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.


                                                                                                                                                                            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.

Monday, January 16, 2017

What's Next for Women's Health Services?

The recent presidential debates and presidential election have sparked debates nationwide on the future of Obamacare. This post does not reflect my political views or designed to address them, but instead highlight the Obamacare changes I have seen enacted into everyday medical practice.  Since August 2012, one overarching theme persists throughout medical offices in the Philadelphia area: preventive women’s health service. Listed below are the preventive services provided to women under Obamacare.

  1. Annual well-women visit (including mammograms and colonoscopies)
  2. Screening for gestational diabetes
  3. Testing for HPV
  4. Counseling for STDs
  5. Counseling and screening for HIV
  6. Contraceptive methods and counseling
  7. Breastfeeding support, supplies and counseling
  8. Screening and counseling for domestic and interpersonal violence


Last year, 6 million mammograms were provided by Medicare. Those same efforts are present in   the Philadelphia area. In the Drexel Internal Medicine outpatient office, the provider always checked and routinely prescribed mammograms for all of her female patients over the age of 40.  While on radiology, the mammography reading room was always busy reading endless screening mammograms. The services provided by Obamacare’s preventive women’s health care services has brought routine screening to fruition for female patients of all socioeconomic backgrounds.


At the adolescent health clinic at St. Christopher’s hospital, providers can screen all adolescent patients for STDs and domestic or interpersonal violence and provide contraceptive methods and counseling free of charge. While I only attended a few sessions at the adolescent clinic, I witnessed endless services provided to adolescents due to the preventative focus of Obamacare.  A 20 year old female was able to receive free STD screening and treatment for herself and her partner.


Although the fate of Obamacare remains unknown, the healthcare message should remain the same: Affordable Access to Preventive Services for Women.
                                                                                                                                       Mary Sims  DUCOM 2017