Researchers from Harvard Medical School proposed the question:
Do patient outcomes differ between those treated by male and female physicians?
From prior studies, this much is known:
Studies have found differences in practice patterns between male and female physicians, with female physicians more likely to adhere to clinical guidelines and evidence-based practice.
Patients’ illnesses included pneumonia, heart failure, intestinal bleeding, urinary infections and lung disease.
All were treated by general internists in the hospital. The researchers compared results in patients who got most or all of their care from women internists with those who got most or all of their care from men.
The findings from the researchers:
Elderly hospitalized patients treated by female internists have lower mortality and readmissions compared with those cared for by male internists.
With such a large number of patients studied, even small differences among participants’ outcomes result in big numbers:
The differences were small — about 11 percent of patients treated mostly by women died within 30 days of entering the hospital, versus 11.5 percent of those treated by men. But the all-male research team estimated that there would be about 32,000 fewer deaths each year in the U.S. if male physicians performed at the same level as their female peers.
Husband and wife physicians John Henning Schumann and Sarah-Anne Henning Schumann aren’t surprised, even as they consider the obstacles female physicians have to overcome:
Since half the patients we treat are women and girls, it makes sense that at least half the physician corps should reflect the population. We’ve achieved that in medical school rolls, but overall only a third of practicing doctors are female. And many specialties, including orthopedics, cardiology and neurosurgery, are still dominated by men.
So why is there a gender-based difference in physicians’ care? The authors admit that they are “unable to identify exactly why female physicians have better outcomes than male physicians.”
The authors of an accompanying editorial in the journal explain some of the institutional gender unfairness in medicine:
Jena and colleagues found that female physicians in academia were less likely than their male counterparts to have reached the rank of full professor (11.9% vs 28.6%). Serge et al reported that start-up funding packages—which help launch faculty careers—were 67.5% higher for men than for women ($980 000 vs $585 000). Finally, Jena and colleagues reported that salaries for female academic physicians are $19 879, or 8.0%, lower than those of their male colleagues.
The Henning Schumann’s think that leveling the playing field for female physicians comes down to one thing — respect:
Sarah-Anne: Even in our family, we’re both doctors. I’m a family doctor, trained to see adults and kids. You’re an internist, trained to only see adults. And in both of our families, most of the time, our family members will reach out to you with their questions — even about kids. And my family, who attended my Harvard Medical School graduation, I’ll remind you, seems to value your opinion more. They seem to be looking for opinions more from men. That’s kind of an interesting thing.
John: I never really thought about that. I can see how that’s totally male privilege. It has to be frustrating to be taken less seriously.
Sarah-Anne: I’m in a Facebook group of physicians who are moms. While it’s not every doctor-mom in the country, there are over 60,000 of us in it. So many tell stories of being mistaken for nurses — and taking great offense at that. We have worked so hard to get where we are and want to be treated as equals to our male colleagues.
But I see the mix-up as a compliment rather than an insult. To be compared [to] a nurse says that patients are seeing me as someone who is caring for them and nurturing.
John: That’s a smart way to reframe it. Our colleague Jill used to get angry when people assumed she was a nurse. Instead, she decided to embrace it and use it as a call to service. Now she asks patients if they need an extra blanket or something to drink. And she believes that she provides better, more empathic care.
The back-and-forth between the Henning Schumann’s is really interesting and worth reading in its entirety:
Sarah-Anne: I’m assuming the difference is because of the way that women, in general, communicate. It’s about being better listeners, more nurturing and having emotional intelligence.
John: There are plenty of men who are good communicators.
Sarah-Anne: Yes, just as there are plenty of women who don’t really have those qualities. For female doctors, having worked their way through pre-med, med school and residency, they can have some of that nurturing communication skill beaten out of them.
John: That happens to men, too!
Sarah-Anne: That’s true. But this study shows us — just possibly — that if female doctors, on average, communicate better, their style might be more effective in treating disease and preventing death.