A new study could add to the argument over equal pay in the ranks of medicine: Older patients treated by female doctors tend to do better than those treated by males.
Public health researchers at Harvard found that elderly patients were less likely to die or be readmitted to the hospital within 30 days if treated by female doctors rather than male. The study doesn’t explain why this happens, but prior studies have found that female doctors tend to spend more time with patients, communicate better, and follow clinical guidelines more often than their male colleagues.
The findings not only launch a grenade at the gender pay gap in medicine, they also suggest the methods of female physicians — if replicated broadly — could significantly improve the quality of medical care in the United States.
“We need to understand why these differences exist … and figure out how to translate it to the broader population of physicians,” said Dr. Ashish Jha, a professor of health policy at Harvard T.H. Chan School of Public Health and senior author of the paper.
The study, which examined data from more than 1 million Medicare beneficiaries, said that if male doctors achieved the same outcomes as female doctors, annual deaths of Medicare patients alone would drop by 32,000. That’s comparable to the number of annual deaths from car accidents in the US.
Meanwhile, female physicians are still paid considerably less than males, according to recent research. A paper published this year in JAMA Internal Medicine found that male academic physicians get an average of 8 percent more than females, regardless of specialty, years of experience or productivity, which translates to an average salary bump of about $20,000, although the extent of the disparity varies widely.
Jha said he hopes the study will spur constructive conversation. The wage gap “is particularly unconscionable given the performance of women in terms of providing high quality care,” he said.
Harvard’s study found that, when treated by female internists, Medicare patients had a 4 percent lower relative risk of dying prematurely and 5 percent lower risk of being readmitted to a hospital within 30 days. Researchers examined outcome data between 2011 and 2014 on the eight most common conditions in seniors treated by general internists, including sepsis, pneumonia, congestive heart failure, and acute renal failure.
Patients of female physicians had lower rates of mortality and readmission in all of the conditions examined, although the difference was not always statistically significant. Sepsis is a leading killer of elderly patients and costs more than $20 billion a year to treat. It killed about 182,000 people in the United States in 2014, according to the Centers for Disease Control and Prevention, which launched a national campaign this year to improve treatment of the condition.
The study reported that mortality rates for sepsis were more than 2 percent lower among patients treated by female physicians, and about 1 percent lower for those treated for heart arrhythmia and pneumonia. Female doctors recorded about 1 percent lower readmissions for pneumonia and congestive heart failure. That might not seem like a big difference, but the costs add up quickly when applied to tens of thousands of patients with these conditions.
Jha said the researchers sought to control for a variety of factors, including risk adjusting for the demographics of patients and accounting for differences in the size and types of hospitals where the physicians worked. They also tested the findings by restricting the analysis to hospitalists, to whom patients are randomly assigned, to make sure patient selection of doctors was not skewing the results.
The outcomes remained consistent in that population as well.
“We spent quite a bit of time trying to make sure the findings were robust,” he said. “I feel very confident that findings are real and that it probably says something important about the way men and women are practicing.”
Several studies have examined those differences in recent years in different types of physicians. Johns Hopkins researchers found that female primary care physicians engage in more communication that focuses on the individual needs of the patient; researchers also found they have longer visits than their male counterparts.
More effective communication has been linked with higher rates of patient satisfaction, lower readmissions, and better adherence to therapeutic recommendations. Hospitals nationwide are seeking to improve physicians’ communication with patients, especially as they face financial penalties for readmissions. The task is particularly challenging among elderly patients, who see an average of seven physicians a year across four different practices, according to the Institute of Medicine.
About the Author Reprints
Two essential issues about this topic for my personal health care experiences:
1. I have been to five female physicians; I was treated with more respect; listened to without being interrupted, only for clarification of what I was stating with the patient’s subjective history; my physicians treated me with the best treatment protocol for each individual except one, and I considered the physician’s disturbing behavior because she was finally in the same situation with her male colleagues!; the female physicians overall also had more efficacious medications and other types of treatment than the male physicians who I have been treated, since I was sixty-five.
With that said, the last male physician I had, is a great physician who I still have even though he is located in Florida ( we had to live in that state for almost five years because of an employment opportunity, and we have been living in NH since a year ago on this very date, and I still fly down to see my four physicians about three-four times yearly. Three are male, and one is the best female physician of them all.
I am going to have to try to find a new physician here in NH; but thus far I have yet to find anyone equal to the physicians that I had in Florida ( the only good thing about having to live in that state )! New England is my home; and it has taken us forty-five years to finally return home again. However, the only problem I have ever encountered with trying to find a physician ( or dentist ), in the six states we have lived, has been here ), and I think that because I am at the age of one who has Medicare and a supplemental insurance too, that’s a significant difference that I must consider as a variable in my attempts to find a good physician, and dentist too. Most of the physicians have a clearly capitalist-type of practice than we have ever before experienced. The closest thing to this is when we lived on the Monterey Peninsula, near Carmel-by-the-Sea, where we were able to choose whether or not to have our doctor based on a “ conceirge physician,” if we paid the doctor a yearly fee at the beginning of each year. The cost was typically ten thousand dollars a year, and s/he would be available for us first, and whenever we would have needed to see our physician. We never chose this option, and we still had our own physician each time we needed him. He was one of the best and most compassionate individuals we ever had for any physician, and he is a black male physician. We were never treated with more effective treatment than when we were his patients- never! We are a caucasian couple, and he was the very best doctor who we have ever had before or since.
I disagree. Look at
https://blogs.sph.harvard.edu/ashish-jha/2016/12/19/do-women-make-better-doctors-than-men/ Best regards, Georgette
Did the study remove the bias from female doctors being more likely to treat female patients and vica versa?
My wife had a number of health problems throughout her life – congestive heart failure, Type 1 diabetes, kidney failure. elevated liver functions – and spent a great deal of time visiting a number of different physicians in various fields. Fortunately, she had an internist – a female physician – that was awesome and oversaw all of her various treatments. She personally contacted the various specialists and helped chart her treatments. She also kept in contact with my wife or requested continual updates during hospitalizations.
My wife preferred female physicians and almost all of them were females, who she called her “A Team”. I believe she received the best possible medical treatment possible anywhere.
I just want to make one point on this study: female patients like my wife generally prefer female physicians. As I understand it, females in the U.S. generally have longer life spans than males. I don’t dispute the findings of this study through my personal experience, but could it be that the patients of female physicians do better because they are indeed females who tend to have longer life spans anyway?
Just a thought though again, I believe the treatment my wife received from her female physicians was the best anywhere.
Here is my take : Take colon cancer. Male doctor tells male patient , time for colonoscopy . Male patient says “I don’t want anything up my ass ” Male doctor agrees . “I understand ” Female doctor says “Stupid way to die, get it done “. Females are more used to invasive procedures , and brush off male insecurities .
Years ago I had a growth removed. The male surgeon told me I was going to have an ugly scar. Two weeks later I was checked by a female nurse practitioner who said “wow, that looks great! What a tribute to your body’s healing power”. Words and attitudes do matter.
My experience completely underscores the results of this study. While in my early 60s I began experiencing some alarming symptoms that became worse. After multiple tests over multiple visits yielded no results my female PCP called in the male head of the practice, who promptly went on a rant about my not having had a flu shot and then began to tell me that what I was experiencing was “not really that bad.” My PCP then got him out of the room, assured me she wouldn’t give up trying to find out what was wrong. Fast forward two weeks, I was diagnosed with a somewhat rare autoimmune disorder. I had to go on medical leave for three months to recover from the symptoms the male MD assured me weren’t all that bad. During my leave I was cared for by a female rheumatologist and seen by a male neurologist. He ordered me to undergo a test that my research discovered was extremely painful. I refused it, and when my neurologist discovered that she said she completely understood, and told me we could find out the same answers by using MRI. She asked me if I thought I could do that. I could and did. I’ve now completely recovered, which I’m told is rare with this disorder. My takeaway is that female physicians truly listen to patients, demonstrate more empathy, and view patients as partners.
Did the study address the possibility that the results were biased based on the fact that most female doctors have female patients (and vice versa) and that these female patients might die later than male patients?
Yes, the study looked at hospitalists, who are randomly assigned patients, rather than an outpatient practice.
My own experience as a 74 year old patient tallies with this study. My female PCP makes sure that before she walks out of the exam room, that all of my concerns have been met. As a result, I am getting healthier, and I am also less stressed and enjoy life more. I have had male physicians in the past who provided the same level of care, but far more of my contacts with male physicians have been unsatisfying. This includes a male PCP and the surgeon he referred me to. Both of them failed to listen, and thus missed the information that would have told them that undiagnosed hypothyroidism was the cause of my intestinal pain. I had surgery which was almost certainly unnecessary, and which the surgeon blamed me for. No TSH test was performed, either before or after surgery. I learned of my hypothyroidism a few months later after experiencing a series of fainting spells. A female licensed nurse-practitioner diagnosed me.
Be careful of cause and effect. If elderly male patients are more reluctant to seek treatment by a female doctor – entirely possible – that could bias the results since women tend tyo liver longer. They also tend to shop more for female doctors or male doctors with better “bedside manners.” Have to either remove ad many variables ad possible or else factor them statistically.