A recent Canadian study published in JAMA has revisited the intriguing question of whether there are differences in patient outcomes based on the gender of their physicians, specifically focusing on Female Doctors. While anecdotal observations, like those of Dr. Andrea Lavoie, an interventional cardiologist known for her thorough patient interactions, might suggest that the approach of female doctors could positively influence patient care, this new research delves deeper into the data to uncover more nuanced insights.
The study, conducted across seven Canadian hospitals from 2010 to 2017, analyzed data from over 170,000 patients admitted to general medical wards. These patients were under the care of 54 female doctors and 118 male internists. It’s important to note that the study used the terms “male and female (sex) and men and women (gender) interchangeably,” without drawing distinctions. The initial findings echoed a previous large-scale American study from 2017, indicating a slightly lower mortality rate for patients treated by female doctors. The Canadian research found a 0.47% lower in-hospital death rate compared to patients cared for by male physicians, mirroring the 0.43% lower 30-day mortality rate observed in the US study.
This difference persisted even after researchers adjusted for various patient factors like age, gender, disease severity, and hospital variations. However, a significant shift occurred when physician experience was factored into the analysis. Once experience was accounted for, the mortality rate difference between female doctors and their male counterparts became statistically insignificant. The only marginal exception was observed in cases where the “most responsible physician” was also the attending and discharging doctor.
A diverse team of doctors in a hospital setting, suggesting collaboration and expertise in patient care.
This crucial finding suggests that the apparent advantage in patient mortality associated with female doctors might be more closely linked to physician experience rather than gender itself. Anjali Sergeant, the lead author of the study and a medical student at McMaster University, pointed out that male physicians in the study, on average, had more years of experience. She explained, “the mortality difference between male and female doctors we report could be partially because more female doctors are younger.” This demographic trend in Canada, where a majority of physicians under 40 are women while older doctors are predominantly men, further supports this experience-based explanation. Sergeant also suggested that “Newer, younger doctors may be more up to date on clinical guidelines, which some studies have shown leads to better patient outcomes,” adding another layer to the experience versus gender discussion.
Beyond mortality rates, the researchers also investigated differences in care processes. They analyzed aspects like medication prescriptions and the ordering of diagnostic tests. Interestingly, the study revealed that female doctors tended to request more diagnostic tests than their male colleagues. However, this difference in test ordering did not correlate with any significant impact on patient mortality, suggesting it might reflect variations in practice style rather than outcome effectiveness.
Sergeant emphasized that the study should not be misconstrued as portraying male and female doctors as fundamentally different. She stated, “I don’t think this study should be interpreted as viewing male and female doctors as very different from each other. We know that a lot of the way we behave is mediated by what we’re taught.” Instead, the findings serve to dispel harmful stereotypes about the competence of female doctors. Sergeant firmly asserted, “Female doctors should be respected… because we can see that they’re performing just as well as, if not better than their male counterparts.”
The researchers acknowledge the limitations of relying solely on electronic medical records data. They recognize that other less quantifiable factors could be at play. Prior research indicates that female doctors are often more inclined towards patient-centered care, dedicate more time to patient communication, and exhibit greater empathy. Sergeant noted that exploring the influence of these variables on mortality rates would be valuable, although methodologically challenging.
Dr. Moira Kapral, director of general internal medicine at the University of Toronto, and a practitioner at one of the study hospitals, expressed relief at the study’s findings of minimal difference between male and female doctors. Reflecting on her career trajectory, she stated, “I’m old enough to have started [practising medicine] at a time when there were hardly any women in our particular field.” Dr. Kapral highlighted the historical obstacles faced by women in medicine and the occasional patient biases against female doctors. For her, the key message of this study is patient reassurance: “That shouldn’t be a factor in deciding who your physician should be or worrying about what your outcomes are likely to be.”
Dr. Lavoie echoed this sentiment, noting the study has sparked valuable conversations among her peers. She concluded, “So [if we can rule out physician gender as a factor in patient mortality], what are the best ways for us to deliver care to patients so that we improve their outcomes. That’s really the bottom line, right?” Ultimately, this study reinforces the importance of focusing on factors beyond gender, such as experience and care delivery methods, to optimize patient outcomes and ensure all doctors, both male and female doctors, are equipped to provide the best possible care.
