Hospital patients treated by female physicians have better outcomes

Patients cared for by female physicians in hospital were less likely to die or be readmitted compared with those treated by male physicians, according to a new ICES study, led by a University of Toronto researcher. This suggests that female physician sex may be associated with better short- and long-term outcomes among medical patients hospitalized with common medical diagnoses. 

"Past research has largely focused on surgical patients and the admitting physician only. Our findings add to the growing body of research examining the relationship between physician sex and patient outcomes, broadening the evidence beyond surgical care to a wider range of medical conditions and other physicians," says Dr. Angela Jerath, an ICES scientist, and Associate Professor, Department of Anesthesiology & Pain Medicine at the University of Toronto's Temerty Faculty of Medicine. 

The study analyzed ICES data on 958,150 adults hospitalized for one of seven common medical diagnoses, such as acute myocardial infarction and pneumonia, between January 1, 2008, and December 31, 2022. 

Of the patients, 259,759 were treated by female physicians and 698,391 by male physicians. As care may transfer between multiple physicians during a hospital stay, the researchers examined whether patient outcomes varied according to the sex of the most responsible physician and the extent to which patients received care from female physicians during their hospital stay. 

Patients cared for by female physicians had a lower 30-day mortality compared to those cared for by male physicians (12.3 per cent vs. 13.7 per cent), as well as a slightly lower hospital readmission rate (18.6 per cent vs. 18.9 per cent). Greater exposure to care from female physicians during hospitalization was also associated with seven per cent lower odds of dying within 30 days. Similar patterns were observed at 90 days and one year. 

A possible explanation for this difference is that female physicians may engage in more patient-centred communication and spend more time with patients. Furthermore, female physicians may be more likely to order guideline-directed treatments, consult colleagues, and share decision-making. 

"The goal is not to favour one group of physicians over another but to identify practices and behaviours that may help improve care across the health system," says Jerath. "An important strength of this study is that, unlike surgical care, patients admitted to hospital for medical conditions are generally assigned physicians based on rotating schedules rather than patient or referring physician preferences, helping to minimize referral bias." 

The researchers recommend further research to determine whether clinical care differs by physician sex and whether these findings can be extended to other settings locally and in other countries. 

The study "Physician sex and outcomes among hospitalized patients" is in the October issue of JAMA Network Open.