Study: Treatment From Female Doctors in the ER Led to Fewer Deaths

Research is increasingly zeroing in on gender dynamics within health care, from patient outcomes to differences between healthcare workers. Now, a new study finds that hospitalized patients of female doctors may fare slightly better than the patients of male doctors.

The July study, published in JAMA Health Forum, found that patients who were treated by female physicians in hospital settings died at lower rates than patients who were cared for by male physicians.

The researchers analyzed data from 171, 625 hospitalized patients in general medical wards at seven different hospitals in Ontario, Canada from 2010 to 2017.

After adjusting for differences, the researchers found that 4.8% of patients treated by female physicians died in the hospital, compared with 5.2% of the patients of male physicians.

Anjali Sergeant, the lead author of the paper and a medical student at McMaster University, tells Verywell that they were not surprised by the findings. A previous 2017 study reached a similar conclusion.

“However, I was surprised to find that, even though we did find differences in the ways that women practice compared to men (i.e. ordering more imaging tests), this did not help to explain the difference in mortality rate," Sergeant says.

Why Is There a Difference?

Sergeant and colleagues did not find a clear reason why the patients of female doctors died at lower rates.

While the researchers did note that female physicians ordered more diagnostic tests—such as MRIs, CT scans, ultrasounds—than the male doctors did, that factor did not appear to affect patient deaths.

Sergeant says prior research shows that compared to their male colleagues, “female physicians tend to adhere to clinical guidelines more closely, spend longer communicating with their patients, and spend more time reviewing patient histories."

These behaviors can positively impact patients. While Sergeant's study didn't look at these factors, they say that it would be "an interesting area for future research.”

Prior studies on gender and patient outcomes found evidence that female doctors are more likely to practice evidence-based medicine, do as well (or better) on exams, and practice patient-centered care more often than their male colleagues.

Additionally, the current study found that the difference in deaths shrank when accounting for the number of years that their doctors had been practicing. 

Sergeant says these findings suggest that fewer patient deaths among female physicians could be "partially explained by the fact that more female physicians are newer grads," and that "some past evidence has shown that newer grads may be more up-to-date on clinical guidelines which may lead to better patient outcomes.”

Gender Differences In Healthcare

Gender differences between male and female patients in health care has been widely documented.

For example, a recent review found that women with heart disease are more likely to receive intense treatment when their doctor is also a woman, resulting in fewer deaths.

Brad Greenwood, PhD, an associate professor at George Mason University, co-authored a paper that examined gender concordance and mortality rates of female heart attack patients that found that women were more likely to survive a heart attack if the emergency room doctor was also a woman. 

Greenwood says that the factors that could contribute to gender differences that affect health outcomes are largely speculative, but that “research does suggest that concordance between the physician and patient increases the quality of communication.”

“It could be as simple as female physicians getting better information from their female patients either because the patients are more comfortable sharing information, they know which questions to ask, or the patients are more comfortable self-advocating with a female physician," Greenwood says.

While Greenwood adds that the theory is "speculative" and that there are "1,000 moving parts," that reality only "underscores the need for further work to understand the precise mechanics of the finding.”

Differences in Diagnoses

When it comes to heart disease, gender differences affect not only how women present with symptoms, but also how they are diagnosed. Greenwood says that with heart attacks, atypical presentation is more likely to occur in female patients. 

Greenwood says that female physicians might be more attuned to the differences compared to their male colleagues, and therefore quicker to diagnose and treat a woman having a heart attack.

“In this same vein, there is another body of work which suggests female patients are more likely to delay seeking treatment, so this delay might play a role," Greenwood says.

Should You Seek Out a Female Physician?

While some research finds that hospitalized female patients may fare better if they are treated by women, patients should not choose a doctor or refuse care based solely on gender.

“There are tremendously talented physicians of both sexes, and there are weaker physicians of both sexes,” Greenwood says. “What is most important is that patients are treated by physicians they are comfortable with, and that is idiosyncratic to the person.”

Greenwood also emphasizes that the disparity between male and female physicians closes when male physicians treat more female patients, as well as when they practice with more female colleagues, which suggests that the "differences are not malicious and they can be obviated.”

To help close gaps, there needs to be more inclusion and diversity in health care—particularly because racial disparities exist and affect the quality of care people receive, especially women. 

Greenwood thinks that their paper "calls attention to the issue that the medical community has been grappling with, and making strides on, for a while: differences in patient presentation and making sure all patients get the care they need."

However, they add that "what's critical to emphasize is the importance of understanding the diversity of the patient community and ensuring that the physician pool is diverse as well."