A new study suggests that patients who are treated by female doctors have lower mortality rates and are readmitted less frequently when compared to their male colleagues. Although the study did not set out to explain this outcome, it is possibly because female doctors are better at communicating with patients.
Is there a gender bias in treatment outcomes?
Sex disparities in health care and hospital outcomes are well known. For decades, there have been various studies that have shown how female patients are less likely to receive intensive care and related procedures than men, are more likely to experience delayed diagnoses, and tend to have more negative patient experiences too. At the same time, research has shown that female patients are more likely to be dismissed and to have their pain or symptoms underestimated by doctors.
Similarly, multiple studies have now shown that receiving treatment from female physicians and surgeons often leads to better outcomes. For instance, in 2017, a large-scale study found that patients operated on by a female surgeon had a significantly lower chance (12 percent) of dying during the following 30 days of recovery. Then, in 2023, another team found that patients operated on by female surgeons tended to lower rates of adverse post-operative outcomes.
However, despite the growing body of literature on the potential impact of physician sex on patient outcomes, there is still little evidence on whether these effects of physician sex on clinical outcomes varies depending on patient sex.
This is where the new study comes in.
Female doctors and improved outcomes
The researchers examined data for nearly 800,000 patients (458,108 female and 318,819 male) who were covered by Medicare, a US health insurance program designed for people over 65 years of age, younger people with disabilities, and those with end-stage renal disease. The patients had all been hospitalized between 2016 and 2019 and were in hospitals that provided care and treatments for serious illnesses and injuries.
The results are interesting. Patients – male and female – appear to have better rates of survival and were less likely to be readmitted within 30 days of leaving the hospital if they were treated by a female doctor.
The benefits of receiving care from female doctors was more clinically meaningful for female patients when compared to male ones. Female patients had an 8.15 percent mortality rate when treated by a female doctor, compared to 8.38 percent when treated by a male doctor. This may appear small on the face of it, but it is a clinically significant difference when you consider the number of lives that represents.
When it came to men, those treated by a female doctor had a 10.15 percent mortality rate compared to 10.23 percent when treated by a male doctor. However, the team admit that this is too small a difference to rule out the influence of chance.
For readmissions or repeat hospitalization within 30 days of leaving, female patients had a 15.51 percent readmission rate when cared for by female doctors. This is compared to a 16.01 percent rate when treated by a male doctor. Similarly, male patients had a 15.65 percent readmission rate when treated by a female doctor, compared to 15.87 percent rate when treated by a male. This was also considered too small to rule out the role of chance.
While the results demonstrate that patients treated by female doctors tend to experience better outcomes, this does not mean male doctors are bad at their jobs or that someone seeking care should choose a female physician over a male.
It does, however, indicate that there may be gendered difference between how doctors interact with patients.
As the team conclude in their study, “There are several potential mechanisms through which treatment by female physicians may be associated with better outcomes among female patients but not among male patients.”
Firstly, male doctors may underestimate illness severity among female patients.
“Underappreciation of symptoms and risks among female patients may result in delayed or incomplete care, ultimately leading to poorer patient outcomes”, the team explain. “These issues may be exacerbated by the limited opportunities for systematic medical training in women’s health in general medical curricula.”
Secondly, being treated by a female doctor may be associated with patient-centred communication, especially among female patients.
“Ineffective communication hinders patients from providing crucial information for accurate diagnoses and treatment, potentially leading to suboptimal outcomes.”
Thirdly, being treated by a female doctor may also alleviate embarrassment, discomfort and social-cultural taboos that may arise from sensitive examinations or conversations.
“Female patients who receive care from male physicians may experience incomplete physical examinations”, the authors add.
The researchers add that future work needs to examine and identify the underlying mechanism that lead to these differences in patient outcomes, especially in relation to female patients and why they benefit from being treated by female doctors.
The paper is published in the journal Annals of International Medicine.
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