Male or Female Doctor

What’s your preference. Male or a Female doctor?

Previous studies have highlighted that male doctors tend to underestimate the pain levels of their female patients, as well as their gastrointestinal and cardiovascular symptoms, and stroke risk, potentially resulting in delayed or inadequate treatment. Another critique, male doctors often brush off complaints as normal and not diving deeper into cause and solutions. The questions remain.  Which doctor is right, which doctor is wrong, which doctor is over treating, and which ones are doctoring for dollars.

In this week’s email:

Study finds women do better with a female doctor. So, do some men.

A recent study, among the older demographic, treatment by female physicians led to significantly improved outcomes for a representative group of Medicare patients, with notable reductions in mortality and readmission rates.

Interestingly, the advantages of treatment by female physicians were more pronounced for female patients compared to male patients. While previous research had indicated enhanced communication, rapport, and agreement in medical advice specifically for female patients treated by female physicians, such findings were inconclusive for male patients.

In this latest study, published in the Annals of Internal Medicine, the mortality rate for female patients treated by female physicians was 8.15%, compared to 8.38% when treated by male physicians. The disparity was particularly evident among female patients with more severe conditions. Though the difference in mortality rates for male patients was smaller, female physicians still exhibited an edge, with a mortality rate of 10.15% compared to male physicians' rate of 10.23%.

Regarding hospital readmissions, both male and female patients experienced lower adjusted readmission rates when treated by female physicians. For female patients, the readmission rate was 15.51% when treated by a female physician, versus 16.01% when treated by a male physician—a difference deemed clinically significant. However, for male patients, there was no statistically significant difference in readmission rates based on the gender of their physician.

The study also pointed to potential reasons for the improved outcomes observed in female patients treated by female physicians, including the tendency of male physicians to underestimate the severity of their female patients’ illnesses. Past research has highlighted this tendency, noting that male doctors may undervalue their female patients’ pain levels, gastrointestinal and cardiovascular symptoms, and stroke risk, which could result in delayed or insufficient care.

Additionally, female physicians may engage in more effective communication with their female patients, leading to better information exchange, diagnosis, and treatment. Female patients may also feel more comfortable undergoing sensitive examinations and engaging in detailed discussions with female physicians.

Yusuke Tsugawa, M.D., Ph.D., associate professor-in-residence of medicine in the division of general internal medicine and health services research at the David Geffen School of Medicine at the University of California, Los Angeles, and the study’s senior author, emphasized the significance of these findings. He suggested that further research into the underlying mechanisms linking physician gender with patient outcomes could contribute to enhancing healthcare quality universally.

In advocating for more female physicians to address the gender disparities in healthcare, Tsugawa also emphasized the importance of eliminating gender gaps in physician pay.

Bernie Sanders: Free Public College would Boost Minority Healthcare WorkForce

Senator Bernie Sanders (I-Vt.) proposed on Thursday that eliminating all student debt and establishing tuition-free public colleges and universities could be instrumental in addressing the shortage of Black, Latino, and Native American healthcare professionals in the United States.

During a Senate committee hearing addressing the scarcity of minority healthcare workers and the nation's high maternal mortality rate, Sanders stressed the importance of canceling student debt and providing free education at public institutions, including medical schools, to ensure accessibility for all individuals, regardless of their background.

Although efforts have been made to increase the representation of minority healthcare workers, the numbers of Black, Latino, and Native American providers remain disproportionately low. Data from the Association of American Medical Colleges shows that the majority of doctors and nurses in the U.S. are white, followed by Asian Americans. Only 5.7% of doctors in the U.S. are Black, despite Black Americans comprising approximately 14% of the population. Similarly, the percentages of Latino and Native American doctors are low, as are the percentages of registered nurses from these ethnic backgrounds.

The financial burden of college and medical school tuition serves as a significant barrier for many Black, Latino, and Native American individuals pursuing careers in healthcare. Testifying at the hearing, nurse practitioner Jaines Andrades recounted her personal struggle to afford higher education, highlighting the lack of financial resources available to students from disadvantaged backgrounds.

Sanders also advocated for the expansion of resources like the National Health Service Corps and the increase in the size of Historically Black Colleges and Universities (HBCUs), which produce a significant portion of the country's Black physicians.

The unequal racial and ethnic composition of the healthcare workforce, particularly among physicians, negatively impacts Americans of color. Research indicates that patients experience better health outcomes when treated by healthcare providers who share their racial and ethnic background. Yoland Lawson, an OB-GYN and president of the National Medical Association, emphasized the importance of having Black physicians and providers who understand the unique challenges influencing Black patients' health outcomes.

Financial constraints, limited access to medical school, and discrimination within academic and healthcare settings present obstacles to the recruitment, retention, and advancement of Black medical students, residents, and practitioners. Samuel David Cook, a third-year internal medicine resident at The Morehouse School of Medicine, provided a poignant example during the hearing of how Black physicians can better serve Black patients by understanding cultural nuances and preventing potential misdiagnoses or mistreatment.