Being treated by a female physician associated with lower risk of death

NEW YORK, April 22 (UPI) -- Being treated by a female physician can reduce the risk of death and hospital readmission, a new study suggests.

Researchers also observed that women derived an even greater benefit of receiving treatments from female physicians, at least in the inpatient setting.

The study of more than 700,000 Medicare beneficiaries, led by the University of Tokyo in Japan, was published Monday in Annals of Internal Medicine.

Unadjusted mortality was 8.42% for female patients and 10.01% for male patients. After researchers adjusted for patient and physician characteristics and hospital-level averages of exposures, both female and male patients had a lower mortality rate when treated by a female physician.

Among women, mortality risk was 8.15% if a female physician tended to them versus 8.38% if a male physician provided care. However, among men, the difference between female and male physicians was small and not statistically significant.

The unadjusted 30-day readmission rate was 15.23% for female patients and 16.71% for male patients. Both women and men had a lower adjusted readmission rate when treated by a female physician.

Among women, the difference between female and male physicians was clinically important (15.51% versus 16.01%). But among men, the difference in readmission rates was minimal and not of statistical value.

"These findings underscore the need for continued efforts to improve sex diversity within the physician workforce, especially to guarantee that female patients receive high-quality care," the authors wrote.

"Future research is needed to identify the underlying mechanisms that lead to differences in patient outcomes between female and male physicians and to understand why female patients benefit more from having a female physician than male patients," they added.

The study's lead author, Dr. Atsushi Miyawaki, told UPI via email that he undertook this study because as a physician scientist, he is "interested in the gender bias or disadvantage that female patients experience in medicine and the structural factors behind them."

Miyawaki, a senior assistant professor at the University of Tokyo with a primary specialty in public health, also said that as the husband of a female physician, he is intrigued by the role that female physicians play in taking care of patients.

"Our research suggests that our society needs to increase the number of female physicians sufficiently, so that female patients can choose them when they want to," said Miyawaki, who practices general internal medicine.

Other research institutions participating in the study included Harvard Medical School and its teaching affiliates, Massachusetts General Hospital and Brigham and Women's Hospital in Boston; the University of California at San Francisco; the David Geffen School of Medicine at the University of California at Los Angeles; and the UCLA Fielding School of Public Health in Los Angeles.

In the study, Miyawaki and his collaborators noted that "sex disparities in health care quality and hospital care outcomes are well documented. Studies show that female patients are less likely to receive intensive care and procedures, more likely to experience delayed diagnoses and have more negative patient experiences compared with male patients."

They added that "studies have also shown that female patients are more likely than their male counterparts to have their concerns dismissed or to experience discrimination and to have their pain and cardiovascular symptoms underestimated."

However, the researchers cautioned that "the findings may not be generalizable to younger populations."

The study included Medicare patients aged 65 years or older who were hospitalized with medical conditions in 2016 to 2019 and treated by hospitalists. It explored whether the impact of a physician's gender on hospital outcomes varied between female and male patients.

Of the 458,108 female and 318,819 male patients in the study, female physicians treated 142,465 (31.1%) and 97,500 (30.6%) of them, respectively.

Several reasons may account for the notable difference in outcomes between patients treated by female physicians versus their male counterparts. While male physicians may underestimate illness severity among women, female physicians may provide patient-centered care and effective communication to them, the authors noted.

Treatment by female physicians also may help alleviate embarrassment, discomfort and sociocultural taboos during sensitive examinations and conversations for women, they said.

However, for men and women, differences in length of hospital stay, spending for Part B (coverage for outpatient medical services), proportion of intensive evaluation and management claims, and likelihood of discharge to home "were clinically small," according to the study.

"Overall, it is exciting to see such a large, population-based study look at gender inequity among both physicians and patients," Dr. Michelle Fleshner, director of patient safety at the University of Colorado Anschutz Medical Campus in Aurora, Colo., told UPI via email. She was not involved in the research.

"This study adds to a growing body of literature that patients, specifically female, may have improved clinical outcomes with female physicians," said Fleshner, an assistant professor of medicine who practices as a hospitalist.

However, the difference in this study was modest and it would be challenging to determine what's driving the observed trend.

"If this is due to the hypothesis that male physicians may underestimate the concerns of female patients, it reminds us of the importance for advocating for yourself and family members when undergoing medical treatment," Fleshner said.

As a female physician and female patient, she said "this study holds particular significance" to her, adding that she feels female physicians have taken her concerns more seriously.

"This is certainly anecdotal and not always true, but I imagine other female patients can relate to this," Fleshner said. "It would be helpful to identify the 'why' behind this as we teach future physicians of all gender identities how to compassionately and effectively care for patients."

Sex diversity in the physician workforce could have a meaningful impact on patient outcomes, especially in practice areas with predominantly male physicians, such as many surgical specialties, Dr. Michael Barnett, an associate professor of health policy and management at the Harvard T. H. Chan School of Public Health in Boston, told UPI via email.

"This doesn't imply that you need to switch your doctor if they are of a different gender, race or other trait than yourself," Barnett said. "But it does suggest that the level of comfort one might feel from having a physician with a similar background does matter, either due to differences in bias, trust or other causes."