Want to save 32,000 lives a year? Get male doctors to practice more like women.
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Female physicians earn less than male doctors. And now it seems that they may actually deliver better health care for patients in certain situations.
In a new study in JAMA Internal Medicine, researchers from Harvard University wanted to explore whether the sex of the doctor matters when it comes to patient outcomes. A small body of studies has already shown that the gender of the doctor can influence the quality of care patients get, but so far there’s been little research on what that means for mortality risk.
The researchers focused on elderly Medicare patients in hospitals from 2011 through 2014, looking at 30-day mortality data on more than 1.5 million hospitalizations. They also looked at about the same number of readmissions to hospitals within 30 days of discharge in the same time period. Their specific aim: to see whether the patients treated by women were more or less likely to die or be readmitted than those treated by men.
It turns out the patients treated by women had a 4 percent lower risk of dying prematurely and a 5 percent lower risk of being readmitted to a hospital within 30 days compared with the patients cared for by male doctors. In absolute terms, that means the mortality risk went from 11.5 percent among the patients of male doctors to about 11.1 percent among the patients of female doctors.
The gap in readmission rates was similar: 15 percent for female doctors, and 15.6 percent for male doctors.
Overall, the researchers deduced that the sex of the doctor seemed to have an influence on the risk of patient death. "Your chances of dying are lower if your doctor is a woman," Harvard’s Ashish Jha, one of the co-authors on the study and director of the Harvard Global Health Institute, summed up.
The finding is particularly meaningful at the level of population health, Jha explained. "If male physicians achieved the same outcomes as female physicians do, we would save about 32,000 lives a year — and that’s just in the Medicare population. That’s about how many people die from motor vehicle accidents."
To understand what other factors (besides gender) may influence the different health outcomes, the researchers controlled for a number of doctor and patient variables. The patients of male and female doctors were similar, but men saw more patients on average and had more experience than their female peers. When the researchers controlled for these differences, however, female doctors still performed better.
There were a couple of important limitations to this study. First, it was observational research, which means it can only tell us about an association and not cause and effect. Second, there may be other variables the researchers didn’t control for — differences in the socioeconomic status of the patients, for example — that explain their major finding.
So the study can’t offer a clear explanation for this apparent female edge, but Jha thinks one clue may come from why he and his colleagues conducted this research in the first place. "There are about a dozen studies out there that suggest women seem to practice differently than male physicians," he said. "They practice in a more evidence-based manner, they stick more closely to clinical guidelines, they communicate more effectively with patients."
Only one other US study looked at the association between the sex of the doctor and patient mortality (this time, in a small cohort of outpatients), and it found gender didn’t seem to make a difference. But other research on the quality of care patients get has consistently found that gender matters, and female doctors often have an edge on their male peers.
"I think it’s those practice differences that probably explain the results we have," Jha added. "If I’m right on that, it’s good news for those of us who are male doctors, because those are things we can learn."
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