Hospitalized women are less likely to die or be readmitted to the hospital if they are treated by female doctors, a study published Monday in the Annals of Internal Medicine found.
In the study of people ages 65 and older, 8.15% of women treated by female physicians died within 30 days, compared with 8.38% of women treated by male physicians.
Although the difference between the two groups seems small, the researchers say erasing the gap could save 5,000 women’s lives each year.
The study included nearly 800,000 male and female patients hospitalized from 2016 through 2019. All patients were covered by Medicare. For male hospitalized patients, the gender of the doctor didn’t appear to have an effect on risk of death or hospital readmission.
The data alone doesn’t explain why women fare better when treated by other women. But other studies suggest that women are less likely to experience “miscommunication, misunderstanding and bias” when treated by female doctors, said lead study author Dr. Atsushi Miyawaki, a senior assistant professor of health services research at the University of Tokyo Graduate School of Medicine.
The new research is part of a growing field of study examining why women and minorities tend to receive worse medical care than men and white patients. For example, women and minority patients are up to 30% more likely to be misdiagnosed than white men.
“Our pain and our symptoms are often dismissed,” said Dr. Megan Ranney, dean of the Yale School of Public Health. “It may be that women physicians are more aware of that and are more empathetic.”
Research shows that women are less likely than men to receive intensive care but more likely to report having negative experiences with health care, having their concerns dismissed, and having their heart or pain symptoms ignored, the authors wrote in the new study. Male physicians are also more likely than female doctors to underestimate women’s risk of stroke.
Part of the problem, Miyawaki said, is that medical students get “limited training in women’s health issues.”
Dr. Ronald Wyatt, who is Black, said his 27-year-old daughter recently had trouble getting an accurate diagnosis for her shortness of breath. An emergency room physician told her the problem was caused by asthma. It took two more trips to the emergency room for his daughter to learn that she actually had a blood clot in her lungs, a potentially life-threatening situation.
“There is a tendency for doctors to harbor sexist stereotypes about women, regardless of age, such as the notion that women’s symptoms are more emotional or their pain is less severe or more psychological in origin,” said Wyatt, former chief science and chief medical officer at the Society to Improve Diagnosis in Medicine, a nonprofit research and advocacy group.
Women seem to experience fewer of these problems when treated by other women.
For example, a study published JAMA Surgery in 2021 found that women patients developed fewer complications if their surgeon was female. Another JAMA Surgery study published in 2023 found all patients had fewer complications and shorter hospital stays if they were operated on by female surgeons, who worked more slowly than their male counterparts.
Women primary care doctors also tend to spend more time with their patients, Ranney said. Although that extra attention is great for patients, it also means that women see fewer patients per day and earn less, on average, than male doctors.
Dr. Ashish Jha, dean of the Brown University School of Public Health, said several studies suggest that female doctors follow medical evidence and guidelines, and that their patients have better outcomes.
“There’s lots of variation between women and men physicians,” said Jha, who was not involved in the new study. Women “tend to be better at communication, listening to patients, speaking openly. Patients report that communication is better. You put these things together, and you can understand why there are small but important differences.”
The authors of the study said it’s also possible that women are more forthcoming about sensitive issues with female physicians, allowing them to make more informed diagnoses.
That doesn’t mean that women should switch doctors, said Dr. Preeti Malani, a professor of medicine at the University of Michigan. For an individual patient, the differences in mortality and readmission rates seen in the new study are tiny.
“It would be a mistake to suggest that people need to find physicians of the same gender or race as themselves,” Jha said. “The bigger issue is that we need to understand why these differences exist.”
Malani said she’s curious about what women doctors are doing to prevent patients from needing to be readmitted soon after discharge. “How much care and thought is going into that discharge plan?” Malani asked. “Is that where women are succeeding? What can we learn about cultural humility and asking the right questions?”
Others aren’t convinced that the new study proves a physician’s gender makes a big difference.
Few hospitalized patients are treated by a single doctor, said Dr. Hardeep Singh, a professor at Baylor College of Medicine in Houston and a patient safety researcher at the Michael E. DeBakey VA Medical Center.
Hospital patients are treated by teams of physicians, especially if they need specialist care, in addition to nurses and other professionals, Singh said.
“How often do you see the same doc every day in the hospital?” Singh asked. “The point is that it’s not a one-man or one-woman show. Outcomes are unlikely to depend on one individual, but rather on a clinical team and the local context of care. … One name may appear on your bill, but the care is team-based.”
However, Singh said his research on misdiagnoses shows that doctors in general need to do a better job listening to patients.
Jha said he’d like the health system to learn what women doctors are doing right when they treat other women, then teach all physicians to practice that way.
“We should train everyone to be better at generating trust and being worthy of trust,” Jha said.
Wyatt said the country needs to take several steps to better care for women patients, including “de-biasing training” to teach doctors to overcome stereotypes. The health care system also needs to increase the number of women physicians in leadership, recruit more female doctors and do a better job at retaining them. All physicians also need more understanding of how adverse childhood experiences affect patient health, particularly for women, he said.
“More than once I’ve had white female patients tell me they came to be because I listened and they trusted me,” Wyatt said.
