(JR) – Are female doctors better than their male counterparts? An emerging body of research indicates that in some instances, patients fare better under the medical care of women.
Women are underrepresented in the profession, according to statistics from the Federation of State Medical Boards. In 2016, about one third of actively licensed physicians in the United States and the District of Columbia were women. This was up about four percent from 2010.
Meanwhile, female physicians are disproportionately affected by depression when compared to their male peers, and are paid less — trends that might not come as a surprise as the United States and countries across the world try to reckon with pervasive gender inequity and its rippling effects.
But in various aspects of patient care, from colonoscopies to surgeries to diabetes management, studies have shown that the patients of female doctors tend to experience better outcomes. Other research indicates female physicians are likely to spend more time with their patients than male physicians and more commonly recommend preventative care activities. This roundup highlights this recent scholarship.
Though many of these studies present a correlation between physician gender and patient outcomes, it’s important to remember that correlation does not imply causation. While many of the studies control for a number of variables, there might be other factors that contribute to these outcomes independent of physician gender.
These studies might not settle the battle of the sexes once and for all, but they still document observable trends in patient outcomes and might inform future research on the delivery of medical care.
“Physician Characteristics Associated with Higher Adenoma Detection Rate”
Mehrotra, Ateev; et al. Gastrointestinal Endoscopy, 2018. doi: 10.1016/j.gie.2017.08.023.
Summary: Through colonoscopies, physicians can detect and later remove tumors in patients before they become cancerous. However, physicians’ abilities to discover these polyps through colonoscopies varies. This metric, known as the adenoma detection rate (ADR), stands in as one measure of colonoscopy quality. Prior research has found that patients whose doctors had higher ADRs were at a lower risk of developing colorectal cancer later on. For this study, researchers looked at over 100,000 colonoscopy examinations performed by 201 physicians at four healthcare sites across the country. They found that female physicians had higher ADRs than male physicians. Gastroenterologists also performed better than non-specialists, and more recently trained physicians had higher ADRs than doctors with decades of practice. Among the limitations of this study: it didn’t account for certain patient factors that could help explain the findings, such as body mass index, smoking and family history.
“Comparison of Hospital Mortality and Readmission Rates for Medicare Patients Treated by Male vs Female Physicians”
Tsugawa, Yusuke; et al. JAMA Internal Medicine, 2017. doi: 10.1001/jamainternmed.2016.7875.
Summary: This study looked at a random sample of hospitalized Medicare beneficiaries. The researchers examined the links between physician gender and 30-day mortality and readmission rates among their patients. They analyzed over 1.5 million hospitalizations and found that patients under the care of female physicians had slightly lower risks of 30-day mortality and readmission. The researchers tested their findings by limiting their analysis to hospitalists (physicians who focus on hospital care) and examining these differences across a number of conditions and varying degrees of illness severity. Patients with female physicians still fared better. This study did not control for confounding variables (outside factors that might influence the result). The authors made this choice on the grounds that the study design was quasi-randomized (while the patients were not assigned randomly to doctors, they were assigned based on the physicians’ work schedules, which adds an element of chance).
“Comparison of Postoperative Outcomes Among Patients Treated by Male and Female Surgeons: A Population Based Matched Cohort Study”
Wallis, Christopher J.D.; et al. British Medical Journal, 2017. doi: 10.1136/bmj.j4366.
Summary: In this eight-year, retrospective study of over 100,000 patients who underwent surgical procedures in Ontario, Canada, researchers compared outcomes based on physician gender. Of the over 3,314 surgeons in the study, 774 were female and 2,540 were male. The study matched patients based on age, gender, the presence of other diseases or medical conditions, hospital, and surgeon age and number of surgeries they had performed. The scholars found that fewer patients treated by female surgeons died, were readmitted to the hospital or experienced complications in the 30 days following a surgery than those treated by male surgeons.
“A Comprehensive Assessment of Family Physician Gender and Quality of Care: A Cross-Sectional Analysis in Ontario, Canada”
Dahrouge, Simone; et al. Medical Care, 2016. doi: 10.1097/MLR.0000000000000480.
Summary: This study looked at a number of datasets that contained information on physicians’ recommendations for cancer screening, chronic disease management and referrals, as well as their patients’ outcomes, including hospitalization and emergency room visits. Over 4,000 physicians were included in the study. Analyzing these outcomes by the gender of the physicians, the study found that patients of female doctors were more likely to have received cancer screening, diabetes management testing and referrals to specialists. Patients of female doctors also had fewer emergency room visits and hospitalizations.
“Effect of Physicians’ Gender on Communication and Consultation Length: A Systematic Review and Meta-Analysis”
Jefferson, Laura; et al. Journal of Health Services Research & Policy, 2013. doi: 10.1177/1355819613486465.
Summary: This paper reviewed 33 studies on the topic of physician gender and communication differences, including the length, style and content of doctors’ conversations with patients. “Conflicting results are reported for many communication variables,” the authors write. “There is some evidence that female physicians adopt a more partnership building style and spend on average 2.24 [minutes] longer with patients per consultation (95 percent confidence interval 0.62–3.86) than their male colleagues.”
“Patient-Physician Gender Concordance and Weight-Related Counseling of Obese Patients”
Pickett-Blakely, Octavia; et al. American Journal of Preventive Medicine, 2011. doi: 10.1016/j.amepre.2011.02.020.
Summary: Does it matter for obese patients whether their doctor is the same gender as they are? This study found that for men, the answer is yes. Obese men who had male physicians were more likely to receive diet, nutrition and exercise counseling than obese women who saw female doctors and opposite gender patient-doctor pairs. These conclusions were drawn from analysis of post-visit data from nearly 6,000 obese patients and their doctors.
“Physician Gender Differences in General and Cancer-Specific Prevention Attitudes and Practices”
Ramirez, Amelie; et al. Journal of Cancer Education, 2009. doi: 10.1080/08858190802664396.
Summary: This study examined prevention practices and attitudes of 722 doctors via survey data. Survey questions asked doctors to offer their views on the efficacy of cancer screenings and to rate how often they recommend them, among other topics. The study found that male and female doctors generally shared similar attitudes and practices, but women “were more likely to discuss general health prevention activities than male physicians, especially issues considered sensitive.”
“Influence of Gender of Physicians and Patients on Guideline-Recommended Treatment of Chronic Heart Failure in a Cross-Sectional Study”
Baumhäkel, Magnus; et al. European Journal of Heart Failure, 2009. doi: 10.1093/eurjhf/hfn041.
Findings: “Physicians’ gender was also shown to influence drug treatment in patients with heart failure. The present study demonstrated for the first time that drug treatment is more complete when female physicians are taking care of the patients. Female physicians did not treat male or female patients differently with regard to the use and the dosage of angiotensin‐converting enzyme‐inhibitors (ACE‐Is) or (angiotensin‐receptor blockers) ARBs. Use of beta‐blockers was more frequent in male than in female patients, but dosage was not different. In contrast, male physicians favored male patients for both prescription and dosage. A female patient was likely to receive the worst medical treatment from a male physician, whereas male patients were best treated by a female physician. In multivariable analysis adjusted for co‐morbidities, but also possible physician’s confounders such as time since medical board examination, female gender of physicians was an independent predictor of use of beta‐blockers.”
“Physician Gender Is Associated with the Quality of Type 2 Diabetes Care”
Berthold, H. K.; et al. Journal of Internal Medicine, 2008. doi: 10.1111/j.1365-2796.2008.01967.x.
Summary: This study looked at quality of care measures for over 50,000 patients in Germany with diabetes. These measures included blood indicators of glycemic control and blood pressure and cholesterol levels. The researchers found that patients of female doctors were more likely to reach target values for these measures than patients of male doctors. They were also more likely to receive blood pressure medication than patients of male physicians. However, the patients of male physicians were more likely to have their glucose monitored both through self-administered tests and in-office measurements, and more commonly received medications taken by mouth to manage their blood sugar.