My oldest daughter tells a story that she remembers when she was younger. Her sisters and brother were playing with their cousins at my parents' house over summer vacation - the boys all wanted to play "army." They had built a fort in the basement, complete with an army field hospital! The "field hospital" was a small tent, complete with one of my old toy doctor's kit mixed with some of my old medical instruments. My oldest nephew (who happens to be the oldest cousin) told my daughter and her sisters to go into the tent, "You can't be soldiers. You are the nurses." My daughter responded that she wanted to be the doctor!
I am old enough to remember that male nurses were once exceedingly uncommon. Thankfully, that has changed. While I still think that female nurses outnumber male nurses, my impression is that the gap is closing. I am also old enough to remember when female physicians were not very common either. Thankfully, that has changed. In fact, nearly half of all medical students starting medical school this year will be female. In my own field of pediatrics, there are more female pediatricians graduating from residency training programs than there are male pediatricians. Even in the traditionally male-dominated field of surgery, there are more females becoming surgeons (even though males still outnumber females). It is a trend that is long overdue.
Why is this important? Well for one, I think that medical profession should reflect the greater society as a whole. Patients generally want to be treated by physicians who are like them. More interesting to me are the studies showing that female physicians spend more time listening to their patients, ask more questions about their patients' overall well-being (focusing on healing the mind, body, AND spirit), and encourage more shared decisionmaking. Female physicians are also more likely to follow clinical guidelines and order preventive tests compared to their male counterparts. All of this is very interesting. However, just last week, a large retrospective study of over 1.5 million Medicare beneficiaries over age 65 years admitted to the hospital over a three year period from 2011-2014, showed that patients treated by female physicians had a significantly lower 30-day mortality rate compared to those treated by male physicians. These differences persisted even after controlling for 8 specific medical conditions and adjusting for severity of illness. While this is a retrospective study, it is the first study of its kind to show that some of the differences in care between female and male physicians discussed above appear to matter!
There are probably two major lessons here. First, we should NEVER discount the ability of our female colleagues to practice excellent medicine. Female physicians are not only good doctors, they may even be better doctors than males! Second, we should try to learn what things that female physicians are doing to provide better care - and then model that behavior! I think many physicians entered the profession of medicine to take care of patients. Most physicians would like to spend more time with their patients. The data discussed here potentially suggests that we, as health care administrators, should figure out how to foster these behaviors and how to provide ample time for physicians to actually listen to their patients.
I mentioned this study to my daughter just the other night. It turns out that she had already heard of the study. I think she was going to call her cousin and let him know about it as well!
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