New research from the Harvard T.H. Chan School of Public Health has found that death rates in hospitals are lower for patients of female doctors. However, the differences in patient deaths are slight, 11.07 percent with women doctors vs. 11.49 percent with men – within 30 days of admission. The same study found that patients of women doctors are less likely to be readmitted to the hospital; here the difference was 15.02 percent vs. 15.57 percent.
These figures come from a review of more than 1.5 million hospitalizations of Medicare patients age 65 or older between 2011 and 2014. The researchers looked at how many patients died during that period and how many had to be re-admitted. The differences between how well the patients of women internists fared compared to those of male internists may not seem significant, but all told they added up to 32,000 patient deaths. The researchers looked at patients with 8 common medical conditions and took the severity of the illnesses into consideration. They also factored in the patients’ age, gender, income, how sick they were when they were admitted to the hospital, as well as the experience of the physicians and the resources of the hospitals. Bottom line: the male doctors lost more patients than the female physicians did.
Noting earlier findings, the researchers wrote that evidence in primary care settings suggests that compared with male physicians, “female physicians are more likely to practice evidence-based medicine, perform as well or better on standardized examinations, and provide more patient-centered care. Patients of female primary care physicians also experience fewer emergency department visits compared with patients of male primary care physicians.” However, in evaluating information from the new study, the researchers were unable to discern exactly what the women doctors were doing differently to account for better results.
In an accompanying editorial, cardiologist Rita F. Redberg and Anna L. Parks, physicians at the University of California, San Francisco wrote that the Harvard findings point up a need for change “in a system that still pays women less and gives them lower odds of attaining full professorship in academic medicine.” On the up side, they noted that the medical system increasingly focuses on paying for performance and rewarding behaviors that result in better outcomes for patients, both of which could help narrow the gap in pay between male and female physicians.
These findings clearly indicate that a pay gap between male and female physicians can’t be justified on the grounds that the quality of the women’s work doesn’t equal that of men’s. In fact, just the opposite appears to be true.
Andrew Weil, M.D.
Yusuke Tsugawa et al, “Comparison of hospital mortality and readmission rates for Medicare patients treated by male versus female physicians.” JAMA Internal Medicine December 19, 2016; DOI 10.1001/jamainternmed.2016.7875
Anna L. Parks and Rita F. Redberg, “Women in medicine and patient outcomes: equal rights for better work?” JAMA Internal Medicine, December 19, 2016; DOI: 10.1001/jamainternmed.2016.7883