Are Female Doctors Better?

Female doctors are better than their male counterparts under some circumstances, at least according to a study currently making the media rounds.

No, seriously. According to science.

Alright, don’t harpoon me for being an angry, militant feminist just yet. Let’s talk about this study first, and then you can be the judge.

First, a little context.

Women Are At Higher Risk Of Death After Cardiac Events

This is a real thing, y’all. Women were twice as likely to to die after hospitalization for a heart attack in this study (from 1996). And the authors noted that women were generally not treated as aggressively as men. I.e. they were half as likely as men to undergo some of the more invasive but lifesaving procedures. <– statistically significant

Women and elderly people received primary percutaneous coronary intervention – aka lifesaving procedure after heart attack – less often and later than men in this more recent study. <– statistically significant

In another study, younger women and those with a specific arrhythmia were more likely to develop prehospital cardiogenic shock and less likely to be prescribed “evidence-based treatment at discharge.” <– statistically significant

This one’s a bit of a head scratcher for me. Women were literally discharged without prescriptions, the same prescriptions that men with similar pathology were given. I honestly can’t imagine what’s responsible for that, but I’m sure some fancy psychologist can figure it out.

Anyway, my point here is that science supports the idea that women really are at higher risk of death, and, honestly, receiving sub-standard medical care after a cardiac event.

But that’s not the point of this post.

Female Doctors (General Internists) Have Lower Readmission And Death Rates

In unearthing the fact that women are at higher risk than men after cardiac events, researchers wondered what it meant about the treating doctors. What caused this gender disparity? So they did a little digging and looked at WAY more data than I ever want to. Thank goodness these researchers didn’t feel the same way though.

In 2017 a group of investigators affiliated with Harvard Medical School published data examining a physician’s effect on patient mortality and their likelihood to return to the hospital. They included over 1.5 million individual hospitalizations, 18,000 female doctors, and 39,000 male doctors.

Patients treated by female doctors were less likely to die (11.07% for female doctors vs. 11.49% for male doctors) and less likely to return to the hospital after treatment (15.02% for women vs. 15.57% for men). Both of these data points were statistically relevant, even though the raw difference was only on the order of 0.5% for both patient death and return to hospital.

To put these small differences in perspective, the authors calculated the number of patients a female physician would need to treat before preventing one additional death or return to hospital vs. a male physician.

Number of Patients To Prevent One Death: 233
Number of Patients to Prevent One Return To Hospital: 182

So these differences aren’t apparent unless we’re looking at pretty large volumes of patients, but those volumes exist in a lot of hospitals. Meaning that this trend really demands our attention and further investigation, which brings me to the study currently making the rounds.

Women Treated By Male Physicians Die More Frequently

than when they are treated by female physicians, according this this recently published study. The authors said, and this is a direct quote:

female patients treated by male physicians were the least likely to survive an episode of care

They also noted that patients treated by female doctors, in general, regardless of patient gender, were more likely to survive.

This study involved 581,845 patient treatment episodes between the years of 1991 and 2010. In other words, this study brings the heat when it comes to sample size and duration. It’s no bubblegum investigation between two fifth graders. Which means there are a LOT of statistics.

Researchers anaylzed this data six ways from Sunday. This paper has so many statistical references that I had to Google a couple to jog the cob-webby parts of my brain. And those part of my brain do not want to be jogged.

The moral of the story though: the results are statistically significant. This publication represents another data point indicating that female patients are at higher risk than their male counterparts. Especially if a man treats them instead of a female doctor.

But wait, there’s more!

These researchers wanted to draw some conclusions about the root cause of this male/female difference.

Male Physicians Who Interact More With Women Are Better At Treating Them

than male physicians who interact less with women. Seriously, this study showed a trend toward decreased risk for women treated by male physicians as those male physicians’ level of interaction with women in general increased.

Cue the laugh track now. I feel like I’m telling a story about the Rosetta Stone instead of trends in modern healthcare. Because it seems like female doctors have a secret decoder ring, and the men just don’t. It also seems like the decoder ring works with both men and women.

Also, how funny is it to say – when men interact more with women, they’re better at communicating with them??

That’s like saying, “It turns out children become better at language after they talk for a few years.”

Communication Tutors For Med Schools?

Maybe med schools will start teaching physicians how to communicate with women the way Rice University teaches their engineers how to communicate with humans. True story, as a freshman at Rice, I listened to a representative of the engineering department explain why everyone had to attend workshops put on by the Cain Initiative. Which, despite the name, is not a creepy cult that meets in the basement of Baker Hall, the most gothic dorm on campus.

It boiled down to this. Engineers are unskilled at communicating with humans. Which puts them at a disadvantage in life, not just in the workplace. Rice wanted to ensure their engineers were good communicators, so they created a team of communications tutors. From freshman year on, all engineering students were taken by the hand, critiqued, coached, and forced to present endlessly.

And not to brag, but it totally worked. When I came into grad school, I remember several people commenting on the quality of my slides and presentation style*. “You don’t sound like other engineers.” And not just because I talked way too much about Disney movies.

So, Tracy Voss, maybe you could head over to Baylor and teach them a few things about remedial communication techniques for people who are naturally terrible communicators.

*Y’all don’t judge Tracy Voss and Rice University on the quality of this blog. You can attribute all shortcomings to the fact that I was raised by wolves and am wildly unapologetic about that.*

Advocate Assertively

for yourself and/or your loved ones. That’s the moral of this story.

Yes, it seems that male physicians communicate poorly with female patients, leading to increased mortality risk for those female patients. You can’t choose a female physician every time you need healthcare. So whether you’re a man or a woman, you need to communicate as clearly as possible any time you’re in need of healthcare. Especially anything urgent involving your heart, lungs, or brain.

Don’t ever skip over information, even if you think it might not be relevant. And don’t be a hero. I was raised to suck it up and work through the pain. Bleeding hands? Do that bar routine anyway. Soles of your feet black and blue from an aggressive beam crash? You’re still vaulting.

But I know now, from watching hundreds of cases and hearing about thousands, sucking it up is often bad for you. Now, you don’t need to whine about a paper cut. But, you do need to recognize that pain, even if you can handle it, is telling you something important about your body’s needs. And you need to listen to that, or at least communicate it to a physician. Clearly. And proactively.

Female Physicians Are Better

according to these studies anyway. But, that doesn’t mean they’re better scientists, or smarter. None of the studies I’ve mentioned, or the ones they reference say anything about raw talent or intelligence. In fact, they clearly state that we don’t know why female physicians appear to treat their patients more effectively than their male counterparts. Some of them suggest that it does indeed come down to communication.

But at this point, we don’t know why. We only know that female patients are at a disadvantage when treated by male physicians. And as much as I dislike this data (because it kind of sucks for everyone), it’s still science.

Do you have any suggestions for improved communication between physicians and patients? Sound off in the comments or send me a message!

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