At the risk of disturbing some of the most highly competent male colleagues for whom I have the utmost respect and admiration, there’s a rather interesting study that was recently published in the JAMA Internal Medicine within the last one month that has gained some media attention. It suggests that female physicians may be more effective physicians than males. Prior studies have shown that women physicians simply practice differently compared to men. Why is that? We don't quite understand the answer to this essential question. The answer could really help shape the future of how our medical care is received, according to the findings of this study. What the authors report, using previous evidence, is that female doctors tend to follow medical guidelines more closely, provide more preventative care counseling, address the emotional and social aspects of patient health, be more effective communicators, and may even perform better on standardized tests. But so what? Different doesn’t necessarily mean better. Until now, there was no solid evidence to determine if this made any difference in the long run (i.e., improved patient outcomes, which is what truly matters in the end). Can women really be better doctors than men? Should you speed dial your insurance company in order to change doctors? What does it all mean? Being primary care doctors, my husband and I tend to see the same patients in the clinical setting. As disheartening as it may be, I cannot count the number of times (typically when meeting new patients) that question my background and experience: “So where did you go to medical school?” “How long have you been practicing?” “You look so young to be a doctor.” “It must be rough having kids as a doctor. How do you balance it all?” Meanwhile, my husband rarely gets questioned. And never once has he been questioned about how he balances family life with work. Mind you, I have completed 11 years of training, have been practicing for 12, and have 3 more years of experience than my husband. And if you do the math, you can calculate my age (but please don’t!). What happened here? Is there truly a double standard? Let's find out what the study shows. Just like any other new research finding, we need to first dissect the details of the study to determine how it pertains to the rest of us. First of all, the study was done in the inpatient setting, not in outpatient clinics. The researchers studied approximately 1.5 million hospitalized Medicare patients from 2011 to 2014 who were taken care of by general internal medicine physicians, both male and female doctors. They then measured two outcomes that the authors of the study regarded as reflections of success : 1. 30 day mortality: They looked at how many of these hospitalized patients died within 30 days. 2. 30 day readmission: They looked at how many of the patients had to be readmitted after being released from the hospital, suggesting that they may have been discharged too soon or perhaps without proper follow up instructions or care. Patients cared for by female hospitalists had a small but still statistically significantly lower rate of both measures when compared to male physicians. In fact, according to the study, 32,000 more lives a year could be saved if you were taken care of by female physicians in this same way. Surely, the “power” of the study, a term that reflects the number of subjects, in this case 1.5 million hospital visits, makes this study a very interesting one. Compare this to case studies that include only a handful (or less) of enrolled patients, and those types of studies have what we call a “low power,” and are deemed to be weaker evidence. But like all studies, there are also a few drawbacks to note when interpreting the results when it comes to your personal medical care: 1. The study reflects the inpatient setting only, not outpatient clinics. Therefore, it’s not easy to extrapolate information like this one to your primary care physician. 2. It excludes specialist care. It examined general internist performance only. 3. It excludes patients less than age 65. 4. In medicine data needs to be corroborated and repeated multiple times before well-acceptance. But here is what it does suggest: women are certainly not any less competent than men, in case you had any doubts. Unfortunately, however, women physicians are paid on average of 20K less than their male counterparts, and are less likely to receive promotions within the medical field. According to the authors of this study, "Throw in our study about better outcomes, and those differences in salary and promotion become particularly unconscionable." With the rising cost of healthcare, the cost of saving 32,000 more lives per year cannot even compare to closing the salary gap between male and female physicians. Hence, hiring more women physicians is well worth the cost-savings. In my own practice, as a female physician, do I practice medicine close to physician guidelines? Do I practice preventative medicine? And do I believe in the importance of the psychosocial aspects of medicine? If you follow my articles or podcasts, and/or if you allow the opportunity to get to know me as a physician, then you know the answers to these questions. I have to admit that so does my husband. Am I a better doctor than my husband? No way—we both have our strengths and weaknesses as physicians … and humans, for that matter. However, I am definitley as competent and experienced and should really be as equally trusted and respected. My own patients that get to know me do also know this about me. In conclusion, it’s about time that we not only close the gender pay gap in this country (across all career fields), but to also finally break away from the gender stereotypes, even in medicine. Your doctor may not fit the typical male, caucasion, older, eyeglass-wearing profile of the generations passed. And if you judge a book by its cover, unfortunately you may miss out on a great opportunity to receive perhaps some of the greatest medical care. Source
