Patients treated by women doctors have less chance of dying or being readmitted to hospital, possibly because male and female physicians practise medicine differently, which affects the patients’ health outcomes, said researchers.
They also said the gap might be tied to male doctors underestimating the severity of their female patients’ illness.
Additionally, the study, published in the journal Annals of Internal Medicine, found the mortality rate for female patients was 8.15% when treated by women physicians compared with 8.38% when the doctor was male – which the researchers deem a “clinically significant” difference.
Meanwhile, the mortality rate for male patients treated by female doctors was 10.15% – less than the 10.23% rate for male physicians. Researchers found the same pattern for hospital readmission rates, reports The Independent.
Professor Yusuke Tsugawa from the David Geffen School of Medicine at UCLA, who was one of the authors, said patient outcomes between male and female physicians would not be different if the professionals practised medicine in the same way.
“Our findings indicate they practise medicine differently, which has a meaningful impact on patients’ health outcomes,” he said.
“Further research on the underlying mechanisms linking physician gender with patient outcomes – and why the benefit of receiving the treatment from female physicians is larger for female patients – has the potential to improve patient outcomes across the board.”
The study looked at Medicare claims data between 2016 and 2019 for more than 458 000 women patients and more than 319 000 men.
Researchers cited several factors that could be driving the disparities between male and female doctors, saying the gulf may be linked to male doctors underestimating the extent of their female patients’ illness.
Previous studies suggested male doctors underestimate their female patients’ pain levels, gastrointestinal and cardiovascular symptoms, as well as stroke risk, which can lead to delays in accessing treatment or receiving incomplete care.
Additionally, said the researchers, the mortality gap could be linked to women doctors being better able to communicate with their female patients, raising the chances of patients disclosing key information which in turn boosts diagnosis and treatment.
Female patients may be more comfortable with receiving sensitive examinations and having detailed conversations with female doctors.
The team called for further studies to discern more about the differences in both the medicine and care provided by male and female doctors.
Tsugawa said: “A better understanding … could lead to the development of interventions that effectively improve patient care.”
A number of studies show women’s pain is often taken far less seriously than that of men. Previous data demonstrate women are not only forced to spend more time waiting in emergency departments but they are also less likely to be prescribed effective painkillers than men.
Study details
Comparison of hospital mortality and readmission rates by physician and patient sex
Atsushi Miyawaki, Anupam Jena, Lisa Rotenstein and Yusuke Tsugawa,
Published in the Annals of Internal Medicine on 23 April 2024
Abstract
Background
Little is known as to whether the effects of physician sex on patients’ clinical outcomes vary by patient sex.
Objective
To examine whether the association between physician sex and hospital outcomes varied between female and male patients hospitalized with medical conditions.
Design
Retrospective observational study.
Setting
Medicare claims data.
Patients
20% random sample of Medicare fee-for-service beneficiaries hospitalised with medical conditions during 2016 to 2019 and treated by hospitalists.
Measurements
The primary outcomes were patients’ 30-day mortality and readmission rates, adjusted for patient and physician characteristics and hospital-level averages of exposures (effectively comparing physicians within the same hospital).
Results
Of 458 108 female and 318 819 male patients, 142 465 (31.1%) and 97 500 (30.6%) were treated by female physicians, respectively. Both female and male patients had a lower patient mortality when treated by female physicians; however, the benefit of receiving care from female physicians was larger for female patients than for male patients (difference-in-differences, −0.16 percentage points [pp] [95% CI, −0.42 to 0.10 pp]). For female patients, the difference between female and male physicians was large and clinically meaningful (adjusted mortality rates, 8.15% vs. 8.38%; average marginal effect [AME], −0.24 pp [CI, −0.41 to −0.07 pp]). For male patients, an important difference between female and male physicians could be ruled out (10.15% vs. 10.23%; AME, −0.08 pp [CI, −0.29 to 0.14 pp]). The pattern was similar for patients’ readmission rates.
Limitation
The findings may not be generalizable to younger populations.
Conclusion
The findings indicate that patients have lower mortality and readmission rates when treated by female physicians, and the benefit of receiving treatments from female physicians is larger for female patients than for male patients.
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