Do better outcomes from female docs signal need for more empathy?

Are women better doctors than men? It’s still hard to tell, according to a study examining clinical outcomes for female versus male doctors, but there is something to be said about gender concordance in the patient-provider relationship.

Overall, female patients have lower hospital mortality and readmission rates when they are treated by a female physician, the study published in the Annals of Internal Medicine found.

These findings come as healthcare professionals continue to look at other kinds of sociodemographic concordance between patients and providers. Emerging evidence shows that racial concordance can improve the patient-provider relationship and clinical outcomes.

This latest study, completed by researchers at UCLA’s David Geffen School of Medicine and Mass General Brigham, showed that gender concordance can also improve clinical outcomes. This is likely because gender concordance leads to a stronger patient-provider relationship in which patients feel more comfortable candidly discussing their healthcare concerns.

The study assessed Medicare claims data from 2016 to 2019 for around 458,100 female and 319,800 male patients, a third of whom were treated by female doctors. Researchers analyzed patient records for 30-day mortality from the date of hospital admission and 30-day readmission from the date of discharge.

On the whole, patients fared better when they were treated by a female physician, regardless of gender, although this finding was more pronounced among female patients.

The mortality rate for female patients seeing female physicians was 8.15 percent compared to 8.38 percent for women treated by male physicians.

These findings could indicate some benefits for the patient-provider relationship when there’s gender concordance, at least for women. Women visiting with a female physician may feel more comfortable talking about their health, potentially reproductive health. Moreover, female physicians may practice medicine in such a way that they are more likely to trust women’s self-reported health and symptoms.

In fact, that difference in patient engagement could be why even male patients fare better when treated by a female physician, although the difference for male patients was smaller (10.15 percent when seeing female physicians and 10.23 percent when seeing male physicians.)

According to Yusuke Tsugawa, MD, the study’s senior author, outcomes shouldn’t vary by gender if physicians practiced medicine with the same approach.

“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, who’s also associate professor-in-residence of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine. “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.”

Potential reasons for the difference in outcomes could be that male physicians are more likely to discount the symptoms of their female patients. Meanwhile, female physicians may be more likely to have open communication and patient engagement strategies, which benefits patients of all genders but particularly women.

“A better understanding of this topic could lead to the development of interventions that effectively improve patient care,” Tsugawa explained.

These findings make the case for further diversifying the medical workforce. Currently, the number of female medical school matriculants slightly outnumber males, but once women enter the medical workforce, they face an uphill battle in terms of workplace culture and even pay.

“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,” Tsugawa said.