Female doctors edge males with better patient outcomes; simmer down gentleman, and perhaps learn, then do something

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New research estimates that if all physicians were female, 32,000 fewer Americans would die every year (among Medicare patients alone).

Research finds that if all #physicians were female, 32,000 fewer Americans would die each year Click To Tweet

But salaries for female physicians average some $20,000–eight percent–lower than male physicians. At academic hospitals, male physicians receive more research funding and are more than twice as likely as female physicians to rise to the rank of full professor.

These disparities have historically been attributed to the effects of disproportionate domestic responsibilities–including maternity leave and subsequent part-time schedules, according to The Atlantic.

As physicians Rita Redberg and Anna Parks note, this can be perceived to:

“undermine the quality of female physicians’ work and explain male physicians’ higher salaries.”

But to the contrary, female physicians actually tend to provide higher-quality medical care than males, according to research just released. If male physicians were as adept as females, some 32,000 fewer Americans would die every year–among just Medicare patients alone.

The research is published online December 19, 2016 in the journal JAMA Internal Medicine. Researchers from Harvard University reviewed the records of 1,583,028 hospital visits among Medicare patients who were hospitalized between 2011 and 2014, for illnesses such as heart disease, pneumonia and kidney failure. Within 30 days of arriving at the hospital, rates of death and re-admission were significantly lower when the patient’s doctor was female.

To explain the discrepancy, the researchers point to past studies that have shown female physicians are more likely to provide preventive care and psychosocial counseling. Female doctors are also more likely to adhere to clinical guidelines. Though as Drs. Redberg and Parks note in an accompanying editorial to the JAMA research, adherence to clinical guidelines “does not always equate with quality or value of care.”

Instead Drs. Redberg and Parks point to data that say female physicians:

“have a more patient-centered communication style, are more encouraging and reassuring, and have longer visits than male physicians.”

The differences were “modest,” said senior researcher Dr. Ashish Jha, a professor of health policy at the Harvard School of Public Health in Boston.

Overall, less than 11.1% of patients treated by female internists died within 30 days. That compared with just under 11.5% among patients treated by male internists. Still, Dr. Jha said, that difference translates into about 32,000 fewer deaths in the United States annually.

“It’s similar to the number of people who die in motor vehicle accidents each year,” Dr. Jha said.

The findings do not prove that women are better doctors, HealthDay News points out. There could be other reasons that female internists’ patients fared better, according to Jha. But, he said, his team dug for other explanations and did not find any.

The researchers accounted for differences in the patient populations that female and male doctors treated, and differences in the hospitals where they worked, among other things. And patients of female doctors still did a little better.

So, what’s happening? According to Jha, past studies have found that female doctors tend to practice differently than male doctors do. For example, female doctors they tend to communicate with patients more clearly.

Jha said it’s likely some of those differences might explain his team’s findings.

Dr. Parks, a resident at the University of California, San Francisco, urged some caution in interpreting the results.

“We can’t know from this study whether this is cause-and-effect,” said Parks, co-author of an editorial published with the research.

But, she said, if the findings do reflect differences in the way male and female internists practice, that’s important.

“We should probably figure out what behaviors are causing this,” Parks said.

As for patients, Jha said he hopes the findings are enlightening for those who consider female doctors as less competent than men.

“For people who still stereotype doctors based on gender, these findings might help dispel any myths,” Dr. Jha said.

Steve’s Take:

In a study that is sure to rile some male doctors, Harvard researchers have found that female doctors who care for elderly hospitalized patients get better results. Put another way,

“Your chances of dying are lower if your doctor is a woman,” Harvard’s Ashish Jha, one of the co-authors on the study and director of the Harvard Global Health Institute, summed up.

Put a little more clinically, patients cared for by women were less likely to die or return to the hospital after discharge.

But female doctors still earn less than male doctors, says Vox. And despite that obviously indefensible fact, now it seems indisputable that they may actually deliver better health care for patients in certain situations.

Previous research has shown that female doctors are more likely to follow recommendations about prevention counseling and to order preventive tests like Pap smears and mammograms, NPR points out. But the latest work, published Monday in JAMA Internal Medicine, is the first to show a big difference in the result that matters most to patients: life or death.

“Of course! What did you expect?” replied the wife of Dr. Jha, the study’s senior author, when he shared his team’s findings with her. Jha said he expects a backlash over the study results. But his team’s methodology, successfully put through multiple analyses, makes this work noteworthy, he added.

Since half the patients we treat are women and girls, it makes sense that at least half the physician corps should reflect the population. We’ve achieved that in medical school rolls, but overall only a third of practicing doctors are female. And many specialties, including orthopedics, cardiology and neurosurgery, are still dominated by men.

Still the implication is not that everyone should rush to choose a female physician, discarding males in droves. For one, this would be impractical since females make up only one-third of the American physician work force.

While gender differences in practice styles have been shown in past research, Monday’s study is the first to compare such meaningful outcomes as death and re-hospitalization.

These are the results that many patients and doctors–and certainly hospitals and insurance corporations–care about most. In a profession increasingly conscious of bottom lines and quality outcomes, these numbers may be what it takes to spur equal (or better) compensation and opportunity for female physicians.

Steve's Take: Better outcomes must equal better pay for female #physicians Click To Tweet

An editorial about the study once again sounds the call for physicians to remedy the gender disparities in care and the pay gap that favors male physicians over women. Now, there’s compelling, rational data to do just that. And all of us patients fortunate enough to have decent health care know how much our physicians love data.

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