Patient-physician gender concordance and increased mortality

Proc. Natl. Acad. Sci. U.S.A. · Aug 2018

Multicenter Study

Patient-physician gender concordance and increased mortality among female heart attack patients.
Very interesting study covering 20 years of Floridian ED patient admissions for myocardial infarct, looking specifically at the influence of gender-discordance between patient and doctor.

The headline finding was that female heart-attack patients experienced lower survival when treated by a male physician than when by a female physician. Baseline mortality across all patients was 11.9%, with a 1.5% absolute survival decrease when compared to male patients treated by female physicians.

Although on the surface this absolute effect size could be misinterpreted as small, it represents a 12% relative risk difference – quite meaningful when we are considering mortality from the leading cause of death in the U.S.

Could the researchers suggest a reason?

The authors identified two interesting points:
1. Female patients treated in EDs with a higher percentage or a higher number of female physicians were more likely to survive. Although true of both care from a female or male physician, the beneficial survival effect of a greater female physician presence, was more marked when treated by a male doctor.
2. Female patients treated by male physicians were also more likely to survive when the male physician had previously seen more female patients (0.02% increased survival for each female patient seen in the last quarter!).
"These results suggest a reason why gender inequality in heart attack mortality persists: Most physicians are male, and male physicians appear to have trouble treating female patients." – Greenwood, 2018

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Very interesting study covering 20 years of Floridian ED patient admissions for myocardial infarct, looking specifically at the influence of gender-discordance between patient and doctor.

The headline finding was that female heart-attack patients experienced lower survival when treated by a male physician than when by a female physician. Baseline mortality across all patients was 11.9%, with a 1.5% absolute survival decrease when compared to male patients treated by female physicians.

Although on the surface this absolute effect size could be misinterpreted as small, it represents a 12% relative risk difference – quite meaningful when we are considering mortality from the leading cause of death in the U.S.

Could the researchers suggest a reason?

The authors identified two interesting points:
1. Female patients treated in EDs with a higher percentage or a higher number of female physicians were more likely to survive. Although true of both care from a female or male physician, the beneficial survival effect of a greater female physician presence, was more marked when treated by a male doctor.
2. Female patients treated by male physicians were also more likely to survive when the male physician had previously seen more female patients (0.02% increased survival for each female patient seen in the last quarter!).
"These results suggest a reason why gender inequality in heart attack mortality persists: Most physicians are male, and male physicians appear to have trouble treating female patients." – Greenwood, 2018

summary
- Brad N Greenwood, Seth Carnahan, and Laura Huang.
- Carlson School of Management, University of Minnesota-Twin Cities, Minneapolis, MN 55455; wood@umn.edu.
- Proc. Natl. Acad. Sci. U.S.A. 2018 Aug 21; 115 (34): 8569-8574.
AbstractWe examine patient gender disparities in survival rates following acute myocardial infarctions (i.e., heart attacks) based on the gender of the treating physician. Using a census of heart attack patients admitted to Florida hospitals between 1991 and 2010, we find higher mortality among female patients who are treated by male physicians. Male patients and female patients experience similar outcomes when treated by female physicians, suggesting that unique challenges arise when male physicians treat female patients. We further find that male physicians with more exposure to female patients and female physicians have more success treating female patients.

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This article appears in the collection: Effect of doctor gender & age on patient outcomes.
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summary
1

Very interesting study covering 20 years of Floridian ED patient admissions for myocardial infarct, looking specifically at the influence of gender-discordance between patient and doctor.

The headline finding was that female heart-attack patients experienced lower survival when treated by a male physician than when by a female physician. Baseline mortality across all patients was 11.9%, with a 1.5% absolute survival decrease when compared to male patients treated by female physicians.

Although on the surface this absolute effect size could be misinterpreted as small, it represents a 12% relative risk difference – quite meaningful when we are considering mortality from the leading cause of death in the U.S.

Could the researchers suggest a reason?

The authors identified two interesting points:

Female patients treated in EDs with a higher percentage or a higher number of female physicians were more likely to survive. Although true of both care from a female or male physician, the beneficial survival effect of a greater female physician presence, was more marked when treated by a male doctor.

Female patients treated by male physicians were also more likely to survive when the male physician had previously seen more female patients (0.02% increased survival for each female patient seen in the last quarter!).

"These results suggest a reason why gender inequality in heart attack mortality persists: Most physicians are male, and male physicians appear to have trouble treating female patients." – Greenwood, 2018

Daniel Jolley
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Female heart-attack patients are less likely to survive when treated by a male physician than a female physician.
Daniel Jolley
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Patient-physician gender concordance and increased mortality among female heart attack patients.

Could the researchers suggest a reason?

Could the researchers suggest a reason?

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Could the researchers suggest a reason?

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Patient-physician gender concordance and increased mortality among female heart attack patients.

Could the researchers suggest a reason?

Could the researchers suggest a reason?

Notes

Could the researchers suggest a reason?

300 characters remaining

help

You can also include formatting, links, images and footnotes in your notes

Want more great medical articles?

Keep up to date with a free trial of metajournal, personalized for your practice.1,694,794 articles already indexed!

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1,694,794 articles already indexed!