A recent controversial study in JAMA Internal Medicine examined hospital mortality and re-admission rates for Medicare patients treated by male vs. female physicians. The study examined more than 58,000 DO and MD internists’ handling of 1.5 million Medicare patient admissions.
After adjusting for confounding variables such as patient age and coexisting conditions and physician youth, training and experience, the study found that elderly hospitalized patients treated by female doctors have significantly lower mortality and re-admission rates than those cared for by male physicians in the same hospital setting. These findings appear to validate earlier studies, including those in the European Journal of Heart Failure and the Journal of Internal Medicine, that produced similar results.
The study’s authors propose some possible reasons for women physicians’ improved outcomes, including greater reliance on clinical guidelines of evidence-based medicine and practice patterns more focused on patient-centered care. As medicine becomes increasingly focused on pay-for-performance, these types of behaviors that lead to improved outcomes should be rewarded, which may in turn help narrow the pay gap between the sexes. Pay and gender equity will lead to better professional fulfillment, incentivize women to maintain or advance their medical careers, and help provide better health outcomes for the patient—a goal to which we all aspire.
Coverage of this study in Medscape generated over 130 lively, wide-ranging comments that are worth reading.
Pay gap persists
A related editorial in the same issue of JAMA Internal Medicine as the study noted previous research showing that female physicians in academia were less likely than their male counterparts to have reached the rank of full professor (11.9% vs. 28.6%), obtain adequate start-up funding for research projects that help launch faculty careers (67.5% more money for men than women), and be paid equal salaries for the same academic job (8% less for women=nearly $20,000/year difference).
Myriad rationalizations for these disparities have been proposed, the editorial noted: things like the burden of home responsibilities, child-bearing and rearing duties, or part-time schedules affecting female doctors’ quality of work. However, these arguments have been largely disproved by other studies, including the study this article focuses on.
Another interesting observation worth noting; the female doctors in the study were more likely to be DOs: 8.4% of the women doctors in the study were DOs while only 7% of the male physicians were DOs. One has to wonder if future studies will find that DOs’ hands-on holistic approach is also associated with better patient outcomes.
At the least, further investigation is certainly warranted.