Hospitalized women are less likely to die or be readmitted to the hospital if they are treated by female doctors, says a study published Monday in the journal Annals of Internal Medicine.
During the research, which involved people aged 65 and older, 8.15% of women treated by female doctors died within a 30-day period, compared to 8.38% of women treated by male doctors.
Although the difference between the two groups seems small, researchers say closing that gap could save the lives of 5,000 women a year.
The study included nearly 800,000 male and female patients hospitalized between 2016 and 2019. All patients were covered by Medicare. For hospitalized male patients, physician sex did not appear to have an effect on the risk of death or hospital readmission.
The data alone does not explain why women do better when treated by other women. But other studies suggest that women have less likely to experience “miscommunication, misunderstanding and prejudice” when treated by female doctors, said the study's lead author, Dr. Atsushi Miyawaki, a senior assistant professor of health services research at the University of Tokyo School of Medicine.
Differences in medical care
The new research is part of a growing field of study that examines why women and minorities tend to receive worse medical care than men and white patients. For example, women and minority patients are up to 30% more likely to be misdiagnosed than white men.
“Our pain and our symptoms are often ignored,” said Dr. Megan Ranney, dean of the Yale School of Public Health. “It may be that female doctors are more aware of this and are more empathetic.”
Research shows that women are less likely than men to receive intensive care, but are more likely to report having negative experiences with medical care, which is have their worries dismissed and their heart or pain symptoms ignored, the authors wrote in the new study. Male doctors are also more likely than female doctors to underestimate the risk of stroke in women.
Part of the problem, according to Miyawaki, is that medical students are given “limited training in women's health issues.”
Dr. Ronald Wyatt, who is black, said his 27-year-old daughter recently had trouble getting an accurate diagnosis about her difficulty breathing. An emergency room doctor told him the problem was caused by asthma. It took two more trips to the emergency room for her daughter to learn that she actually had a blood clot in her lungs, a potentially life-threatening situation.
Stereotypes in health care
“There is a tendency among doctors to harbor sexist stereotypes about women, regardless of their age, such as the notion that women's symptoms are more emotional or that their pain is less severe or more psychological in origin,” said Wyatt, former chief scientist and chief medical officer of the Society for Improving Diagnosis in Medicine, a nonprofit research and advocacy group.
Women seem to experience fewer of these problems when treated by other women.
For example, a study published in the medical journal JAMA Surgery in 2021 found that Patients developed fewer complications if their surgeon was a woman. Another JAMA Surgery study published in 2023 found that all patients had fewer complications and shorter hospital stays if they were operated on by female surgeons, who worked more slowly than their male counterparts.
Female primary care doctors also tend to spend more time with their patients, Ranney said. While that extra attention is great for patients, it also means that women see fewer patients per day and earn less, on average, than male doctors.
Dr. Ashish Jha, dean of the Brown University School of Public Health, said several studies suggest that female doctors follow evidence and medical guidelines and that Your patients get better results.
“There is a lot of variation between female and male physicians,” said Jha, who was not involved in the new study. Women “tend to communicate better, listen to patients and speak openly. Patients report that communication is better. “If you put these things together, you can understand why there are small but important differences.”
The study authors said it's also possible that women are more forthcoming about sensitive topics with female doctors, allowing them to make more informed diagnoses.
But that doesn't mean women should change doctors, said Dr. Preeti Malani, a professor of medicine at the University of Michigan. For an individual patient, the differences in mortality and readmission rates seen in the new study are small.
“It would be a mistake to suggest that people need to find doctors of the same gender or race as them,” Jha said. “The most important issue is that we need to understand why these differences exist.”
Malani said she is curious to know what doctors are doing to prevent patients from needing to be readmitted soon after discharge. “How much care and attention is put into that discharge plan?” Malani asked. “Is that where women are succeeding? “What can we learn about cultural humility and asking the right questions?”
Others are not convinced that the new study shows that the gender of the doctor makes much of a difference.
Few hospitalized patients are treated by a single doctor, said Dr. Hardeep Singh, a professor at Baylor College of Medicine in Houston, and a patient safety researcher at the Michael E. DeBakey VA Medical Center.
Hospital patients are treated by teams of doctors, especially if they need specialized care, as well as nurses and other professionals, Singh said.
“How often do you go to the same doctor every day in the hospital?” Singh questioned. “It is not the work of one man or one woman. Results are unlikely to depend on an individual, but rather on a clinical team and the local context of care. … A name may appear on your bill, but the care is based on the team.”
However, Singh said his research on misdiagnoses shows that Doctors in general need to do a better job listening to patients.
Jha said she would like the health system to learn what female doctors do well when treating other women and then teach all doctors to practice that way.
“We need to empower everyone to be more trustworthy and trustworthy,” Jha said.
Wyatt said the country needs to take several steps to improve care for women, including “bias training” to teach doctors to overcome stereotypes. The health care system also needs to increase the number of female physicians in leadership positions, hire more female doctors, and do a better job of retaining them. All doctors also need to better understand how adverse childhood experiences affect patient health, particularly women, she said.
