Medicare beneficiaries who are admitted to the hospital are less likely to die and less likely to be readmitted if they are treated by female physicians, according to a study published Monday in JAMA Internal Medicine.
For the study, researchers from Harvard University analyzed CMS data on more than 1.5 million hospital visits. Specifically, researchers tracked whether patients were seen by a male or female doctor, 30-day readmission rates, and 30-day mortality rates. The study controlled for factors such as severity of illness and physician characteristics. It also controlled for hospital fixed effects, which meant it "effectively compar[ed] female and male physicians within the same hospital," the authors wrote.
The study found that patients who saw a female physician had a 0.43 percent lower risk-adjusted 30-day mortality rate and a 0.55 percent lower risk-adjusted readmission rate.
Ashish Jha, one of the co-authors on the study and director of the Harvard University Global Health Institute, said the seemingly small decreases in mortality could have a big effect on a large patient population. "If male physicians achieved the same outcomes as female physicians do, we would save about 32,000 lives a year—and that's just in the Medicare population," he explained. "That's about how many people die from motor vehicle accidents."
Understanding the findings
The authors said the take-home message was not that female doctors are better—but that stakeholders should learn what female physicians are doing differently that may increase care quality. For instance, Jha noted that previous research has shown female physicians are better at following care guidelines and using patient-centered communication. "I think it's those practice differences that probably explain the results we have," Jha said. "If I'm right on that, it's good news for those of us who are male doctors, because those are things we can learn."
Elizabeth Drye of the Yale-New Haven Hospital Center for Outcomes Research and Evaluation, who wasn't involved in the study, agreed that it was important to understand what was driving quality differences. "If there is something systemic here that we can learn from, we want to study why and make sure all health care providers are using those practices," she said.
Harlan Krumholz, also of the Yale-New Haven Center, said that for now, patients shouldn't alter their physician preferences based on the study findings. "The results may lead to bragging rights," he said. "But until more research can validate the findings and help us understand why it might occur, people should not be making decisions based on it" (Evans, Wall Street Journal, 12/19; Hamblin, The Atlantic, 12/19; Marcus, CBS News, 12/19; Belluz, Vox, 12/19; Jha, "An Ounce of Evidence," Harvard University, 12/19).
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