Who is the better doctor? A man or a woman? Reporting that women are more effective in any male-dominated industry is bound to create a stir. An important conversation sparked from The Atlantic’s headline, “Women Physicians May Be Better Than Male Physicians.” The widely publicized research, initially from a JAMA article, found that patients who receive care from female internists have lower 30-day mortality and readmission rates than do patients cared for by male internists. The authors of the JAMA article were the first to admit that more research is needed to understand the clinical implications for patient outcomes due to differences in how male and female physicians practice medicine.
I can tell you what women physicians have told me about their experiences with whom is the better doctor. A group table of ten women physicians in a round table discussion shared their frustrations in trying to assess a patient’s needs during a 15-minute visit. These doctors think that women with complex medical issues, such as fibromyalgia, select women physicians because of beliefs that the female doctors will listen. Then the women physicians described struggling with meeting their maximum time quotas. Although the doctors were taught that the medical history is the heart of medicine, getting a thorough medical history takes time.
Sifting through this discussion, I found the following elements to be essential in moving towards rewarding value of care over number of services provided:
- Equity and fairness in career advancement and pay for all physicians is key to professional fulfillment. Part of the sting for women about the gender research is the $20,000 pay gap between male and female doctors after controlling for other factors.
- Communication matters between patient and physician and between the physician and their team. We need to better select and train medical students and residents to exhibit quality communication.
- What matters the most is not which gender provides the best care, but which practices in medicine improve patient satisfaction and outcomes.
For optimizing the delivery of excellent medicine, we don’t have time to struggle over whom is the best doctor. My hope is that physicians, medical administrators, and the public see the value in continued research on what contributes to good clinical outcome.