Editor’s Note: Jennifer Caudle is a board-certified family medicine physician and assistant professor of family medicine at the Rowan University School of Osteopathic Medicine in New Jersey. Follow her on Twitter @DrJenCaudle. The opinions expressed in this commentary are solely those of the author.
Dr. Jennifer Caudle: A recent study showed that patients are in better hands with female physicians
However, the study leaves many unanswered questions for future researchers to parse, she writes
“Did we really need a study to tell us this?”
That was what one of my colleagues said on Facebook the day this study, from Harvard T.H. Chan School of Public Health, was published saying that male and female physicians have different patient outcomes. Researchers analyzed data from over 1 million patients to see if 30-day mortality and hospital readmission rates differed between patients treated by male and female internal medicine physicians. The conclusion? Patients treated by female physicians had lower mortality and lower hospital readmission rates than patients treated by male physicians.
“Damn straight!” cheered others of my fellow female physicians from far and wide.
Not only does this study have potentially wide-reaching health implications, but it might also help push the needle for gender equality in medicine further. As a female family physician, I must admit that I felt empowered after reading the study. It felt good to see a study that recognized the work and efforts of female physicians and it makes me proud to see that female doctors provide great care. While this study argues that women make outstanding physicians (perhaps with better patient outcomes), it must also be said that men make outstanding physicians, too. Male and female physicians work together, and as the saying goes, “it takes a village.”
Study researchers acknowledged that “literature has shown that female doctors may be more likely to adhere to clinical guidelines, provide preventive care more often, use more patient-centered communication, perform as well or better on standardized examinations, and provide more psychosocial counseling to their patients than do their male peers.” Given these characteristics, some might have assumed the very outcome that the study demonstrated, that female physicians may have healthier outcomes for patients than male physicians.
Surprising or not, this study and its findings are absolutely a big deal not only for women, but for our system of health care as well. Over the years, the number of women in medicine has increased; according the Association of American Medical Colleges, women made up 47.5% of medical school graduates in 2013-2014. However, despite the fact that women make up almost 50% of medical school graduates, gender disparities in salary and rank and promotions persist. Furthermore, researchers estimated approximately 32,000 fewer patients would die “if male physicians could achieve the same outcomes as female physicians every year.”
The study does have some significant limitations, including the fact that the sample size was limited to only those who were hospitalized and 65 years or older. Would the outcome have been the same if the age demographic were broadened or if nonhospitalized patients were included? I wonder if this might be the case. However, the study researcher, Dr. Ashish Jha, said in a recent interview that he felt “very confident that if he had looked at younger patients the results would be very similar.”
The same question could be asked for the type of physician studied, as the study involved only internal medicine physicians. What would the findings have been if family physicians, pediatricians or other specialists were evaluated?
Fundamentally the main question the study was not able to answer is the one you’re probably asking yourself: Why did female physicians have better outcomes than their male counterparts? Is it because women tend to follow evidence-based guidelines and provide more psychosocial counseling to patients, as research has suggested? Is it that women are better communicators or are more caring or nurturing by nature? I suspect the answer is some combination of “all of the above,” but we will need more research to find out.
While this study may have some female doctors high-fiving each other, I know that won’t be true for others. As one female physician told me, despite the study results she doesn’t think gender matters in the ability to provide quality medical care.
Regardless, I believe this is an important study that has the potential to benefit many. It’s clear we need more research, and our first order of business is to explore how this study and others will allow us, whatever our gender, to provide better quality health care to patients.