeons in Britain meant that patients did not have a choice of male or female surgeon. This will change, however, with increasing numbers of female consultants and may have implications for the staffing of specialist breast units. Subjects, methods, and resultsIn September 1997 a female consultant surgeon became available at Victoria Infirmary's specialist breast clinic, which had previously been run by a male consultant. From October 1997, 100 consecutive newly referred patients were identified by clinic receptionists on arrival and asked to fill in an anonymous questionnaire. Patients were asked their age and ethnic origin. The questionnaire then gave three options for consultant surgeon-male, female, or no preference-and the patients were asked to state the reason for their preference. Ninety eight completed questionnaires were obtained; two patients declined to complete the questionnaire.Sixty seven patients (95% confidence interval 58 to 75) had no preference for a male or female consultant and 31 (23 to 41) preferred a female consultant. No patient preferred a male consultant. Patients who preferred a female surgeon were younger (median age 35 (range 16-56) years versus 42 (18-83) years for women with no preference; P = 0.005, independent t test). Seven (23%) women who preferred female surgeons gave their ethnic origin as Asian compared with one (1%) woman with no specific preference (P = 0.003, Fisher's exact test).Women who stated a preference for a female surgeon made comments such as "women are easier to talk to" and "I feel less embarrassed with a woman." Patients who had no preference in general felt that a surgeon's sex did not affect competence and that the most important issue was to have a good surgeon irrespective of sex.

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Norwalk-like virus contamination of oysters and orange juice, and hepatitis A virus contamination of oysters have been responsible for large outbreaks of foodborne viral disease in Australia. Rotavirus, adenovirus, astrovirus, parvovirus and other enteroviruses also contribute to the incidence of gastroenteritis in this country but the role of foods and waters in transmitting these viruses is unclear. Protocols for the investigation, surveillance and reporting of foodborne viral illness require further development to enable a more accurate description of the problem. Few laboratories have the capability to analyse foods for viruses and specific training in this technology is needed. Management of food safety in Australia largely relies on the implementation of HACCP principles, but these need to be adapted to address the specific risks from viruses.