Monday, January 30, 2017

Gender Differences in Patient Care


Recently, I came across a MedPage Today article titled “Older Hospital Patients Get Better Care from Female Docs” that sparked my interest.  It was based on a study in JAMA Internal Medicine by Tsugawa Y, et al which found that elderly hospital patients seen by female internists were less likely to die or be readmitted in the short term than those treated by male physicians.  Within 30 days of admission, patients who had been treated by female internists showed lower odds of death (adjusted mortality 11.07% versus 11.49%, adjusted risk difference -0.43%, P<0.001) and hospital readmission (adjusted readmissions 15.02% versus 15.57%, adjusted risk difference -0.55%, P<0.001).  These findings persisted across eight common medical conditions and across patients' severity of illness and corroborated previous studies suggesting that differences in practice patterns between male and female physicians may have important clinical implications for patient outcomes.

What do female doctors do differently than male doctors?    

The authors noted that compared with male physicians, female physicians are more likely to adhere to clinical guidelines, practice evidence-based medicine, perform as well or better on standardized examinations, and provide more patient-centered care. Patients of female primary care physicians also experience fewer emergency department visits compared with patients of male primary care physicians.  

In an accompanying editorial, JAMA Internal Medicine editors commented that in contrast to concerns that household responsibilities, childbearing, or part-time schedules adversely affect the quality of female physicians' work (and explain male physicians' higher salaries), the data showed that the opposite is true.    Finally, they suggest that creating systems that promote equity in start-up packages, career advancement, and remuneration for all physicians would provide better professional fulfillment for all physicians as well as improved patient satisfaction and outcomes.

Amen.

                                                                                                                                                                            Judith Wolf, MD

                                                                                                                                                          Associate Director, WHEP

 

  • Tsugawa Y, et al "Comparison of hospital mortality and readmission rates for Medicare patients treated by male versus female physicians" JAMA Internal Medicine 2016; DOI: 10.1001/jamainternmed.2016.7875.
  • Parks AL and Redberg RF "Women in medicine and patient outcomes: equal rights for better work?" JAMA Intern Med 2016; DOI: 10.1001/jamainternmed.2016.7883.
  • AND BE SURE TO CHECK OUT DONNESBURY’S TAKE ON THE ISSUE: http://doonesbury.washingtonpost.com/strip/archive/2017/01/29

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