Patient–physician gender concordance and increased mortality among female heart attack patients, 2018, Brad N. Greenwood et al.

Hutan · Aug 9, 2018

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Trish · Aug 8, 2018

This paper was mentioned on another thread here.

Significance
A large body of medical research suggests that women are less likely than men to survive traumatic health episodes like acute myocardial infarctions. In this work, we posit that these difficulties may be partially explained, or exacerbated, by the gender match between the patient and the physician. Findings suggest that gender concordance increases a patient’s probability of survival and that the effect is driven by increased mortality when male physicians treat female patients. Empirical extensions indicate that mortality rates decrease when male physicians practice with more female colleagues or have treated more female patients in the past.
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Abstract
We 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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Inara · Aug 8, 2018

Empirical extensions indicate that mortality rates decrease when male physicians practice with more female colleagues or have treated more female patients in the past.
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If you train enough, you will get accustomed to females. You can even learn to respect them and treat them as equals!

That's a shame.

I always knew there is a reason why I feel a bit less comfortable with male doctors...

Tia · Aug 8, 2018

This study was mentioned on Woman's Hour today in a discussion about gender inequality in health care. The discussion seems to have been prompted by a report from the BMA that has just been released entitled 'Addressing unmet needs in women's health'. The discussion focuses heavily on domestic abuse but also mentions some other factors.

https://www.bbc.co.uk/programmes/b0bd6y8p it starts at about 18 minutes.

If anyone wants to tweet or email in could be interesting, they did ask for interaction.

The report: https://www.bma.org.uk/collective-v...ch/public-and-population-health/womens-health

TrixieStix · Aug 9, 2018

Merged thread

"Overall, the team found that female physicians outperformed their male colleagues, and their patients were, on the whole, more likely to live. That’s consistent with other studies: For example, it’s what Ashish Jha from the Harvard T. H. Chan School of Public Health found in 2016, in a study of almost 1.6 million U.S. patients. “If male physicians had the same outcomes as female physicians, we’d have 32,000 fewer deaths in the Medicare population,” Jha wrote. “That’s about how many people die in motor vehicle accidents every year.” It was a striking finding..."

https://www.theatlantic.com/science...-attacks-if-treated-by-female-doctors/566837/

Hutan · Aug 9, 2018

the Atlantic article said:

Greenwood and Huang doubt that these differences are driven by explicit sexism. Instead, it might be that women are more comfortable explaining their symptoms to female doctors, who are in turn more likely to connect those symptoms with heart attacks. It could also be, as the team writes, “that the most skillful physicians—i.e., female physicians—provide the highest return to their skills when treating the most challenging patients—i.e., female patients.”

But Ashish Jha says that “the data are less clear than [the team] makes it out to be.” While it’s clear that male physicians are better at taking care of men with heart attacks than women, “it’s harder to tell if female physicians have no such gender disparity because their numbers are so small.” (In the U.S., there are only half as many female doctors as male ones.)
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So it sounds as if there are a few things going on. As well as some male doctors not treating female patients so well (due to dismissing the patient as over-exaggerating symptoms or not bothering to become familiar with different ways female patients might present), it might be that some female patients aren't as comfortable explaining what they are feeling to a male doctor. And then it seems that female doctors might be, on average, better at treating both men and women. [Edit: as well as the possibility that the finding is a statistical artefact due to the number of female doctors being relatively small.]

Even the latter cause two causes might arguably be a result of sexism.

Given that the Greenwood et al study tracked outcomes of patients in one hospital from 1991 to 2010, the female doctors perhaps were, on average, better than their male counterparts simply because, more often than not, those women who got to the stage of being in charge of treating heart attacks had to be more determined, more dedicated and smarter on average than their male colleagues.

This Japanese university went as far as changing the tests scores in medical exams (males' up, females' down),
https://www.independent.co.uk/news/...doctors-grades-changed-medicine-a8475966.html in order to reduce the intake of female students. But there are plenty of more subtle forces acting to filter less focused or less competent female doctors out of the profession while allowing similar male doctors to continue to practice.

Woolie · Aug 9, 2018

Hutan said: ↑

And then it seems that female doctors might be, on average, better at treating both men and women.
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I wonder whether the women are, on average, younger than the men, and their training therefore more up-to-date? That would be likely, because the numbers of females doctors graduating is much higher now than, say, 30 years ago - so most doctors over 50 will be men.

Little Bluestem · Aug 23, 2018

Instead, it might be that women are more comfortable explaining their symptoms to female doctors
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This would be because they know the female doctors will listen to them.

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Patient–physician gender concordance and increased mortality among female heart attack patients, 2018, Brad N. Greenwood et al.

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Patient–physician gender concordance and increased mortality among female heart attack patients, 2018, Brad N. Greenwood et al.

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