Does your doctor’s gender matter?

Robert H. Shmerling, MD
Robert H. Shmerling, MD, Faculty Editor, Harvard Health Publications

Follow me on Twitter @RobShmerling

I’ve read medical research studies that surprised me. I’ve read medical news that inspired me to learn more. And, sure, there have been plenty of studies that went way over my head. But it’s rare that I’ve read a study that made me feel defensive. Until now.

Researchers publishing JAMA Internal Medicine reported that older adults admitted to the hospital fare better if under the care of a female physician rather than a male physician. More specifically, the patients in this study were less likely to end up back in the hospital, or die, in the 30 days after discharge if cared for by female physicians than similar patients cared for by male physicians.

How “good” was the study?

The study was large. Nearly 1.6 million hospital admissions among people covered by Medicare were analyzed for deaths within 30 days. Another 1.6 million admissions were analyzed for readmission within 30 days. When comparing care provided by male to female internists, the results clearly demonstrated small differences that consistently favored the female physicians:

  • Deaths within 30 days of admission occurred in 11.07% of patients cared for by female physicians while 11.49% of patients cared for by male physicians died in that timeframe.
  • Readmission to the hospital within 30 days of discharge occurred in 15.02% of patients with female physicians but in 15.57% of those cared for by male physicians.
  • Even after accounting for several relevant factors, such as severity or type of patients’ illness, or type of medical training, age or experience of the physicians, the findings remained largely the same.

Although these differences may seem small, they could have a large impact on unnecessary suffering, premature death, and costs of care when considered over the millions of hospital admissions that occur each year.

Your reaction, please

When I surveyed the members of my household about these results, the reactions ranged from “Of course, everyone knows women are better at everything,” (my wife’s perspective) to, “There must be some other reason for these findings; the researchers must have missed something.”   OK, that last one was from me. Did I mention I was feeling defensive?

But after reading the research report’s results carefully, it’s hard to come up with an alternative explanation for the study’s findings. And there is other research that suggests that female physicians outperform their male counterparts in certain aspects of medical care, such as communication skills.

So, what’s their secret?

And that brings us to this question. If female physicians are getting better results, how do they do it? Just what are the differences in the ways male and female physicians practice that lead to better outcomes for patients of women doctors?

The answer is important. Identifying the differences in how male and female physicians provide care could lead to improved care across the board, regardless of physician gender.

The study’s authors are appropriately cautious in their conclusions because a study of this type cannot determine why the results turned out as they did. But they did offer a few possibilities:

  • Female physicians may follow clinical guidelines more often.
  • Female physicians may communicate better, with less medical jargon.
  • Male physicians may be less “deliberate” in addressing complicated patients’ problems (as suggested by past research).

I would add a couple of other possibilities:

  • Perhaps female physicians listen more carefully.
  • Female physicians may spend more time with their patients, and this could allow the doctor to get a better sense of the patient’s symptoms and help ensure that her recommendations are understood well by the patient.

There are more questions to answer

Beyond making us think about what female physicians are doing right, this study raises a number of other questions:

  • Would the results be the same if other areas of medicine were similarly studied? This study excluded patients cared for by other types of doctors such as surgeons, obstetricians, and psychiatrists.
  • Would physician gender matter if the patients were younger? The average age of patients in this Medicare-covered study population was nearly 81.
  • How would the results be affected if outpatients were included?

How can we use this information to improve care of patients?

Undoubtedly, future research will try to tease out how female and male doctors practice differently. Then it will be important to figure out why these differences exist and which ones matter most. It’s probable that each gender has something to teach the other. One thing is certain: accepting the possibility that female physicians may outperform male physicians in certain aspects of medical care, and then trying to understand why, is much more constructive than being defensive about it.

Comments:

  1. Sue G

    I just so happen to be considering a change from a foreign born male hematologist to (hopefully) a female. I’m not sure if I can get a switch or not but am not too happy with this Doctor who has had me on a strong anticholinergic drug for a newly found blood disorder for nearly a year. I recently researched the drug and it appears my fatigue and tiredness was not entirely from my condition, but a side effect of this strong sedating antihistamine on my brain. I have usually preferred & had a female primary but needed a specialist so I did not complain. I feel he does not have the compassion & the honesty required to treat a 71 year old woman this way. I still have good mental ability but I think a woman doctor would not have been this uncaring. Apparently, if I continue to take this drug I am risking the onset of Dementia & or AD in the future.

  2. Lyn Hill

    Higher levels of empathy might be the reason for the apparent difference between male and female doctors. I’ve had male doctors with high levels of empathy and female doctors who wouldn’t score well, so this might be a better predictor of outcomes than gender.

    Another factor for older adults is that we have early experiences with authoritarian male doctors. I was terrified of doctors as a child because they made the symptoms of the abuse I was receiving at home sound like a psychosomatic weakness on my part. I wonder if the results would be the same for patients in a different generation.

    A doctor friend said that younger patients are more likely to research their symptoms on the Internet , self-diagnose, and insist on being prescribed a certain medication whether the doctor agrees or not. She said older doctors tend to have a harder time dealing with these patients.

    This may suggest a change in the way medical students are being selected and trained.

  3. Steve

    ofcourse be it any part of the world doctors gender does matter. When my wife was carrying she was triple sure that she would consult only a female Gyno. This helps them to be more connected and understand for the matter. Even some men would prefer a male when they have issues which they are not comfortable sharing to an opposite gender. drpkahlon.com Steve, Dentist

  4. kldjfldjf

    It seems like in many occupations men are more likely to try to increase their pay by doing things that are detrimental for their customers.

  5. Alan

    Nice Article

  6. William Martin

    Not a very “scientific” comment, but I’ve had several surgeries including heart bypass, brain tumor removal, two cancer surgeries. I’m also a type 2 diabetic, with a bad heart (100% service-connected veteran for heart), so many doctors don’t want to deal with me.
    If I had a choice, based on my observations & experiences, I’d prefer a female physician. I’ve never talked to a female physician who came across as “I know what’s best for you. Trust me, I’m next to God”. I ran across that attitude often with males.
    Females tend to talk in such a way that you are included in your medical care. You become invested and I believe that’s half the battle.

  7. ballstothewalls

    My woman doctor was too busy “running around with her kids” to follow up on some crucial labwork, and when she did finally call, sounded exhausted and distracted. I had to be the one to suggest additional testing and analysis of results. As far as empathy…not so sure…I’ve been to some pretty cold hearted female ob-gyns.

  8. Lena Lindstrom

    I think the likeliest cause does have something to do with the higher levels of empathy present in the average female vs the average male (and it is my understanding that physicians generally score well behind the general population when tested for empathy…which is a grave concern in itself…something is clearly amiss with the type of person being admitted to medical school in the first place and with how they are trained).
    Those who actually CARE more about their patients are more motivated to practice cautious and comprehensive medicine, because it will actually bother them if their incompetence were the source of their patient’s suffering.

  9. henry St

    Despite my nervousness, I adapted to female doctors: surgeon, PCP, and — surprise — urologist PA. I’ve also see gruff and non-nurturing deal with my wife (though a specialist, she didn’t know Lyme Disease!). It may say more about the patient (i.e., assume women are nurturing) than about the doctor. OUr ages: late ’70s.

  10. Clyde

    I am a white male in my mid-60’s. In 1985 my employer offered a medical insurance plan which included an HMO with a highly-reputable clinic and hospital. I chose that plan and, in enrolling, it gave me several choices as primary care physician. I chose a woman because I felt a woman might be more likely to be dedicated to the profession, as not many women were then encouraged go into medicine. It was a great decision. Since then, because of moves, I’ve had three more PCPs and all have been women. All have been caring and attentive.

  11. Lawrence Mann

    I am a 82 year old white male that was very healthy until about 4 years ago when I had a pacemaker installed by a male doctor. This operation has turned out very well with no problems.
    In the last two years I have had 7 operations on joints and other minor problems. They all were performed by male doctors and turned out to be fine. I had two broken bones removed from my back, cataracts removed by a by a female doctor from both eyes, both hips replaced by a male doctor and both hands operated on by a male doctor. This was a total of 7 operations. All the doctors were just as caring and the operations turned out fine with no problems. The female doctor probably took more time with me and was very good. I would not put her above the care etc. given to me by the male doctors.

  12. Lola Berissi

    I, on the contrary of what I just read above, I prefer male
    doctors ; for some reason, they inspire me more confidence.

    Yet, some of my doctors, I have many health problems, are
    female doctors.

    I trust more male doctors, especially in heart, surgery,
    psychiatry, orthopedic procedures.

    For your informatiion I live in São Paulo, Brazil

  13. AARNE

    JUST LEFT THE “CARE” OF A FOREIGN-BORN FEMALE PHYSICIAN WHO WAS TOTALLY DEVOID OF A NURTURING SPIRIT – EVEN A KINDLY FACIAL EXPRESSION. A STONE-FACED, UNCARING, “BIG DEAL” WHO I DISCARDED = LACK OF HUMANITY IS CRUCIAL WHEN DEALING WITH PATIENTS SUFFERING GREATLY WITH LIFE-THREATENING AILMENTS.

    • Ken George

      I would prefer to be treated by a truck driver, if he /she showed at least some compassion towards those who face an unpleasant, and possibly, a short and struggling future.

  14. Deb

    Interesting article, and not surprising. Women generally (but not always) have a greater capacity for empathy. I have only ever had one male Dr, preferring female physicians, but he had an unusual ability (for a man) to communicate care and concern.

  15. Peter Storey

    Female clinicians are led more by the heart than by the head. Big-headedness is more evident in all males, especially successful professionals.