Women and men are more likely to survive when treated by female doctors compared to male doctors, but the difference in heart attack survival is greater for women.
Seth Carnahan, PhD
A new study suggests that hospitals have a good reason to hire more female physicians for their emergency department staff. Women experiencing heart attacks are more likely to survive when treated by a female doctor than a male doctor.
The results show that both men and women have better outcomes for acute myocardial infarction (AMI) when treated by a female physician, but that the biggest difference between male and female physicians is in outcomes for women.
Patients treated by female physicians had a 0.2% difference in survival rates between genders: 12% of women died from their heart attack compared to 11.8% of men. That gender disparity grew to 0.7% for patients in the care of male doctors: 13.3% of women died compared to 12.6% of men.
"Our work corroborates prior research showing that female doctors tend to produce better patient outcomes than male doctors," study author Seth Carnahan, PhD, Olin Business School, Washington University in St. Louis, St. Louis, MO, said in a statement. "The novel part of what we are doing is showing that the benefit of having a female doctor is particularly stark for a female patient."
Carnahan, along with study authors Brad N. Greenwood, PhD, MBA, Carlson School of Management, University of Minnesota—Twin Cities, Minneapolis, MN, and Laura Huang, PhD, MBA, Harvard Business School, Harvard University, Boston, MA, used data from patients admitted to Florida hospitals for acute myocardial infarction from 1991 to 2010. The researchers examined the data from 581,845 AMI cases to produce a baseline mortality rate of 11.9% for all patients.
“We also found that male physicians are more effective at treating female AMI patients when they work with more female colleagues and when they have treated more female patients in the past,” wrote Greenwood, Carnahan, and Huang.
The study found that women treated in hospitals with 5% more female physicians in the emergency department (e.g. 10% vs 15%) were 0.4% more likely to survive their heart attack. Compared to the baseline mortality rate of 11.9%, that denotes an increase of nearly 3.5%.
These findings represent a “fundamental catch-22 for medical providers and female patients,” wrote the authors. “Although mortality rates for female patients treated by male physicians decrease as the male physician treats more female patients, this decrease may come at the expense of earlier female patients.”
However, the authors point to the ways this knowledge could be used to improve outcomes for all patients with acute myocardial infarction.
“Having training programs that are more gender neutral, or showing how men and women might present symptoms differently, could improve outcomes for female patients," Carnahan said.
The authors added that there is potential for residents, nurses, and other physicians to assist the supervising physician in treating a patient with acute myocardial infarction. The current study did not analyze the influence of these healthcare providers on outcomes for patients with AMI, but the authors point to this as an opportunity for future research.
The study, “Patient—physician gender concordance and increased mortality among female heart attack patients,” was published on August 6, 2018 in the Proceedings of the National Academy of Sciences (PNAS).