Recently, educator and writer, Annalise Mabe published a disquisition on sexism in the medical community after experiencing it first hand during an appointment with her male OB-GYN.
“We don’t always have time to take off work again, or the luxury to walk out of the doctor’s office and find someone else — some other doctor in our network, under our insurance plan, in that same month that we may need answers to urgent medical queries concerning our bodies,” Mabe wrote. “We don’t have the luxury of walking out because what we want (our test results, answers to our questions, a prescription) is held above our heads, and we have to play nice in order to get it. It becomes survivalist in a way: If I can get through this, if I just don’t say anything, perhaps I will get the answers I need and can go on about my day. “
While Mabe primarily set out to address patient/doctor dynamics, many of her talking points are seconded by broader cross-sectional analysis.
A new study authored by a team of researchers from Harvard University, for instance, concluded that patients treated by female doctors expressed lower rates of death and readmission to the hospital compared to patients who were treated by male doctors at the same facilities.
To shape their findings, the researchers recruited a random sample of Medicare fee-for-service beneficiaries hospitalized with a condition and treated by general internists. All of the respondents involved were 65 years of age or older and examined between January 1, 2011, and Dec. 31, 2014.
Outcomes were subsequently adjusted for patient and physician characteristics and hospital settings to exclude factors not related to gender.
The new paper doesn’t offer any causal explanations with respect to the lower mortality and hospitalization rates associated with patients treated by female doctors though follow-up analysis yielded a strong correlative relationship.
According to the authors, female doctors save roughly 32,000 more lives per year than their male counterparts.
“Studies have found differences in practice patterns between male and female physicians, with female physicians more likely to adhere to clinical guidelines and evidence-based practice. However, whether patient outcomes differ between male and female physicians is largely unknown,” the authors explained of their objective. “Elderly hospitalized patients treated by female internists have lower mortality and readmissions compared with those cared for by male internists. These findings suggest that the differences in practice patterns between male and female physicians, as suggested in previous studies, may have important clinical implications for patient outcomes. We found that additional adjustment for length of stay, use of care, discharge location, patient volume, or physicians’ years of practice did not affect our findings.”
Hospital mortality and readmission rates for patients treated by male doctors compared to female doctors
Previously conducted research indicates that women tend to perform better on standardized tests (especially in math) in addition to displaying more sustained performance when being assessed academically. This may help to explain why polls consistently identity female doctors as the more trusted among patient samples.
On this front, the University of Toulouse recently determined that patients tend to take prognosis more seriously when it comes from female general practice doctors.
Many of the accounts cited in Mabe’s essay confirmed as much, with patients voicing variations of: Female practitioners make me feel more at ease.
The Harvard researchers behind the latest report more discreetly honed in on the association between physician sex and 30-day mortality and readmission rates.
Because the study only employed hospital care physicians, it could safely be assumed that all of the practitioners received patients based on their specific work schedules as opposed to some other superficial metric.
Even when the authors controlled for hospital fixed effects and underlying severity of illness, female physicians were linked with lower patient mortality and readmission rates across all of the medical conditions featured in the new report.
“The final sample for the analyses of 30-day mortality rates included 1 583 028 hospitalizations treated by 57 896 physicians. Overall 30-day mortality for the entire sample was 179 162. Patients cared for by female physicians had lower 30-day mortality than did patients treated by male physicians after accounting for patient characteristics. The difference in mortality persisted after adjustment for hospital fixed effects. Further adjusting for physician characteristics had a limited effect on these results,” the authors conclude.
“Our findings that female internists appear to have better outcomes for inpatient care than their male peers are consistent with results from prior studies of process measures of quality. There is evidence in the primary care setting suggesting that, compared with male physicians, female physicians are more likely to practice evidence-based medicine, perform as well or better on standardized examinations, and provide more patient-centered care. Patients of female primary care physicians also experience fewer emergency department visits compared with patients of male primary care physicians. Data from other industries suggest that men may be less deliberate in their approach to solving complex problems. If these findings also apply to how male and female physicians approach clinical problems and decisions, these patterns of behavior may provide a plausible mechanism linking physician sex with patient outcomes.”
The new study was approved by the Harvard Medical School Institutional Review Board.