Women are better doctors than men?

[BJJVP]

Women more likely to survive heart attacks if treated by another woman: Study

Am I crazy or is this article just complete nonsense? Women have atypical symptoms? How about everyone has atypical symptoms? Men are less likely to follow guidelines and don't communicate as well? This isn't a sexist statement? I also love how they quote 2 people from business schools for a medical article. I guess they have a point. I always wondered why I don't order ASA for female pts with ST elevation. According to these business doctorates, as a male physician, I just wasn't able to tease out the subtleties of the STEMI/troponin elevation and couldn't bring myself to follow AHA guidelines because the pt was a female. This article explains it all.

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[miacomet]

I don't think anybody, including the authors, is saying this is definitive. Pretty hard to study IMHO, but even weirder that someone would get bent out of shape about it.

 

[gro2001]

Women more likely to survive heart attacks if treated by another woman: Study

Am I crazy or is this article just complete nonsense? Women have atypical symptoms? How about everyone has atypical symptoms? Men are less likely to follow guidelines and don't communicate as well? This isn't a sexist statement? I also love how they quote 2 people from business schools for a medical article. I guess they have a point. I always wondered why I don't order ASA for female pts with ST elevation. According to these business doctorates, as a male physician, I just wasn't able to tease out the subtleties of the STEMI/troponin elevation and couldn't bring myself to follow AHA guidelines because the pt was a female. This article explains it all.

I don't think it's so far fetched in principle. I've seen lots of people's symptoms minimized, under-appreciated, or blown off based on the inherent biases of the physician. I've probably done it myself. It's not in principle surprising that on average male physicians may under rate the risk of symptoms reported by female patients, resulting in different diagnostic or treatment approaches. Or maybe women on average tend to report their symptoms differently when speaking to a male vs female physician. Or a bunch of other possible mechanisms.

If I had to speculate wildly, I think the difference would largely be accounted for the variability of treating NSTEMIs. There is a range of possible treatment options for someone with atypical symptoms, non-diagnostic ECG, and a troponin elevation from:

1) Immediately start heparin drip, aspirin, clopidogrel, beta blocker, statin, call cardiologist, place on the cardiology floor.

vs

2) Give aspirin, repeat troponin in a couple of hours, and delay further treatment till then because it really doesn't seem like an NSTEMI.

If male physicians seeing female patients tend to err on the side of option 2 slightly more often than option 1, it could lead to such an outcome.

 

[sylvanthus]

I understand the annoyance, it is totally fine today to bash men, if the same stuff was reversed, wed have women up in arms over it screaming sexism. But its not sexist if men are the target, and its not racist if white men are the target. Yay for reverse discrimination.

 

[BJJVP]

I don't think anybody, including the authors, is saying this is definitive. Pretty hard to study IMHO, but even weirder that someone would get bent out of shape about it.

How about if I have a couple of professors from the school of business publish some studies stating that white patients have a higher mortality when being treated by minority doctors? What if the article were to simply assume that the discrepancy is because minority doctors have a difficult time communicating with white patients? Suppose the article makes it to CBS, ABC and CNN news sites. As long as I state that this is not definitive, I should be surprised that someone would get bent out of shape by it?

My job is hard enough as it is without irresponsible articles in popular news outlets reporting this garbage. Every single medical student & resident rotating through the ER has it pounded into their heads that women and diabetics may have atypical symptoms. It is almost detrimental because they think that old men without DM must have classical symptoms in ACS. To suggest that male physicians are so biased, that despite this fact being pounded into their brains, they delay care & deviate from guidelines or just blow off subtleties of the presentation to the point of leading to significant mortality increases is playing with fire. The physician-patient interaction is very complex but this article wants to simplify things into a male-female gender issue. My decision to admit a patient and the treatments I prescribe are based on many things (general appearance, overall health, likelihood of actual disease, risk of harm due to empiric treatment, how helpful the work-up will be to the outpt physician, probability of alternative dx, the stakes of missing the dx, etc). To put it out there in a national news article that, "Female physicians may follow clinical guidelines more often," or that "Male physicians may be less 'deliberate' in addressing complicated patients’ problems" is offensive. I already have mothers bringing in their kids worried about dry drowning 2 days after their child fell into the pool & panicked older pts who think I need to lower their blood pressure of 170/99 instantly so they don't have a stroke tonight. Now, female pts who've read these articles wonder if they truly had gastroenteritis or if they will die in their sleep tonight because their subconsciously biased male doctor missed their MI.

Maybe I just need a vacation.

 

[BJJVP]

I don't think it's so far fetched in principle. I've seen lots of people's symptoms minimized, under-appreciated, or blown off based on the inherent biases of the physician. I've probably done it myself. It's not in principle surprising that on average male physicians may under rate the risk of symptoms reported by female patients, resulting in different diagnostic or treatment approaches. Or maybe women on average tend to report their symptoms differently when speaking to a male vs female physician. Or a bunch of other possible mechanisms.

If I had to speculate wildly, I think the difference would largely be accounted for the variability of treating NSTEMIs. There is a range of possible treatment options for someone with atypical symptoms, non-diagnostic ECG, and a troponin elevation from:

1) Immediately start heparin drip, aspirin, clopidogrel, beta blocker, statin, call cardiologist, place on the cardiology floor.

vs

2) Give aspirin, repeat troponin in a couple of hours, and delay further treatment till then because it really doesn't seem like an NSTEMI.

If male physicians seeing female patients tend to err on the side of option 2 slightly more often than option 1, it could lead to such an outcome.

I agree that treatment option #2 MAY lead to worse outcomes. I might choose option #2 for a pt with atypical complaints, but I would do so whether or not the pt were male or female. Also, I don't think male physicians are more likely to choose option #2 than female physicians. At least not to the degree which is implied in the article.

 

[Groove]

“Research” fueled by the gender inequality feminism crowd in this “Battle Royale of the sexes” era. Let’s face it...having an outcome of “men provide superior care” was never really an option of this study, or any study these days for that matter.

I find studies like this to be anything but helpful and are divisive and pointless.

I can’t believe people fund this kind of stuff.

 

[s109442]

How about if I have a couple of professors from the school of business publish some studies stating that white patients have a higher mortality when being treated by minority doctors? What if the article were to simply assume that the discrepancy is because minority doctors have a difficult time communicating with white patients? Suppose the article makes it to CBS, ABC and CNN news sites. As long as I state that this is not definitive, I should be surprised that someone would get bent out of shape by it?

My job is hard enough as it is without irresponsible articles in popular news outlets reporting this garbage. Every single medical student & resident rotating through the ER has it pounded into their heads that women and diabetics may have atypical symptoms. It is almost detrimental because they think that old men without DM must have classical symptoms in ACS. To suggest that male physicians are so biased, that despite this fact being pounded into their brains, they delay care & deviate from guidelines or just blow off subtleties of the presentation to the point of leading to significant mortality increases is playing with fire. The physician-patient interaction is very complex but this article wants to simplify things into a male-female gender issue. My decision to admit a patient and the treatments I prescribe are based on many things (general appearance, overall health, likelihood of actual disease, risk of harm due to empiric treatment, how helpful the work-up will be to the outpt physician, probability of alternative dx, the stakes of missing the dx, etc). To put it out there in a national news article that, "Female physicians may follow clinical guidelines more often," or that "Male physicians may be less 'deliberate' in addressing complicated patients’ problems" is offensive. I already have mothers bringing in their kids worried about dry drowning 2 days after their child fell into the pool & panicked older pts who think I need to lower their blood pressure of 170/99 instantly so they don't have a stroke tonight. Now, female pts who've read these articles wonder if they truly had gastroenteritis or if they will die in their sleep tonight because their subconsciously biased male doctor missed their MI.

Maybe I just need a vacation.

Great post your making a lot of sense and your frustrations are valid, but yeah plan an amazing vacation, do it brother

 

[OneTwoThreeFour]

How about if I have a couple of professors from the school of business publish some studies stating that white patients have a higher mortality when being treated by minority doctors? What if the article were to simply assume that the discrepancy is because minority doctors have a difficult time communicating with white patients? Suppose the article makes it to CBS, ABC and CNN news sites. As long as I state that this is not definitive, I should be surprised that someone would get bent out of shape by it?

My job is hard enough as it is without irresponsible articles in popular news outlets reporting this garbage. Every single medical student & resident rotating through the ER has it pounded into their heads that women and diabetics may have atypical symptoms. It is almost detrimental because they think that old men without DM must have classical symptoms in ACS. To suggest that male physicians are so biased, that despite this fact being pounded into their brains, they delay care & deviate from guidelines or just blow off subtleties of the presentation to the point of leading to significant mortality increases is playing with fire. The physician-patient interaction is very complex but this article wants to simplify things into a male-female gender issue. My decision to admit a patient and the treatments I prescribe are based on many things (general appearance, overall health, likelihood of actual disease, risk of harm due to empiric treatment, how helpful the work-up will be to the outpt physician, probability of alternative dx, the stakes of missing the dx, etc). To put it out there in a national news article that, "Female physicians may follow clinical guidelines more often," or that "Male physicians may be less 'deliberate' in addressing complicated patients’ problems" is offensive. I already have mothers bringing in their kids worried about dry drowning 2 days after their child fell into the pool & panicked older pts who think I need to lower their blood pressure of 170/99 instantly so they don't have a stroke tonight. Now, female pts who've read these articles wonder if they truly had gastroenteritis or if they will die in their sleep tonight because their subconsciously biased male doctor missed their MI.

Maybe I just need a vacation.

Do you mean this?
Research: Having a Black Doctor Led Black Men to Receive More-Effective Care

 

[Arcan57]

I don't think it's so far fetched in principle. I've seen lots of people's symptoms minimized, under-appreciated, or blown off based on the inherent biases of the physician. I've probably done it myself. It's not in principle surprising that on average male physicians may under rate the risk of symptoms reported by female patients, resulting in different diagnostic or treatment approaches. Or maybe women on average tend to report their symptoms differently when speaking to a male vs female physician. Or a bunch of other possible mechanisms.

If I had to speculate wildly, I think the difference would largely be accounted for the variability of treating NSTEMIs. There is a range of possible treatment options for someone with atypical symptoms, non-diagnostic ECG, and a troponin elevation from:

1) Immediately start heparin drip, aspirin, clopidogrel, beta blocker, statin, call cardiologist, place on the cardiology floor.

vs

2) Give aspirin, repeat troponin in a couple of hours, and delay further treatment till then because it really doesn't seem like an NSTEMI.

If male physicians seeing female patients tend to err on the side of option 2 slightly more often than option 1, it could lead to such an outcome.

This was also a longitudinal study over a decade. Considering the mortality numbers quotes are no where near today’s rates, it’s quite possible that your chance of having a positive outcome and your chance of being treated by a female physician are being influenced by the same variable, the year the patient presented.

This would also seem to explain the “more female colleagues equals better care” also. I wouldn’t mind seeing data on contemporary care stratified by sex of treating physician. If the difference is real and of the magnitude reported, that’s a huge deal. I think the majority of it is going to be confounding though.

 

[Psai]

This nonsense is almost as bad as those crap midlevels are just as good as doctors studies