Elderly patients in the hospital tend to fare better under female doctors than male ones, a study published Monday in JAMA Internal Medicine suggests. Among patients in the sample, 30-day readmission rates and 30-day mortality rates were lower among those seen by female internists than by their male counterparts.
An estimated 32,000 fewer patients would die every year “if male physicians could achieve the same outcomes as female physicians,” the authors, a group of Harvard researchers, wrote in the study. Patients treated by women had mortality rates of 11.07%, compared with 11.49% for those seen by men. Readmission rates were 15.02% among those seen by women, compared with 15.57% for male physicians.
"I want us to try to understand why this difference exists and what that means for improving hospital care," said Dr. Ashish Jha, a professor of health policy at the Harvard School of Public Heath and co-author of the study. "I don't want people to somehow walk away thinking men can't practice medicine."
For the study, researchers examined hospital readmissions and mortality data for a random sample of traditional Medicare beneficiaries 65 or older who ended up in acute-care hospitals from Jan. 1, 2011, through Dec. 31, 2014. Those data consisted of slightly more than 1.5 million hospitalizations, in which patients were seen by 58,344 physicians. About a third of those physicians were women.
The researchers adjusted the data to account for different characteristics of hospitals and patients, as well as physician characteristics that were not based on sex, such as experience level. These types of adjustments ensure that the study's findings do not simply reflect a situation where male physicians are seeing sicker patients, for instance.
The female physicians tended to be younger––their average age was 42.8 years, compared with 47.8 for men. They also were more likely to have training in osteopathic medicine and to have treated fewer patients.
But the authors say those differences shouldn't be construed as explaining the disparities in readmission and mortality rates by physician gender, and the study does not identify causes. Differences in the way men and women practice medicine have been established, but there's not much research into the actual effect on patients and clinical outcomes.
"There is data out there that women practice evidence-based medicine, and they tend to stick more closely to clinical guidelines," Jha said. "We need to know, is that what really explains these outcomes differences? If the answer is yes, I think that's good news, because it means all of us can get better if we focus on those issues."
Discrepancies between female and male physicians persist in other ways, too, such as compensation. In July, a study published in JAMA Internal Medicine found that at top public medical schools in the U.S., the average unadjusted annual salary of a female academic physician is $51,000 less than that of a male academic physician, although the salary differences varied across specialties.
Jha said he hoped the new study would fuel efforts to rectify inequalities in the ways male and female doctors are compensated or otherwise rewarded, such as being promoted. "It's pretty substantial," he said, referring to the pay gap. "And completely, I would say, unacceptable."
