HOSPITALIZED PATIENTS MORE LIKELY TO SURVIVE IF THEIR PRIMARY PHYSICIAN IS A WOMAN

 A study involving more than 170,000 patients hospitalized in 7 different facilities in Toronto, Canada found that patients whose lead physician was female had a significantly higher survival rate than patients attended by male physicians. Overall 48 out of every 1000 of patients attended by female physicians died in hospital within 30 days compared to 52 out of every 1000 treated by male physicians--almost 8 percent fewer deaths. 

                                                                        Credit: DMCA

The results of this large Canadian study are very similar to those of an earlier study of hospitalized Medicare patients in the US, which also found a comparable and significant difference in survival rates between patients treated by female compared to male doctors. You can read my earlier post about this here.

In the Canadian study, the difference in outcomes between inpatients of male and female physicians did not depend on the sex, age, severity of illness, or other characteristics of the patients.

There were several differences that may have contributed to female physicians' better patient outcomes. In particular, they ordered more studies, including CT scans, MRIs and ultrasounds. Previous research has shown that female physicians are more likely to review patient records, consult with colleagues and make referrals, spend more time listening to and talking with patients, show more empathic concern and take complaints and symptoms more seriously, all of which may contribute to better patient outcomes.

Still, before concluding that women are simply better doctors than men, another variable turned out to be equally significant in the Canadian study--the number of years of experience doctors had. Contrary to what one might think, this and other studies have shown that physician years of experience and patient outcome are negatively correlated, that is more years of experience correlates with more rather than fewer patient deaths. 

"Some [studies] suggest that physicians closer to their residency training are more up to date on clinical guidelines and are more likely to follow evidence-based practice, which may improve patient outcomes," the authors explain.

In the Canadian cohort of physicians, the female clinicians had on average 4.3 years of experience vs. 7.4 years for their male colleagues. This age difference proved to be as predictive of patient outcomes as physician gender.

So what's the bottom line? The authors of the Canadian study point out that they do not want to ". . . perpetuate gender stereotypes." So instead of looking for doctors who are female, perhaps we should instead look for doctors who are young, up-to-date in their clinical knowledge, empathic, good listeners and communicators, who take our issues seriously, and are willing to order appropriate tests, consult other doctors and refer when needed. 

You can be your own judge of whether you're more likely to find these qualities in a male or a female physician. 

-----

REA 7/17/21

YOU'RE LESS LIKELY TO DIE IN HOSPITAL IF YOU'RE TREATED BY A FEMALE PHYSICIAN

Women doctors treat differently, save lives

Male and female physicians practice medicine differently. For example, women doctors spend more time with their patients, communicate more, offer more encouragement, and are more likely to adhere to the latest clinical guidelines.

A major new national study shows that those or other differences save lives. The study found that hospitalized elderly patients treated by female rather than male internists were 4 percent less likely to die and 5 percent less likely to be re-hospitalized within 30 days of admission. This was true across a wide range of conditions. And the sicker the patient, the bigger the difference between patient outcomes for female vs. male physicians.

Female physicians practice medicine differently--and more effectively

Credit: Ilmicrofono Oggiono

"The difference in mortality rates surprised us," said Yusuke Tsugawa, a researcher at Harvard University's T. H. Chan School of Public Health and the study's lead author. "The gender of the physician appears to be particularly significant for the sickest patients."

A four or five percent difference in survival rates may not seem like a lot, but since 10,000,000 patients like those in this study are hospitalized in the US every year, the authors estimate that if male physicians performed as well as their female colleagues, 32,000 lives would be saved--more than the number of Americans who die in traffic accidents every year.

The study, published today in the prestigious JAMA Internal Medicine, tracked the outcomes of more than 1.5 million Medicare hospitalizations from 2011 through 2014. All of the patients were 65 years old or older, 40 percent were men, 60 percent women. These were seriously ill patients--within 30 days of being admitted to the hospital, more than 15 percent were re-hospitalized and more than 11 percent died. About one third of patients were treated by female internists or hospitalists, two thirds by male physicians. Although earlier research has identified a number of differences between how female and male physicians practice, this is the first national study to see if those differences impact patient outcomes.

Although this study shows conclusively that the physician's gender does affect the risk that hospitalized elderly patients will die or be re-hospitalized, it does not pin down just what produces those differences.

"There was ample evidence that male and female physicians practice medicine differently," says Ashish Jha, Director of the Harvard Global Health Institute. "Our findings suggest that those differences matter and are important to patient health. We need to understand why female physicians have lower mortality so that all patients can have the best possible outcomes."

In the meantime, an accompanying editorial in the same journal points out that the medical profession needs to take a hard look at the gap in both pay and career advancement between female physicians and their male colleagues.

You can listen to an interview with the authors at this URL.