Patients Have Lower Mortality When Treated by Female Physicians

A new study found patients have a lower mortality when treated by female physicians, but female patients have a greater benefit from being treated by females.¹

“It is important to note that female physicians provide high-quality care, and therefore, having more female physicians benefits patients from a societal point-of-view,” said investigator Yusuke Tsugawa, MD, PhD, MPH, associate professor-in-residence of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at UCLA, in a press release.²

Sex disparities often exist in health care, with research showing female patients are less likely to receive intensive care and procedures, more likely to face delayed diagnoses, and have more negative patient experiences including being dismissed by symptoms, compared with male patients.¹ Studies have shown female physicians lead to better communication and rapport, and female patients are more likely to agree with the provided advice. However, the positive outcomes of being treated by a female physician are unknown for male patients.

Investigators, led by Atsushi Miyawaki, MD, PhD, from the department of health services research at The University of Tokyo, conducted a retrospective observational study to assess whether the association between physician sex and hospital outcomes varied between hospitalized female and male patients. They collected a 20% random sample of Medicare fee-for-service beneficiaries hospitalized with medical conditions during 2016 – 2019 and leveraged data from the Medicare Data on Provider Practice and Specialty. The primary outcomes were patients’ 30-day mortality and readmission rates. They adjusted the rates for patient and physician characteristics.

The sample included 458,108 females and 318,819 males aged ≥ 65 years. Female physicians treated 31.1% of female patients and 30.6% of male patients. The exposure variables were 4 patient-physician dyads: female patient–female physician, female patient–male physician, male patient–female physician, and male patient–male physician.

Although both female and male patients had lower mortality when treated by female physicians, females experienced a greater benefit (difference-in-differences, -0.16 percentage points [pp] (95% confidence interval [CI], -0.42 to 0.10 pp). The team observed a large and clinically meaningful difference between female patients being treated by female vs male physicians.

Female patients had a lower mortality rate (8.15%) when treated by female physicians compared to when treated by male physicians (8.38%) (average marginal effect [AME], -0.24 pp (95% CI, - 0.41 to -0.07 pp). As for male patients, males only had a slightly lower mortality rate when being treated by female physicians (10.15%) over male physicians (10.23%) (AME, -0.08 pp (95% CI, -0.29 to 0.14). Investigators noted a similar pattern for patients’ readmission rates.

A limitation the team pointed out was the findings may not be generalizable to younger populations with the sample being older adults.

Investigators hypothesized the factors driving the differences, such as male doctors underestimating the severity of their female patients’ illness, female doctors being better at communicating with their female patients, and female patients being more comfortable with receiving sensitive examinations and having detailed conversations with female physicians.²

“What our findings indicate is that female and male physicians practice medicine differently, and these differences have a meaningful impact on patients' health outcomes,” Tsugawa said. “Further research on the underlying mechanisms linking physician gender with patient outcomes, and why the benefit of receiving the treatment from female physicians is larger for female patients, has the potential to improve patient outcomes across the board.”

References

1. ^{Miyawaki A, Jena AB, Rotenstein LS, Tsugawa Y. Comparison of Hospital Mortality and Readmission Rates by Physician and Patient Sex. Ann Intern Med. Published online April 23, 2024. doi:10.7326/M23-3163}
2. ^{Treatment From Female Doctors Leads to Lower Mortality And Hospital Readmission Rates. EurekAlert! April 22, 2024. https://www.eurekalert.org/news-releases/1041811. Accessed April 23, 2024}